The chance of a live birth after assisted reproduction in women with thyroid disorders.

assisted reproductive technology clinical epidemiology hyperthyroidism hypothyroidism in vitro fertilization

Journal

Clinical epidemiology
ISSN: 1179-1349
Titre abrégé: Clin Epidemiol
Pays: New Zealand
ID NLM: 101531700

Informations de publication

Date de publication:
2019
Historique:
received: 03 04 2019
accepted: 31 05 2019
entrez: 10 9 2019
pubmed: 10 9 2019
medline: 10 9 2019
Statut: epublish

Résumé

Women with thyroid disorders may have increased infertility and poor reproductive outcomes, but it is unclear if assisted reproductive technology (ART) is effective in this population. The aim of this study was to examine the chance of a pregnancy (biochemical and clinical), and a live birth after ART, in women with thyroid disorders undergoing ART treatment, compared to women without thyroid disorders. Among live-born children, we assessed the risk of congenital malformations. In a nationwide cohort study of all women undergoing ART treatments in Denmark from 1 January 1994 throughout June 2017, we calculated the chance of a pregnancy and a live birth after embryo transfer. Women with thyroid disorders were stratified into two groups: those diagnosed with hypothyroid or hyperthyroid disorders. The adjusted OR (aOR) of a biochemical and a clinical pregnancy, a live born child and a congenital malformation was computed using multilevel logistic regression models. In total, 199,674 embryo transfers were included in 2,101 women with thyroid disorders and in 65,526 women without thyroid disorders. The chance of a biochemical pregnancy was significantly reduced in women with hyperthyroidism (aOR=0.80, 95% CI 0.69-0.93), and the aOR of a live birth was 0.86, 95% CI 0.76-0.98. The aOR for a live birth in women with hypothyroidism was 1.03 (95% CI 0.94-1.12). Children of women with hypothyroidism, who were conceived after ART treatment, had a significantly increased risk of any congenital malformation (aOR=1.46 [95% CI 1.07-2.00]). Women with hyperthyroidism receiving ART treatment had a decreased chance of a live birth per embryo transfer compared to women without thyroid disorders. Women with hypothyroidism did not have a decreased chance of a live birth but their offspring had an increased risk of congenital malformation.

Identifiants

pubmed: 31496823
doi: 10.2147/CLEP.S208574
pii: 208574
pmc: PMC6693421
doi:

Types de publication

Journal Article

Langues

eng

Pagination

683-694

Déclaration de conflit d'intérêts

The authors report no conflicts of interest in this work.

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Auteurs

Line Riis Jølving (LR)

Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.
Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

Michael Due Larsen (MD)

Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.
Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

Jens Fedder (J)

Centre of Andrology and Fertility Clinic, Department D, Odense University Hospital, Odense, Denmark.
Research Unit of Human Reproduction, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

Sonia Friedman (S)

Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.
Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Crohn's and Colitis Center, Brigham and Women's Hospital, Boston, MA, USA.
Division of Gastroenterology, Hepatology and Endoscopy Research, Harvard Medical School, Boston, MA, USA.

Bente Mertz Nørgård (BM)

Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.
Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Crohn's and Colitis Center, Brigham and Women's Hospital, Boston, MA, USA.
Division of Gastroenterology, Hepatology and Endoscopy Research, Harvard Medical School, Boston, MA, USA.

Classifications MeSH