{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T23:03:04Z","timestamp":1762642984653,"version":"3.37.3"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T00:00:00Z","timestamp":1701734400000},"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":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Unexplained infertility affects nearly one\u2010third of infertile couples. Women with unexplained infertility are more likely to have a high\u2010normal thyroid\u2010stimulating hormone level\u00a0(TSH: 2.5\u20135\u2009mIU\/L) compared to women with severe male factor infertility. Practice guidelines vary on whether treatment should be initiated for TSH levels &gt;2.5\u2009mIU\/L in women attempting conception because the effects of treating a high\u2010normal TSH level with levothyroxine are not known. We evaluated conception and live birth rates in women with unexplained infertility and high\u2010normal TSH levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Patients and Measurements<\/jats:title><jats:p>Retrospective study including 96\u00a0women evaluated for unexplained infertility at a large academic medical centre between 1 January 2000 and 30 June\u00a02017 with high\u2010normal TSH (TSH: 2.5\u20135\u2009mIU\/L and within the normal range of the assay) who were prescribed (<jats:italic>n<\/jats:italic>\u2009=\u200931) or not prescribed (<jats:italic>n<\/jats:italic>\u2009=\u200965) levothyroxine. Conception and live birth rates were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The conception rate in the levothyroxine group was 100% compared to 90% in the untreated group (<jats:italic>p<\/jats:italic>\u2009=\u2009.086 unadjusted; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05 adjusted for age; <jats:italic>p<\/jats:italic>\u2009=\u2009.370 adjusted for TSH; <jats:italic>p<\/jats:italic>\u2009=\u2009.287 adjusted for age and TSH).\u00a0The live birth rate was lower in the levothyroxine group (63%) compared to the untreated group (84%) (<jats:italic>p<\/jats:italic>\u2009=\u2009.05 unadjusted; <jats:italic>p<\/jats:italic>\u2009=\u2009.094 adjusted for age; <jats:italic>p<\/jats:italic>\u2009=\u2009.035 adjusted for TSH; <jats:italic>p<\/jats:italic>\u2009=\u2009.057 adjusted for age and TSH).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women with unexplained infertility and high\u2010normal TSH levels treated with levothyroxine had a higher rate of conception but lower live birth rate compared to untreated women, with the limitation of a small sample size. These findings assert the need for prospective, randomized studies to determine whether treatment with levothyroxine in women with unexplained infertility and high\u2010normal TSH is beneficial.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.15003","type":"journal-article","created":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T10:35:51Z","timestamp":1701772551000},"page":"192-198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Levothyroxine for a high\u2010normal TSH in unexplained infertility"],"prefix":"10.1111","volume":"100","author":[{"given":"Francesca","family":"Galbiati","sequence":"first","affiliation":[{"name":"Division of Endocrinology Diabetes and Hypertension Brigham and Women's Hospital Boston Massachusetts USA"},{"name":"Harvard Medical School Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tahereh Orouji","family":"Jokar","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars M.","family":"Howell","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Runjia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Pittsburgh School of Public Health Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay T.","family":"Fourman","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston Massachusetts USA"},{"name":"Metabolism Unit Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hang","family":"Lee","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston Massachusetts USA"},{"name":"Biostatistics Center Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong\u2010Hyeon","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Pittsburgh School of Public Health Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1731-2927","authenticated-orcid":false,"given":"Pouneh K.","family":"Fazeli","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit Massachusetts General Hospital Boston Massachusetts USA"},{"name":"Neuroendocrinology Unit, Division of Endocrinology and Metabolism University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,5]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Key Statistics from the National Survey of Family Growth 2015\u20132019.https:\/\/www.cdc.gov\/nchs\/nsfg\/key_statistics\/i-keystat.htm#infertility"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.11.037"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12958-015-0032-1"},{"key":"e_1_2_8_5_1","unstructured":"The Business Research Company.Fertility Treatments Global Market Report 2021. 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