scholarly journals Maternal thyroid function in multifetal pregnancies before and after fetal reduction

2000 ◽  
Vol 164 (1) ◽  
pp. 7-11 ◽  
Author(s):  
O Ogueh ◽  
AP Hawkins ◽  
A Abbas ◽  
GD Carter ◽  
KH Nicolaides ◽  
...  

The aim of the study was to investigate maternal thyroid function in pregnancy by monitoring the circulating concentrations of thyroid stimulating hormone (TSH), free thyroxine (fT(4)) and human chorionic gonadotrophin (hCG) in multifetal pregnancies before and after embryo reduction. We studied two groups of women: group 1 comprised singleton (n=12) and twin (n=12) pregnancies achieved after superovulation and in vitro fertilisation and embryo transfer (IVF-ET), and group 2 were multifetal pregnancies (n=39) undergoing selective fetal reduction to twin pregnancies. Blood samples were obtained initially at 10-12 weeks gestation (before fetal reduction) and then 4 and 8 weeks afterwards. Before fetal reduction, the circulating concentrations of fT(4) in multifetal pregnancies were significantly greater than those in singleton or twin pregnancies (singleton, mean 16.49 pmol/l (interquartile range 14.09-18.13 pmol/l); twins, 15.84 (15.36-16.95 pmol/l); multifetal, 21.08 (16. 64-26.29 pmol/l); P<0.005 for singleton and twins), and in a multiple regression analysis, fT(4) was significantly related to the number of fetuses (F=23.739, P=0.0001), but not to hCG. After fetal reduction to twins, the circulating concentrations of fT(4) in multifetal pregnancies decreased progressively towards those in control twin pregnancies, but remained significantly greater at both 4 (P=0.003) and 8 weeks (P=0.050). This pattern of change in the concentrations of fT(4) is similar to, but lags behind, that of hCG, which attains twin levels 4 weeks after fetal reduction. This may represent a delayed thyroid response to the decreasing concentrations of hCG, but the alternative is that the maternal thyroid function is controlled by a fetal factor in addition to hCG.

2015 ◽  
Vol 6 (4) ◽  
pp. 97-104
Author(s):  
Arina Yurevna Malenova ◽  
Irina Gennadevna Kytkova

Research objective - studying of features of the relation to pregnancy, the child, motherhood of women in IVF situation. Selection: 100 married pregnant women aged from 28 till 42 years (the first pregnancy of the first trimester, complications in the anamnesis isn't present) representing two groups on 50 people: 1) after artificial insemination (empirical group); 2) in a situation natural pregnancy (control group). The leading motives of pregnancy, types of the attitude towards themselves, pregnancies, to the child, people around, the prevailing installations in the sphere of the family relations, features of representation of future mothers about themselves and "the ideal parent" are defined by testing. Distinctions in all respects with women from control group are found. It is established that in vitro fertilisation the high level of readiness for motherhood according to its motivational characteristics is observed. Prevalence of constructive motives of pregnancy against concern in the health and aspirations to meet social expectations is revealed. The leading types of a gestational dominant are optimum and euphoric, the hypertrophied positive emotional background of pregnancy is observed. In the future of a bike probability the dependent relations with the child, preference of the sponsoring or authoritative style of family education. Revaluation of own parental qualities when comparing with image of ideal mother is observed. Results allow to carry women to the group of risk demanding psychological maintenance before and after the childbirth.


2005 ◽  
Vol 17 (2) ◽  
pp. 276 ◽  
Author(s):  
J. Pryor ◽  
S. Romo ◽  
D.D. Varner ◽  
K. Hinrichs ◽  
C.R. Looney

