Use of levothyroxine for euthyroid, thyroid antibody positive women with infertility: Analyses of aggregate data from a survey of European thyroid specialists (Treatment of Hypothyroidism in Europe by Specialists: An International Survey).
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Negro Roberto, Žarković Miloš, Attanasio Roberto, Hegedüs Laszlo, Nagy Endre V, Papini Enrico, Akarsu Ersin, Alevizaki Maria, Ayvaz Göksun, Bednarczuk Tomasz, Beleslin Biljana Nedeljković, Berta Eszter, Bodor Miklos, Borissova Anna Maria, Boyanov Mihail, Buffet Camille, Burlacu Maria-Cristina, Ćirić Jamina, Cohen Chagit Adler, Díez Juan J, Dobnig Harald, Fadeyev Valentin, Field Benjamin C T, Fliers Eric, Führer Dagmar, Galofré Juan C, Hakala Tommi, Jan Jiskra, Kopp Peter, Krebs Michael, Kršek Michal, Kužma Martin, Leenhardt Laurence, Luchytskiy Vitaliy, Puga Francisca Marques, McGowan Anne, Melo Miguel, Metso Saara, Moran Carla, Morgunova Tatyana, Niculescu Dan Alexandru, Perić Božidar, Planck Tereza, Poiana Catalina, Robenshtok Eyal, Rosselet Patrick Olivier, Ruchala Marek, Riis Kamilla Ryom, Shepelkevich Alla, Tronko Mykola, Unuane David, Vardarli Irfan, Visser Edward, Vryonidou Andromachi, Younes Younes R, Perros Petros
Аннотация
DESIGN: The data presented derive from Treatment of Hypothyroidism in Europe by Specialists, an International Survey (THESIS), a questionnaire conducted between 2019 and 2021 to document the management of hypothyroidism by European thyroid specialists. Here, we report the aggregate results on the use of LT4 in infertile, euthyroid women with positive TPOAb.
RESULTS: A total of 2316/5406 (42.8%) respondents stated that LT4 may be indicated in TPOAb positive euthyroid women with infertility. The proportion of those replying positively to this question varied widely across different countries (median 39.4, range 22.9%-83.7%). In multivariate analyses males (OR: 0.8; CI: 0.7-0.9) and respondents >60 years (OR: 0.7; 0.6-0.8) were the least inclined to consider LT4 for this indication. Conversely, respondents managing many thyroid patients ("weekly" [OR: 1.4; CI: 1.0-1.9], "daily" [OR: 1.8; CI: 1.3-2.4]) and practicing in Eastern Europe (OR: 1.5; CI: 1.3-1.9) were most likely to consider LT4.
CONCLUSIONS: A remarkably high number of respondents surveyed between 2019 and 2021, would consider LT4 treatment in TPOAb positive euthyroid women with infertility. This view varied widely across countries and correlated with sex, age and workload, potentially influencing patient management. These results raise concerns about potential risks of overtreatment.