Preconceptional thyroid-stimulating hormone affects antral follicle count rather than pregnancy outcomes in patients with first in vitro fertilization/intracytoplasmic sperm injection cycle

• Published in: Reproductive and developmental medicine Vol. 9; no. 2; pp. 92 - 99
• Main Authors: Cai, Jie, Li, Huan-Huan, Tian, Xiang-Ming, Yang, Li, Sun, Jun-Jian, Zhou, Wen-Hui
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.06.2025
• Subjects: Thyroid-stimulating hormone; fertilization; Infertility; Pregnancy outcome; Bilateral antral follicle count
• ISSN: 2096-2924; 2589-8728
• DOI: 10.1097/RD9.0000000000000105

Objective: To study the effects of preconceptional thyroid-stimulating hormone (TSH) levels on antral follicle count (AFC) and pregnancy outcomes in a first in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycle. Methods: A retrospective cohort study was conducted to explore the effects of preconceptional TSH levels on AFC and pregnancy outcomes in 1340 patients. The patients were divided into three groups: group 1, 0.55 ≤ TSH < 2.5 μIU/mL (n = 868); group 2, 2.5 ≤ TSH < 4.0 μIU/mL (n = 334); and group 3, TSH ≥ 4.0 μIU/mL (n = 138). Results: There were significant differences in AFC (P = 0.002), number of zygotes (P = 0.008), and fertilization rate (P = 0.015) among the three groups. Among the three groups, there were no obvious differences in live birth (P = 0.559), high-quality embryo (P = 0.108), or clinical pregnancy (P = 0.939) rates. Binary logistics regression analysis showed that TSH correlated with AFC when TSH was ≥4 μIU/mL (P = 0.033); however, TSH levels had no effect on live birth or clinical pregnancy rate. Conclusions: Although the preconceptional TSH level negatively related with AFC, number of zygotes, and fertility rate, especially when TSH was >4 μIU/mL, TSH was not an independent factor on the live birth rate among fertile women undergoing their first IVF/ICSI-embryo transfer treatment. The effect of TSH levels on couples undergoing assisted reproductive technology requires further investigation.