@entity1955 dose adjustment in @entity1375 XXXX achieving pregnancy through IVF.

@entity1 @entity1375 @entity1955 @entity2016
OBJECTIVE: About one out of two @entity1 with @entity1375 has to increase the dosage of exogenous @entity1955 ( @entity2016 ) during pregnancy. Considering the detrimental impact of IVF on thyroid function, it has been claimed but not demonstrated that @entity2016 dose adjustment may be more significant in @entity1375 @entity1 who become pregnant after IVF. DESIGN: Retrospective cohort study. METHODS: Hypothyroid-treated @entity1 who achieved a live birth through IVF were reviewed. @entity1 could be included if thyroid function was well compensated with @entity2016 before the IVF cycle (i.e., serum TSH <2.5 mIU/l and serum free T4 within the normal range). Serum TSH and dose adjustment were evaluated at five time points during pregnancy. The trimester ranges for serum TSH considered as reference to adjust @entity2016 therapy were 0.1-2.5 mIU/l for the first trimester, 0.2-3.0 mIU/l for the second trimester, and 0.3-3.0 mIU/l for the third trimester. RESULTS: Thirty-eight @entity1 were selected. During the whole pregnancy 32 @entity1 (84%; 95% CI: 72-96%) required an increase in the dose of @entity2016 . In most cases (n=28), this occured within the first 5-7 weeks of gestation (74%, 95% CI: 58-85%). At 5-7 weeks of gestation, the median (interquartile range) increase of @entity2016 dose for the whole cohort was 26% (0-50%). At 30-32 weeks, it was 33% (14-68%). In order to identify predictive factors of dose adjustment, we compared @entity1 who did (n=28) and did not (n=10) adjust @entity2016 dosage at 5-7 weeks' gestation. Significant differences emerged for thyroid autoimmunity prevalence and for the distribution of @entity1375 aetiology. CONCLUSIONS: The vast majority of @entity1375 -treated @entity1 who achieve pregnancy through IVF need an increase in the @entity2016 dose during gestation. This requirement tends to occur very early during gestation.
