利沃甲素可能不能充分准备甲状腺功能低下的女性进行受控的卵巢过度刺激
Rachel A Bradbury1,2, Karen Byth3,4, Howard C Smith1,2
1Westmead Fertility Centre, Westmead Hospital, Sydney, New South Wales, Australia.
概括
在受控卵巢高刺激 (COH) 期间,接受levothyroxine替代疗法的低甲状腺症妇女在卵巢自由T3水平较低. 这与受精率的降低有关,这表明T3优化可能会改善结果.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 甲状腺生理学甲状腺生理学
背景情况:
- 甲状腺轴调节失调在接受受控卵巢高刺激 (COH) 的甲状腺功能低下妇女中更为明显.
- 尚不清楚这些患者的卵巢卵泡液中的甲状腺激素水平是否受到影响.
研究的目的:
- 为了调查卵巢卵泡甲状腺激素水平是否在COH期间被充分替换的甲状腺功能低下妇女中受到损害.
- 确定这些水平对周期和怀孕结果的影响.
主要方法:
- 一项前性队列研究比较了16名用levothyroxine替代的甲状腺功能低下妇女和46名经历首次COH周期的甲状腺功能良好妇女.
- 毛囊液和血清甲状腺激素 (TSH,自由T3,自由T4) 在不同时间点测量.
- 卵细胞检索,受精,怀孕流产和活产率在各组之间进行了比较.
主要成果:
- 与利沃甲状腺妇女相比,用levothyroxine替代的妇女的血清和卵泡液自由T3水平较低.
- 在甲状腺功能低下组中,受精率明显较低 (52%对71%).
- 没有观察到卵细胞产量,早期妊娠损失或活产率的显著差异.
结论:
- 适当替换的甲状腺功能低下妇女在COH期间表现出较低的卵泡液自由T3和降低的受精率.
- 优化自由T3水平可能对提高甲状腺功能低下患者的COH成功至关重要.
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