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

Line Riis Jølving,1,2 Michael Due Larsen,1,2 Jens Fedder,3,4 Sonia Friedman,1,2,5,6 Bente Mertz Nørgård1,2,5,61Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark; 2Research Unit of Clinical Epidemiology, Department of Clinical Research, Univ...

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Main Authors: Jølving LR, Larsen MD, Fedder J, Friedman S, Nørgård BM
Format: Article
Language:English
Published: Dove Medical Press 2019-08-01
Series:Clinical Epidemiology
Subjects:
Online Access:https://www.dovepress.com/the-chance-of-a-live-birth-after-assisted-reproduction-in-women-with-t-peer-reviewed-article-CLEP
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author Jølving LR
Larsen MD
Fedder J
Friedman S
Nørgård BM
author_facet Jølving LR
Larsen MD
Fedder J
Friedman S
Nørgård BM
author_sort Jølving LR
collection DOAJ
description Line Riis Jølving,1,2 Michael Due Larsen,1,2 Jens Fedder,3,4 Sonia Friedman,1,2,5,6 Bente Mertz Nørgård1,2,5,61Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark; 2Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; 3Centre of Andrology and Fertility Clinic, Department D, Odense University Hospital, Odense, Denmark; 4Research Unit of Human Reproduction, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; 5Crohn’s and Colitis Center, Brigham and Women’s Hospital, Boston, MA, USA; 6Division of Gastroenterology, Hepatology and Endoscopy Research, Harvard Medical School, Boston, MA, USAPurpose: 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.Patients and methods: 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.Results: 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]).Conclusion: 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.Keywords: assisted reproductive technology, in vitro fertilization, hyperthyroidism, hypothyroidism, clinical epidemiology
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spelling doaj.art-8feca9a762bb445ebda3bb7485c19c702022-12-22T01:54:51ZengDove Medical PressClinical Epidemiology1179-13492019-08-01Volume 1168369447746The chance of a live birth after assisted reproduction in women with thyroid disordersJølving LRLarsen MDFedder JFriedman SNørgård BMLine Riis Jølving,1,2 Michael Due Larsen,1,2 Jens Fedder,3,4 Sonia Friedman,1,2,5,6 Bente Mertz Nørgård1,2,5,61Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark; 2Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; 3Centre of Andrology and Fertility Clinic, Department D, Odense University Hospital, Odense, Denmark; 4Research Unit of Human Reproduction, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; 5Crohn’s and Colitis Center, Brigham and Women’s Hospital, Boston, MA, USA; 6Division of Gastroenterology, Hepatology and Endoscopy Research, Harvard Medical School, Boston, MA, USAPurpose: 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.Patients and methods: 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.Results: 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]).Conclusion: 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.Keywords: assisted reproductive technology, in vitro fertilization, hyperthyroidism, hypothyroidism, clinical epidemiologyhttps://www.dovepress.com/the-chance-of-a-live-birth-after-assisted-reproduction-in-women-with-t-peer-reviewed-article-CLEPAssisted reproductive technologyin vitro fertilizationhyperthyroidismhypothyroidismclinical epidemiology
spellingShingle Jølving LR
Larsen MD
Fedder J
Friedman S
Nørgård BM
The chance of a live birth after assisted reproduction in women with thyroid disorders
Clinical Epidemiology
Assisted reproductive technology
in vitro fertilization
hyperthyroidism
hypothyroidism
clinical epidemiology
title The chance of a live birth after assisted reproduction in women with thyroid disorders
title_full The chance of a live birth after assisted reproduction in women with thyroid disorders
title_fullStr The chance of a live birth after assisted reproduction in women with thyroid disorders
title_full_unstemmed The chance of a live birth after assisted reproduction in women with thyroid disorders
title_short The chance of a live birth after assisted reproduction in women with thyroid disorders
title_sort chance of a live birth after assisted reproduction in women with thyroid disorders
topic Assisted reproductive technology
in vitro fertilization
hyperthyroidism
hypothyroidism
clinical epidemiology
url https://www.dovepress.com/the-chance-of-a-live-birth-after-assisted-reproduction-in-women-with-t-peer-reviewed-article-CLEP
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