In commercial bovine in vitro fertilization (IVF) companies, there is a continuous need to improve results. Efforts to maximize in vitro embryo production have included modifications in the use of sperm separation gradients. The development of commercially available sperm centrifugation gradients represents a new possibility of increasing the number of viable sperm that can be obtained from low concentration (fresh or frozen, sexed or unsexed) semen samples in order to improve the efficiency of the IVF system to make embryo production as efficient as possible. The objective of this study was to compare two different separation gradients, as follows: Group 1: Percoll (Sigma, St. Louis, MO, USA), in 45% and 90% gradients; Group 2: EquiPure (Nidacon, Gathenburg, Sweden), in top and bottom layers. Before and after separation, sperm were evaluated at 200× magnification for total motility, and then stained to assess viability at 400× with fast-green/eosin stain (Sigma). Sperm separation was performed using frozen/thawed semen from one bull. Semen was separated by centrifugation at 200g for 30 min in both density gradients. Results obtained from Groups 1 and 2 were compared by chi-square test. Sperm separation with Percoll yielded lower numbers of sperm (average sperm concentration after separation of 92 × 106, vs. 159 × 106 sperm/mL for EquiPure; P < 0.05) but resulted in higher motility (60% vs. 39%, respectively; P < 0.05) of separated sperm. Rates of live sperm cells were not significantly different between groups (69.5% vs. 70%, respectively; P > 0.1). These results indicate that the commercial separation medium EquiPure may be associated with higher sperm concentration levels but with lowered sperm motility when compared to Percoll for bovine sperm separation. However, Equipure provided similar percentages of live sperm when compared to Percoll, which is currently used in our laboratory.


2018 ◽  
Vol 99 (3) ◽  
pp. 496-503
Author(s):  
O S Zolotykh ◽  
S V Lomteva ◽  
K Yu Sagamonova

Aim. To study the proteomic profile of follicular fluid in patients with infertility in assisted reproductive technology programs. Methods. The study included women with infertility included in assisted reproductive technology programs: 15 women who had in vitro fertilisation which resulted in pregnancy (group 1) and 16 women with a negative result of this program (group 2). Fractionation of the follicular fluid samples was performed using the sets of special magnetic beads. Proteomic profiling was performed by tandem MALDI-mass-spectrometry. The anti-Müllerian hormone level was measured by ELISA. Results. The study revealed differences in the detectability of follicular fluid proteins with different regulatory properties in patients of groups 1 and 2. With the negative outcome of in vitro fertilisation, expression of a number of proteins involved in the processes of folliculogenesis, ovulation, selection of the dominant follicle, as well as proteins necessary for the development of the zygote and blastula was reduced in females' follicular fluid. Increased expression in women from group 2 was registered for proteins enhancing proteolytic reactions, cell apoptosis, including oocytes, which disrupt the positive action of activin and damage structural and functional state of mitochondria. A definite relationship was found between the level of anti-Müllerian hormone and rate of detection of a number of proteins, in particular protocadherin-2α, cystatin C, betaglycan, prostatic acid phosphatase, and dermicidin. Conclusion. The revealed changes in proteomic profile of the follicular fluid obviously play an important role in the molecular mechanisms that determine the effectiveness of assisted reproductive technologies; the identified differentially expressed proteins can serve as objective markers for predicting the outcomes of in vitro fertilisation.


Author(s):  
Vasim Ismail Patel ◽  
Akshay B. K.

<p class="abstract"><strong>Background:</strong> The thyroid is an<strong> </strong>endocrine gland. It secretes two hormones thyroxine (T<sub>4</sub>), triiodothyronine (T<sub>3</sub>). Hypothyroidism is a common condition encountered by a clinician. Subclinical hypothyroidism (SCH) defined as normal free thyroxine (T4) and elevated thyroid stimulating hormone (TSH), is primarily a biochemical diagnosis with or without clinical symptoms. Studies have observed that TSH levels vary at different times in a day. In practice not much importance is given to the timing of the sample collection (pre-prandial or post-prandial sate). SCH is diagnosed depending on TSH value. So the condition may be under or over diagnosed based on a single value. So we conducted this study to determine whether timing of sample collection had any significant relationship in the determination of levels of thyroid hormones.</p><p class="abstract"><strong>Methods:</strong> The study was carried on 114 patients who visited ENT department, NMCH between July 2018 and June 2019. Group-1 consisted of 38 normal patients. Group-2 consisted of 36 hypothyroidism patients GROUP-3 consisted of 40 subclinical hypothyroidism patients. Thyroid function tests (TSH and free T4) were done in fasting state and 2 hours postprandially.  </p><p class="abstract"><strong>Results:</strong> TSH values were found to be significantly lowered after food in all the three groups. Free T4 values did not show any statistically significant alteration after food.</p><p class="abstract"><strong>Conclusions:</strong> There was a significant decline in TSH values postprandially. This might lead to inappropriate diagnosis and management of patients as cases of hypothyroidism, especially in cases of sub clinical hypothyroidism.</p>


