Routine use of levothyroxine for patients undergoing IVF with any form of abnormal Thyroid function test is very common. An increased risk of adverse pregnancy outcomes, including early pregnancy loss, has been reported in euthyroid women with elevated thyroid peroxidase (TPO) antibody concentrations. Thyroid hormone replacement in such women who are undergoing assisted reproductive technologies (ART) does not appear to reduce the risk of early pregnancy loss.
In a trial evaluating levothyroxine or no treatment in 600 euthyroid Chinese women with TPO antibodies who were undergoing in vitro fertilization with embryo transfer, there was no difference in the miscarriage or live birth rates. For euthyroid pregnant women with TPO antibodies who are not undergoing ART, thyroid hormone treatment to prevent the development of hypothyroidism during pregnancy and reduce the risk of early…
