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Year : 2011  |  Volume : 8  |  Issue : 3  |  Page : 3-6

Improvement in fertility outcome follows initiation of thyroxine for women with subclinical hypothyroidism

Department of Endocrinology, St. John's Medical College, Bangalore-560034, Karnataka, India

Correspondence Address:
G Bantwal
Department of Endocrinology, St. John's Medical College, Bangalore-560034, Karnataka
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Source of Support: None, Conflict of Interest: None

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Background: Hypothyroidism is the most common endocrinological problem affecting women who present with ovulatory dysfunction thereby leading to infertility. It's milder form, subclinical hypothyroidism (characterized by supranormal TSH levels and normal freeT4 levels), may also contribute to disturbed reproductive function. Since it is known, based on historical data, that thyroid hormones have a beneficial effect on pregnancy outcomes, we proposed that institution of thyroxine replacement therapy in infertile women with SCHT leads to favorable fertility outcomes. Methods: In a cohort of 14 infertile women with SCHT, we conducted and assessed: l)an in depth thyroid hormonal profile prior to LT4 therapy, 2)institution of LT4 replacement therapy in women with SCHT and 3) monitoring response to therapy by assessing pregnancy rate and adjusting the dosage based on TSH levels. Results: Following institution of thyroxine replacement therapy, the average time period to conception was 5 months. A conception rate of 78.5% was achieved, among whom 27.2% had a full term delivery and the rest are being followed up. Three 1st trimester miscarriages (21.5%) occurred. Conclusions: Based on the presented protocol, a higher fertility rate was observed which was associated with normal TSH levels regularized with LT4 therapy. Abortions were accounted for by inadequate LT4 and prior discontinuation of LT4 therapy

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