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)

Objectives The use of levothyroxine (LT4) treatment aiming to improve fertility in euthyroid women with positive thyroid peroxidase antibodies (TPOAb) is not supported by the available evidence. The aim of the study was to document the use of LT4 by European thyroid specialists in such patients. Des...

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Main Authors:	Negro, Roberto (Author) , Žarković, Miloš (Author) , Attanasio, Roberto (Author) , Hegedüs, Laszlo (Author) , Nagy, Endre V. (Author) , Papini, Enrico (Author) , Akarsu, Ersin (Author) , Alevizaki, Maria (Author) , Ayvaz, Göksun (Author) , Bednarczuk, Tomasz (Author) , Beleslin, Biljana Nedeljković (Author) , Berta, Eszter (Author) , Bodor, Miklos (Author) , Borissova, Anna Maria (Author) , Boyanov, Mihail (Author) , Buffet, Camille (Author) , Burlacu, Maria-Cristina (Author) , Ćirić, Jamina (Author) , Cohen, Chagit Adler (Author) , Díez, Juan J. (Author) , Dobnig, Harald (Author) , Fadeyev, Valentin (Author) , Field, Benjamin C. T. (Author) , Fliers, Eric (Author) , Führer, Dagmar (Author) , Galofré, Juan C. (Author) , Hakala, Tommi (Author) , Jan, Jiskra (Author) , Kopp, Peter (Author) , Krebs, Michael (Author) , Kršek, Michal (Author) , Kužma, Martin (Author) , Leenhardt, Laurence (Author) , Luchytskiy, Vitaliy (Author) , Puga, Francisca Marques (Author) , McGowan, Anne (Author) , Melo, Miguel (Author) , Metso, Saara (Author) , Moran, Carla (Author) , Morgunova, Tatyana (Author) , Niculescu, Dan Alexandru (Author) , Perić, Božidar (Author) , Planck, Tereza (Author) , Poiana, Catalina (Author) , Robenshtok, Eyal (Author) , Rosselet, Patrick Olivier (Author) , Ruchala, Marek (Author) , Riis, Kamilla Ryom (Author) , Shepelkevich, Alla (Author) , Tronko, Mykola (Author) , Unuane, David (Author) , Vardarli, Irfan (Author) , Visser, Edward (Author) , Vryonidou, Andromachi (Author) , Younes, Younes R. (Author) , Perros, Petros (Author)
Format:	Article (Journal)
Language:	English
Published:	August 2024
In:	Clinical endocrinology Year: 2024, Volume: 101, Issue: 2, Pages: 180-190
ISSN:	1365-2265
DOI:	10.1111/cen.15099
Online Access:	Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1111/cen.15099 Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/cen.15099
Author Notes:	Roberto Negro, Miloš Žarković, Roberto Attanasio, Laszlo Hegedüs, Endre V. Nagy, Enrico Papini, Ersin Akarsu, Maria Alevizaki, Göksun Ayvaz, Tomasz Bednarczuk, Biljana Nedeljković Beleslin, Eszter Berta, Miklos Bodor, Anna Maria Borissova, Mihail Boyanov, Camille Buffet, Maria-Cristina Burlacu, Jamina Ćirić, Chagit Adler Cohen, Juan J. Díez, Harald Dobnig, Valentin Fadeyev, Benjamin C. T. Field, Eric Fliers, Dagmar Führer, Juan C. Galofré, Tommi Hakala, Jiskra Jan, Peter Kopp, Michael Krebs, Michal Kršek, Martin Kužma, Laurence Leenhardt, Vitaliy Luchytskiy, Francisca Marques Puga, Anne McGowan, Miguel Melo, Saara Metso, Carla Moran, Tatyana Morgunova, Dan Alexandru Niculescu, Božidar Perić, Tereza Planck, Catalina Poiana, Eyal Robenshtok, Patrick Olivier Rosselet, Marek Ruchala, Kamilla Ryom Riis, Alla Shepelkevich, Mykola Tronko, David Unuane, Irfan Vardarli, Edward Visser, Andromachi Vryonidou, Younes R. Younes, Petros Perros

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Summary:	Objectives The use of levothyroxine (LT4) treatment aiming to improve fertility in euthyroid women with positive thyroid peroxidase antibodies (TPOAb) is not supported by the available evidence. The aim of the study was to document the use of LT4 by European thyroid specialists in such patients. 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.
Item Description:	Zuerst veröffentlicht: 10. Juni 2024 Gesehen am 02.12.2024
Physical Description:	Online Resource
ISSN:	1365-2265
DOI:	10.1111/cen.15099

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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