Preconceptional thyroid stimulating hormone levels and outcomes of intrauterine insemination among euthyroid infertile women

Among euthyroid patients undergoing IUI, TSH level was not associated with cycle parameters or clinical pregnancy rate. TSH level was inversely related to the odds of spontaneous abortion.

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Anatte E. Karmon, M.D., Maria Batsis, M.D., Jorge E. Chavarro, M.D., Sc.D., Irene Souter, M.D.

Volume 103, Issue 1, Pages 258-263



To evaluate differences in intrauterine insemination (IUI) outcomes among euthyroid women with preconceptional thyroid-stimulating hormone (TSH) values in the normal (0.4–2.4 mIU/L) and high-normal (2.5–4.9 mIU/L) ranges.


Cohort study.


A single fertility center.


A total of 1,477 women who underwent 4,064 IUI cycles between the years 2004 and 2012.



Main Outcome Measure(s):

Live birth, clinical pregnancy, spontaneous abortion (SAB), and IUI cycle parameters.


Cycles were categorized into 4 groups based on preconceptional TSH values: 0.40–1.36 mIU/L; 1.37–1.86 mIU/L; 1.87–2.49 mIU/L; and 2.50–4.99 mIU/L. No statistically significant differences were found in IUI cycle parameters, clinical pregnancy rates, or live births per initiated cycle among the 4 TSH groups. However, preconceptional TSH was inversely related to SAB and positively related to live birth among women who achieved a clinical pregnancy. In this group of women, cycles with TSH values between 2.5 and 4.9 mIU/L were related to lower odds of SAB (odds ratio: 0.32; 95% confidence interval: 0.16–0.65) and higher odds of live birth (odds ratio: 2.80; 95% confidence interval: 1.43–5.48) compared with cycles among women in the lowest TSH group.


Among euthyroid patients, preconceptional TSH values in the high-normal range (between 2.5 and 4.9 mIU/L) are not associated with adverse IUI outcomes.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.