SynthesisReproductive biology and endocrinology : RB&E2018
Effect of levothyroxine supplementation on pregnancy outcomes in women with subclinical hypothyroidism and thyroid autoimmuneity undergoing in vitro fertilization/intracytoplasmic sperm injection: an updated meta-analysis of randomized controlled trials.
Synthesis in Reproductive biology and endocrinology : RB&E, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 4 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Pooled it
- Thyroid dysfunction in Iranian pregnant women: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2020Pooled it
- Effect of antithyroid antibodies on women with recurrent miscarriage: A meta-analysis.American journal of reproductive immunology (New York, N.Y. : 1989) · 2020Pooled it
- Thyroxine replacement for subfertile women with euthyroid autoimmune thyroid disease or subclinical hypothyroidism.The Cochrane database of systematic reviews · 2019Pooled it
- Hashimoto's Thyroiditis and Female Fertility: Endocrine, Immune, and Microbiota Perspectives in Assisted Reproduction-A Narrative Review.Biomedicines · 2025Review
- Exploring the Immunological Aspects and Treatments of Recurrent Pregnancy Loss and Recurrent Implantation Failure.International journal of molecular sciences · 2025Review
- Homocysteine and thyroid diseases.Frontiers in endocrinology · 2025Review
- Risks of suboptimal and excessive thyroid hormone replacement across ages.Journal of endocrinological investigation · 2024Review
- Consequences of undertreatment of hypothyroidism.Endocrine · 2024Review
- Impaired embryo development potential associated with thyroid autoimmunity in euthyroid infertile women with diminished ovarian reserve.Frontiers in endocrinology · 2024Article
- TSH levels after fresh embryo transfer are associated with reproductive outcomes in euthyroid women undergoing the first IVF/ICSI cycles.Scientific reports · 2023Article
- Pregnancy outcomes and newborn characteristics in women with follicular fluid thyroid autoantibodies undergoing assisted reproduction.Journal of medical biochemistry · 2023Article
- Thyroid Autoimmunity in Female Infertility and Assisted Reproductive Technology Outcome.Frontiers in endocrinology · 2022Review
- Laboratory characteristics analysis of the efficacy of levothyroxine on subclinical hypothyroidism during pregnancy: a single-center retrospective study.Bioengineered · 2021Article
- Review
- Reproductive Outcomes in Cases of Subclinical Hypothyroidism and Thyroid Autoimmunity: A Narrative Review.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2020Review
- A hidden cause of infertility in hypothyroid patients.Clinical case reports · 2020Article
- Thyroid disorders in subfertility and early pregnancy.Therapeutic advances in endocrinology and metabolism · 2020Review
- The exploration of Hashimoto's Thyroiditis related miscarriage for better treatment modalities.International journal of medical sciences · 2020Review
- Serum and follicular fluid thyroid hormone levels and assisted reproductive technology outcomes.Reproductive biology and endocrinology : RB&E · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundEvidence suggests that subclinical hypothyroidism (SCH) and thyroid autoimmunity (TAI) are associated with adverse pregnancy outcomes. This systematic review and meta-analysis was conducted to determine whether levothyroxine (LT4) supplementation would improve pregnancy outcomes among infertile women with SCH and/or TAI who underwent in vitro fertilization (IVF) or intracytoplastic sperm injection (ICSI).
methodsWe searched databases of PubMed, EMBASE, Web of Science, Cochrane Controlled Trials Register databases, and Clinicaltrials.gov up to April 2018 to identify eligible studies. Studies that focused on the treatment effect of LT4 on pregnancy outcomes of women with SCH and/or TAI who underwent IVF/ICSI were included in the data synthesis. We only included randomized controlled trials (RCTs). Relative risks (RR) and 95% confidence intervals (CI) were calculated using a random-effects model to assess the results of pregnancy outcomes, including clinical pregnancy rate, miscarriage rate, live birth rate and preterm birth rate.
resultsFour published RCTs including 787 infertile couples undergoing IVF/ICSI were included in this meta-analysis. Notably, the study observed no significant associations of LT4 treatment with the clinical pregnancy rate (RR = 1.46, 95% CI: 0.86-2.48), live birth rate (RR = 2.05, 95% CI: 0.96-4.36), or preterm birth rate (RR = 1.13, 95% CI: 0.65-1.96). However, patients receiving LT4 supplementation had a significantly decreased miscarriage rate relative to those receiving a placebo or no treatment (RR = 0.51, 95% CI: 0.32-0.82). A further sub-group analysis showed that LT4 supplementation did not improve the miscarriage rates among patients with SCH (RR = 0.67, 95% CI: 0.39-1.15) or TAI (RR = 0.28, 95% CI: 0.07-1.06).
conclusionsGiven its potential to reduce the miscarriage rate, LT4 supplementation is recommended for infertile women with SCH and/or TAI who are undergoing IVF/ICSI. However, additional population-based RCTs are needed to confirm this recommendation.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.