The effect of ovulation induction with clomiphene citrate on pregnancy outcomes in patients with subclinical hypothyroidism: A retrospective study

Abstract

Objectives: The literature indicates that there is no clear consensus on the effectiveness of assisted reproductive techniques (ART) in women with thyroid disorders. In this study, we aimed to compare the reproductive outcomes of patients taking clomiphene citrate (CC), focusing on those with normo-thyroid TSH concentrations (<2.5 µIU/ml) and those with subclinical hypothyroidism (2.5-5.0 µIU/ml).

Methods: In this retrospective observational study, the medical records of 300 patients, who applied to the infertility department of Kanuni Sultan Süleyman Education and Research Hospital and administered CC between the years of January 2011 to December 2016 were examined. We analyzed the medical records of all women who took clomiphene citrate (CC) and had measured TSH levels between 2011 to 2016. Patients were divided into two groups as normo-thyroid and sub-clinic hypothyroidism. ART success was compared between the groups.

Results: A total of 300 patients were included in the study, with 226 patients classified as normo-thyroid based on their TSH values at admission and 74 patients classified as having sub-clinic hypothyroidism. Among them, 123 normo-thyroid patients and 41 sub-clinic hypothyroid patients achieved pregnancy, with no significant difference found between the groups. Pregnancies were divided into groups as follows: singleton pregnancy, abortion, ectopic pregnancy, twin pregnancy and chemical pregnancy and then compared. The singleton pregnancy rate was 92.7% in normo-thyroid women and 85.4% in the sub-clinic hypothyroidism group with no statistically significant difference between the subgroups.

Conclusion: Subclinical hypothyroidism does not alter pregnancy rates in women receiving CC for ovulation induction. In light of this study’s results, further research involving a greater number of patients from diverse ethnic backgrounds and various hospitals is needed to better understand the impact of subclinical hypothyroidism on reproductive outcomes in women taking CC.

doi: https://doi.org/10.12669/pjms.41.5.10535

How to cite this: Ince E, Atis A, Akca A, Karakis LS, Ince O. The effect of ovulation induction with clomiphene citrate on pregnancy outcomes in patients with subclinical hypothyroidism: A retrospective study. Pak J Med Sci. 2025;41(5):1370-1375. doi: https://doi.org/10.12669/pjms.41.5.10535

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