The Influence Of L-T4 On Patience With TBOAb Negative Subclinic Hypothyroidism Undergoing IVF/ICSI-ET

Objective: To explore the necessarity and treatment indication of replacement with L-T4 in SCH patients of TPOAb negative TSH < 10mlU/ml during the IVF/ICSI-ET cycles.Methods: 1.Choose the TPOAb negative patients with fresh embryo transfer had or doing IVF/ICSI-ET operation for conception-aiding in our hospital.The patients divided into two groups based on TSH: A group: 2.5 < TSH ? 5mlU/L.B group: 5 < TSH < 10mlU/L.Then arranged them into groups with L-T4 and without L-T4.: A1 group are given L-T412.5ug/day q.n,then increase to 25ug/day a week later.B1 group are given L-T4 25ug/day q.n initially,then 50ug/day a week later.Adjust the dose after reexamine TSH.A2 and B2 are groups without L-T4.Compare with group C of patients with TSH 0.27-2.49mlU/L.Test on ovulation indiction day,oocyte day TSH,lab and clinic indicator.Results: A2 outweights B2 with higher transferable embryos rate(p < 0.05).B2 fails to C in normal fertilization rate?transferable embryo rate and high-grade embryo rate(p < 0.05).B1 trumphs B2 in normal fertilization rate,transferable embryo rate(p < 0.05).B1 are lower than the control group in normal fertilization rate(p < 0.05);TSH goes straight up in C,A1 and A2.B2 goes to the top on the day before ovulation indiction day then goes down a little on oocyte day;B1 goes down with the help of L-T4,then reaches the same level of group C,but TSH goes up to the same level of B1 on oocyte day.2.According to the level of TSH in serum in the follicular fluid was re-grouped on getting the oocyte day.The criteria were as follows: group one-serum TSH(0.27 ~ 2.5 mIU / L);group two of serum TSH 5 < TSH ? 10 mIU / L;group three of serum TSH 5 < TSH ? 10 mIU / L.The levels of BMP-15,GDF-9,Cortisol,SHBG,E2 and PROG in follicular fluid were detected by ELISA.Conclusion: L-T4 has little influence on TPOAb negtive sub clinic Hypothyroidism patients with serum2.5 < TSH ? 5mlU/L during IVF/ICSI-ET cycles.Patients with serum TSH 5 < TSH ? 10 mIU / L who were given L-T4 gain improvement during IVF/ICSI-ET cycles.