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Albu ◽  
D Albu

Abstract Study question Is there a relationship between thyroid autoimmunity and serum level of anti-müllerian hormon (AMH) in infertile women with normal ovarian reserve undergoing in vitro fertilisation (IVF)? Summary answer In infertile women with normal ovarian reserve serum AMH level above 5ng/ml is associated with higher level of thyroid hormones and less frequent thyroid autoimmunity What is known already Previous studies suggest that thyroid autoimmunity is associated with a decreased ovarian reserve. Moreover, it was reported that thyroid hormone administration could improve serum AMH level. However, the relationship between serum AMH level and thyroid autoimmunity and function in infertile women with normal ovarian reserve undergoing IVF is largely unknown. Since in IVF the serum AMH level is an important marker which dictate the management of the couple, the identification of all the factors possibly related to this parameter is very important. Study design, size, duration: We performed a retrospective study in the Department of Reproductive Medicine of a private hospital. The medical records of all consecutive patients who underwent IVF between January 2015 and December 2018 with all causes of infertility were reviewed. Study group included 581patients with a mean age of 34.4±4.1 years, mean AMH of 3.78±2.4 ng/mL, mean serum TSH level of 1.89±1 microUI/ml and mean serum free T4 level of 1.05±0.98 ng/dl. Participants/materials, setting, methods Patients with known thyroid disorders or under thyroid hormone treatment at the moment of evaluation were excluded. Only patients with serum level of thyroid stimulating hormone (TSH), free tyroxine (free T4), anti thyroid peroxidase antibodies (ATPO,) anti thyroglobulin antibodies (ATG), AMH and age available for analysis were included in the study. This parameters are evaluated on a systematic basis in all the patients undergoing IVF in our Department, except very few cases. Main results and the role of chance Patients were divided according to their serum AMH level in two groups: group 1 with AMH level 5 ng/ml and below (n = 450 patients) and group 2 with AMH above 5 ng/ml (n = 131 patients). When the two groups were compared we found that patients in group 2 were younger in comparison with patients in group 1 (32.9±3.8 versus 35±4 years, p &lt; 0.0001). After adjustment for age, patients in group 2 had significantly higher serum free T4 level (1.07±0.12 versus 1.04±0.14 ng/dl, p = 0.015), lower ATG (17.59±41.8 UI/ml versus 39.4±136.16 UI/ml, p &lt; 0.018) and presented less frequently with high ATPO antibodies (35% versus 41.8%, p = 0.047). In a logistic regression model with AMH as a dependent variable, free T4, but not TSH was independently and positively associated with higher AMH levels (above 5 ng/ml) (p = 0.025) after adjustment for anti thyroid antibodies levels. Morever, in this logistic model the presence of high ATPO, but not ATG, were negatively related to higher AMH level (p = 0.037). Limitations, reasons for caution Patients included in this study are infertile patients with indication for IVF treatment. Therefore, the results of this study should be used with caution in other populations Wider implications of the findings: Our study suggest that serum AMH level might be related to thyroid autoimmunity, but also to thyroid hormones levels. If confirmed by further studies, this findings could offer a way to improve serum AMH level and to better understand the markers of ovarian reserve in an IVF setting. Trial registration number NA


2018 ◽  
Vol 16 (3) ◽  
pp. 472-475
Author(s):  
Gideon Koren ◽  
Yona Amitai ◽  
Meital Shlezinger ◽  
Rachel Katz ◽  
Varda Shalev

