Johannes Wogatzky 1 *, Birgit Schechinger 1 , Dietmar Spitzer 2 and Nicolas Herbert Zech 1
*Johannes Wogatzky, IVF Centers Prof Zech-Bregenz, Roemerstrasse 2, 6900 Bregenz
1.Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, et al. (2002) Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 87: 489-499.
2. Duntas LH (2011) Environmental factors and thyroid autoimmunity. Ann Endocrinol (Paris) 72: 108-113.
Wogatzky et al., Journal of Food & Nutritional Disorders 2013, 2:4
Published: October 15, 2013
In Assisted Reproduction Techniques (ART), autoimmune disorders of the thyroid gland present as common concomitant diseases. Hypothyroidism caused by autoimmune thyroiditis can impair fertility and pregnancy. Hashimoto thyroiditis (HT) is the most common autoimmune thyroid disease (AITD). Patients with HT undergoing IVF/ICSI using the long protocol are thought to benefit from a broad therapeutic concept. We compared the outcome of two different therapeutic schemes for HT patients presenting at our fertility clinic and compared the outcome to ART patients without thyroiditis. TSH level was adjusted to under 2 µIU/mL using L-thyroxine, as required. Concurrent medication from the time of oocyte puncture included daily administration of fragmin (dalteparin) and acetylsalicylic acid (ASA), as well as prednisolone in increasing dosage. One group of these HT patients (group1, n=56) had additionally highly-dosed folic acid, another group (group 2, n=50, referred to as the supplemented group) was alternatively supplemented with a micronutrient preparation containing selenium, high-dose folic acid, B-vitamins, antioxidants and iron. We compared the number of oocytes, fertilization rate, blastocyst formation rate, pregnancy- and ongoing pregnancy rate between the two groups. Also, the ART outcomes of both groups were compared to ART results of non-HT patients within the same age group. We observed a significant increase in the blastocyst rate and demonstrated a substantial rise in ongoing pregnancy rate of the supplemented patients. These also needed less L-thyroxine to achieve optimal TSH level. The outcome of the micronutrient supplemented patients corresponded to the average of healthy IVF patients without HT at our clinic.