Volume 10, Issue 4 (8-2012)                   IJRM 2012, 10(4): 373-376 | Back to browse issues page

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Mosaddegh M H, Ghasemi N, Jahaninejad T, Mohsenifar F, Aflatoonian A. Treatment of recurrent pregnancy loss by Levothyroxine in women with high Anti-TPO antibody. IJRM 2012; 10 (4) :373-376
URL: http://ijrm.ir/article-1-292-en.html
Treatment of recurrent pregnancy loss by Levothyroxine in women with high Anti-TPO antibody
Mohammad Hosein Mosaddegh1 , Nasrin Ghasemi * 2, Tahere Jahaninejad3 , Fatemeh Mohsenifar4 , Abbas Aflatoonian5
1- Department of Pharmacology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2- Department of Medical Genetics, Research and Clinical Centre for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , n479g@yahoo.co.uk
3- Shahid Sadoughi University of Medical Sciences, Yazd, Iran
4- Yazd Azad University, Yazd, Iran
5- Department of Obstetrics and Gynecology, Research and Clinical Centre for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abstract:   (5087 Views)
  
Background: Recurrent pregnancy loss (RPL) is defined as two or more consecutive pregnancy losses before twenty weeks of gestation. It is caused by a variety of genetics and non-genetics factors. Thyroid autoimmunity could associate with pregnancy loss.
Objective: To investigate the effectiveness of Levothyroxine in treatment of RPL in women with high auto-thyroid antibodies.
Materials and Methods: In this observational cross sectional study, 900 women who had a history of recurrent pregnancy loss were studied. All women with high anti-TPO antibody without any other problems entered in this study. Levothyroxine was given to them two months before pregnancy till the end of pregnancy. The doses of levothyroxine were depended on the anti-TPO levels, which were decided by endocrinologist. Women followed for the results of pregnancies.
Results: The success rate of pregnancy in women with abnormal anti-TPO with Levothyroxine therapy was 82.85%. Mean of anti-TPO in women with treatment before taking medication was 488.35 and after that it was 123.35 UI/ml. This difference was significant (p<0.05). The mean of the antibodies was not significantly different in women without treatment.
Conclusion: This study showed that Levothyroxine reduces the incidence of spontaneous abortions in women with high Anti-TPO antibody.  It decreased anti-TPO antibody levels after 2-3 months treatment.
Keywords: Recurrent pregnancy loss, Levothyroxine, Anti-TPO antibody
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Type of Study: Original Article |
References
1. Toth B, Jeschke U, Rogenhofer N, Scholz C, Würfel W, Thaler CJ, et al. Recurrent miscarriage: current concepts in diagnosis and treatment. J Reprod Immunol 2010; 85: 25-32. [DOI:10.1016/j.jri.2009.12.006]
2. Carrington B, Sacks G, Regan L. Recurrent miscarriage: pathophysiology and outcome. Curr Opin Obstet Gynecol 2005; 17: 591-597. [DOI:10.1097/01.gco.0000194112.86051.26]
3. Monien S, Kadecki O, Baumgarten S, Salama A, Dörner T, Kiesewetter H. Use of heparin in women with early and late miscarriages with and without thrombophilia. Clin Appl Thromb Hemost 2009; 15: 636-644. [DOI:10.1177/1076029609335501]
4. Rai R, Regan L. Recurrent miscarriage. Lancet 2006; 368: 601-611. [DOI:10.1016/S0140-6736(06)69204-0]
5. Redline RW. Thrombophilia and placental pathology. Clin Obstet Gynecol 2006; 49: 885-894. [DOI:10.1097/01.grf.0000211957.68745.6b]
6. Firouzabadi RD, Ghasemi N, Rozbahani MA, Tabibnejad N. Association of p53 polymorphism with ICSI/IVF failure and recurrent pregnancy loss. Aust N Z J Obstet Gynaecol 2009; 49: 216-219. [DOI:10.1111/j.1479-828X.2009.00972.x]