Abstract In Israel, about 55% of drinking water is derived from desalination (DSW) which removes all iodine. A recent study from Israel demonstrated high rates of iodine deficiency among school-aged children and pregnant women. There are concerns that low iodine may lead to impaired thyroid function. However, to date, the impact of consuming DSW on body iodine status has not been studied. The objective was to assess whether the increased use of DSW is associated with increased rates of hypothyroidism. Using data from a large health fund in Israel, we compared proportions of patients with higher than normal thyroid stimulating hormone (TSH), and lower than normal T3 and T4 levels before and after a massive desalination project became operational in August 2013 in areas with high vs. low use of DSW. Over 400,000 cases were compared in 2010–2013 vs. 2014–2016. Overall, there was no increase in the proportion of individuals with higher than normal TSH levels, or lower than normal T3 and T4 levels. In conclusion, in this population-based study, following the introduction of DSW, there was no evidence of increased incidence of low thyroid function tests, and the trends were similar in both areas highly consuming, or not consuming, DSW.


2020 ◽  
Author(s):  
Shiri Shinar ◽  
Swati Agrawal ◽  
Darine El‐Chaâr ◽  
Nimrah Abbasi ◽  
Robert Beecroft ◽  
...  

Author(s):  
Frank A. Quinn ◽  
Gennady N. Gridasov ◽  
Sergey A. Vdovenko ◽  
Natalia A. Krasnova ◽  
Nadezhda V. Vodopianova ◽  
...  

AbstractUndiagnosed thyroid disease is a common problem with significant public health implications. This is especially true during pregnancy, when the health of both the mother and the developing child can be adversely affected by abnormal maternal thyroid function. Measurement of serum thyroid stimulating hormone (TSH) and thyroid peroxidase antibodies (TPO-Ab) are two common ways to assess maternal thyroid status. The objective of our study was to determine the prevalence of abnormal TSH and TPO-Ab tests in a population of pregnant women in the Samara region of the Russian Federation. Serum samples were obtained from 1588 pregnant women as part of their routine antenatal care. TSH and TPO-Ab were measured, and trimester-specific reference values for TSH (2.5–97.5 percentiles) were calculated using TPO-Ab-negative women. TSH results outside these ranges were considered abnormal; TPO-Ab levels outside the manufacturer's reference range (>12IU/mL) were considered abnormal. Overall, the prevalence of abnormal results was 6.3% for TSH and 10.7% for TPO-Ab. High TSH (>97.5 trimester-specific percentile) and TPO-Ab-positive results were most common in the first trimester (5.7% and 13.8%, respectively). TSH levels were associated with gestational age and TPO-Ab status, and with maternal age in TPO-Ab-negative women. TPO-Ab status was associated with both maternal and gestational age. Women with TSH >2.5mIU/L had a significantly increased risk of being TPO-Ab-positive, and this risk increased with age. Based on our data, we conclude that abnormal TSH and TPO-Ab are common in pregnant women of the Samara region. Given the association of thyroid dysfunction to adverse pregnancy outcomes, screening of this population for abnormal thyroid function should be considered.


2006 ◽  
Vol 24 (1) ◽  
pp. 23-28 ◽  
Author(s):  
David Johnson

Over a period of three years, acupuncture was offered to patients entering assisted reproduction therapy. Acupuncture sessions were given at varying, but usually weekly, intervals during the in vitro fertilisation (IVF) cycle, and immediately before and after embryo transfer. Twenty two patients (average age 36.2 years) were treated over a total of 26 IVF cycles and 15 pregnancies were achieved, as determined by presence of foetal heartbeat on ultrasound at four weeks post embryo transfer. This was a success rate of 57.7% compared with 45.3% for patients in the IVF unit not treated with acupuncture (P>0.05). Relaxing effects were noted following acupuncture and it is speculated that this may have contributed to the increase in pregnancy rate for the acupuncture group.


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