{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T20:06:46Z","timestamp":1768680406598,"version":"3.49.0"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T00:00:00Z","timestamp":1660694400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Reproductive outcomes in euthyroid women with high\u2010normal thyroid\u2010stimulating hormone (TSH) levels are comparable to those in euthyroid women with low TSH levels; however, few studies have investigated whether strictly controlled TSH levels after levothyroxine (LT4) treatment impair reproductive outcomes in infertile women with subclinical hypothyroidism (SCH). This study aimed to investigate the impact of high\u2010normal versus low\u2010normal TSH levels on reproductive outcomes in women undergoing their first in vitro fertilisation and embryo transfer (IVF\u2010ET) cycle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This was a retrospective cohort study. Patients were divided into low\u2010normal (TSH\u2009&lt;\u20092.5\u2009mIU\/L, and \u22650.27\u2009mIU\/L) and high\u2010normal (TSH\u2009\u2265\u20092.5\u2009mIU\/L, and &lt;4.2\u2009mIU\/L) groups based on TSH levels after LT4 treatment. TSH levels after LT4 treatment and before ovarian stimulation were recorded. Reproductive outcomes were compared between the low\u2010normal and high\u2010normal TSH groups and between the euthyroid and LT4\u2010treated groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 6002 women, 548 of whom were LT4\u2010treated women, were finally included in this study. Among the LT4\u2010treated women, 129 women had low\u2010normal TSH levels, and 167 women had high\u2010normal TSH levels. The clinical pregnancy rate, miscarriage rate, and live birth rate were comparable between the low\u2010normal and high\u2010normal groups (all <jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05). When adjusted by age, anti\u2010Mullerian hormone (AMH) levels, infertility duration, transferred embryos, and dose and duration of LT4 treatment, high\u2010normal TSH levels neither significantly decreased miscarriage (adjusted odds ratio [aOR]\u2009=\u20092.27, 95% confidence interval [CI]\u2009=\u20090.77\u20136.69, <jats:italic>p<\/jats:italic>\u2009=\u2009.14) nor increased clinical pregnancy (aOR\u2009=\u20091.15, 95% CI\u2009=\u20090.70\u20131.89, <jats:italic>p<\/jats:italic>\u2009=\u2009.57 or live birth (aOR\u2009=\u20090.97, 95% CI\u2009=\u20090.60\u20131.59, <jats:italic>p<\/jats:italic>\u2009=\u2009.92). Similar obstetric outcomes were observed between the low\u2010normal and high\u2010normal TSH groups after LT4 treatment and between the euthyroid and LT4\u2010treated groups (all <jats:italic>p<\/jats:italic>\u2009\u2265\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High\u2010normal TSH levels did not have adverse effects on clinical and obstetric outcomes when compared with low\u2010normal TSH levels after LT4 treatment. However, whether it is appropriate to set 2.5\u2009mIU\/L as the goal of treatment before IVF\/ICSI remains to be determined in further well\u2010designed studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14802","type":"journal-article","created":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T02:08:37Z","timestamp":1659060517000},"page":"426-435","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of reproductive outcomes in subclinical hypothyroidism women with high\u2010normal versus low\u2010normal thyroid\u2010stimulating hormone levels after treatment with levothyroxine"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4348-0481","authenticated-orcid":false,"given":"Yuchao","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Reproductive Medicine the Third Affiliated Hospital of Zhengzhou University Zhengzhou Henan 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