Association between Subclinical Hypothyroidism and Adverse Pregnancy Outcomes in Assisted Reproduction Technology...

Area of Science:

• Reproductive Endocrinology
• Maternal-Fetal Medicine
• Thyroidology

Background:

• Subclinical hypothyroidism (SCH) is linked to increased perinatal risks in pregnant women.
• The impact of SCH on outcomes in assisted reproduction technology (ART) singleton pregnancies requires further investigation.

Purpose of the Study:

• To evaluate the association between SCH and perinatal outcomes in ART singleton pregnancies.
• To assess the efficacy of levothyroxine therapy in mitigating risks associated with SCH.

Main Methods:

• Retrospective analysis of 650 ART singleton pregnancies (Jan 2020-July 2023).
• Defined SCH as TSH > 2.5 mU/L with normal free T4.
• Compared outcomes (preterm birth, preeclampsia, FGR) across normal thyroid function, untreated SCH, and treated SCH groups.

Main Results:

• Preterm birth rate before 34 weeks was significantly higher in untreated SCH (Group B) compared to normal thyroid function (Group A).
• Levothyroxine therapy (Group C) significantly reduced the preterm birth rate before 34 weeks compared to Group A.
• Higher TSH levels correlated with an increased rate of preterm delivery before 34 weeks.

Conclusions:

• SCH is associated with a significantly higher rate of preterm birth before 34 weeks in ART pregnancies.
• Levothyroxine therapy acts as a significant protective factor against early preterm birth in this population.
• Universal thyroid function screening and timely hormone therapy in ART pregnancies may reduce perinatal complications.