7. Galofre JC, Davies TF. Autoimmune thyroid disease in pregnancy: a review. J Women's Health (Larchmt) 2009; 18: 1847-1856. [DOI:10.1089/jwh.2008.1234]
8. Poppe K, Glinoer D, Tournaye H, Devroey P, van Steirteghem A, Kaufman L, et al. Assisted reproduction and thyroid autoimmunity: an unfortunate combination? J Clin Endocrinol Metab 2003; 88: 4149-4152. [DOI:10.1210/jc.2003-030268]
9. Calvo RM, Jauniaux E, Gulbis B, Asunción M, Gervy C, Contempré B, et al. Fetal tissues are exposed to biologically relevant free thyroxine concentrations during early phases of development. J Clin Endocrinol Metab 2002; 87: 1768-1777. [DOI:10.1210/jcem.87.4.8434]
10. Stagnaro-Green A, Roman SH, Cobin RH, el-Hazary E, Alvarez-Marfany M, Davies TF. Detection of at-risk pregnancy by means of highly sensitive assays for thyroid autoantibodies. JAMA 1990; 264: 1422-1425. [DOI:10.1001/jama.1990.03450110068029]
11. Lejeune B, Grun JP, de Nayer P, Servais G, Glinoer D. Antithyroid antibodies underlying thyroid abnormalities and pregnancy lossor pregnancy induced hypertension. Br J Obstet Gynaecol 1993; 100: 669-672. [DOI:10.1111/j.1471-0528.1993.tb14236.x]
12. Menken J, Trussell J, Larsen U. Age and infertility. Science 1986; 233: 1389-1394. [DOI:10.1126/science.3755843]
13. Osmanagaoglu K, Tournaye H, Kolibianakis E, Camus M, van Steirteghem A, Devroey P. Cumulative delivery rates after ICSI in women aged >37 years. Hum Reprod 2002; 17: 940-944. [DOI:10.1093/humrep/17.4.940]
14. Rashid M, Rashid MH. Obstetric management of thyroid disease. Obstet Gynecol Surv 2007; 62: 680-688. [DOI:10.1097/01.ogx.0000281558.59184.b5]
15. Poppe K, Glinoer D. Thyroid autoimmunity and hypothyroidism before and during pregnancy. Hum Reprod Update 2003; 9: 149-161. [DOI:10.1093/humupd/dmg012]
16. Nilsson IM, Astedt B, Hender U, Bezerin D. Intrauterine death and circulating anticoagulant "antithromboplastin". Acta Med Scand 1975; 197: 153-159. [DOI:10.1111/j.0954-6820.1975.tb04897.x]
17. Cowchock S, Smith JB, Gocial B. Antibodies to phospholipids and nuclear antigens in patients with repeated abortions. Am J Obstet Gynecol 1986; 155: 1002-1010. [DOI:10.1016/0002-9378(86)90335-2]
18. Kaplan D. Fetal wastage in patients with rheumatoid arthritis. J Rheumatol 1986; 13: 875-877.
19. Challis JR, Lockwood CJ, Myatt L, Norman JE, Strauss JF 3rd, Petraglia F. Inflammation and pregnancy. Reprod Sci 2009; 16: 206-215. [DOI:10.1177/1933719108329095]
20. Lejeune B, Grun JP, de Nayer P, Servais G, Glinoer D. Anti-thyroid antibodies underlying thyroid abnormalities and miscarriage and pregnancy induced hypertension. Br J Obstet Gynecol 1993; 100: 669-672. [DOI:10.1111/j.1471-0528.1993.tb14236.x]
21. Negro R, Mangieri T, Coppola L, Presicce G, Casavola EC, Gismondi R, et al. Levothyroxine treatment in thyroid peroxidase antibody-positive women undergoing assisted reproduction technologies: a prospective study. Hum Reprod 2005; 20: 1529-1533. [DOI:10.1093/humrep/deh843]
22. Roussev RG, Kaider BD, Pride DE, Coulam CB. Laboratory evaluation of women experiencing reproductive failure. Am J Reprod Immunol 1996; 35: 415-420. [DOI:10.1111/j.1600-0897.1996.tb00503.x]
23. Poppe K, Glinoer D, Tournaye H, Devroey P, Schiettecatte J, Haentjens P, et al. Thyroid autoimmunity and female infertility. Verh K Acad Geneeskd Belg 2006; 68: 357-377.
24. Wang S, Teng WP, Li JX, Wang WW, Shan ZY. Effects of maternal subclinicalhypothyroidism on obstetrical outcomes during early pregnancy. J Endocrinol Invest 2012; 35: 322-325.
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