激素替代疗法对血清甲状腺激素的影响:回顾性分析
Pietro Molinaro1, Livia Pellegrini2, Giulia Mariani2
1IVIRMA Global Research Alliance, IVI Roma, Rome, Italy.; University of Valencia, Valencia, Spain.
Reproductive biomedicine online
|August 28, 2025
概括
在试管婴儿准备期间,激素替代疗法 (HRT) 会增加甲状腺刺激激素 (TSH) 水平. 高TSH (> 2.5 mU/ l) 与降低活产率有关,但不导致流产,因此需要进一步研究.
科学领域:
- 生殖内分泌学
- 甲状腺生理学
- 在体外受精
背景情况:
- 激素替代疗法 (HRT) 对于辅助生殖技术中的子宫内膜制备至关重要.
- 甲状腺功能,特别是血清甲状腺刺激激素 (TSH),在生殖结果中起作用.
- 在体外受精 (IVF) 周期中,HRT对TSH水平的影响需要澄清.
研究的目的:
- 调查HRT对单个胚胎移植 (SET) 的女性血清TSH水平的影响.
- 确定在HRT期间的TSH水平与妊娠结果之间的关联,包括流产和活产率.
主要方法:
- 对516名接受SET治疗的女性 (≤49岁) 进行回顾性队列研究.
- 在四个时间点测量了TSH水平:基线,子宫内膜评估,胚胎移植和怀孕测试.
- HRT涉及口服雌激醇和阴道孕激素;在TSH>2.5mU/ l时,使用了勒沃西.
主要成果:
- 与基线 (T0) 相比,HRT在子宫内膜评估 (T1) 和怀孕测试 (T3) 中显著增加了TSH水平.
- 当TSH在T3时低于2.5mU/ l时,单变量分析显示更高的流产率和更低的持续妊娠和活产率.
- 多变量分析显示TSH>2.5mU/ l与流产之间没有显著的关联,但与活产率有显著的负相关性 (aOR0. 54, p=0. 02).
结论:
- 在试管婴儿准备周期中,HRT显著提高了TSH度.
- 在HRT期间的TSH水平> 2.5mU/ l与较低的活产率有关,但不一定是流产.
- 需要进一步研究以充分阐明HRT,甲状腺功能和生殖成功之间的关系.
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