Altered thyroid hormone profile in offspring after exposure to high estradiol environment during the first trimester of pregnancy: a cross-sectional studyReportar como inadecuado

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BMC Medicine

, 12:240

First Online: 16 December 2014Received: 20 August 2014Accepted: 14 November 2014DOI: 10.1186-s12916-014-0240-0

Cite this article as: Lv, PP., Meng, Y., Lv, M. et al. BMC Med 2014 12: 240. doi:10.1186-s12916-014-0240-0


BackgroundThe increasing number of babies conceived by in vitro fertilization and embryo transfer IVF-ET shifts concern from pregnancy outcomes to long-time health of offspring. Maternal high estradiol E2 is a major characteristic of IVF-ET and lasts throughout the first trimester of pregnancy. The fetal thyroid develops during this period and may thus be affected by exposure to the supra-physiological E2. The aim of this study is to investigate whether the high E2 maternal environment in the first trimester increases the risk of thyroid dysfunction in children born following IVF-ET.

MethodsA cross-sectional survey design was used to carry out face-to-face interviews with consecutive children attending the hospital. A total of 949 singletons born after fresh embryo transfer ET n = 357, frozen ET n = 212, and natural conception NC n = 380, aged 3 to 10 years old, were included. All children were thoroughly examined. Meanwhile, another 183 newborns, including 55 fresh ET, 48 frozen ET, and 80 NC were studied. Levels of serum T3, FT3, T4, FT4, and TSH and levels of maternal E2 at different stages of the first trimester were examined.

ResultsThe mean serum E2 levels of women undergoing fresh ET during the first trimester of pregnancy were significantly higher than those of the women undergoing frozen ET or following NC. The thyroid hormone profile, especially the levels of T4, FT4, and TSH, were significantly increased in 3- to 10-year-old children conceived by fresh ET compared to NC. The same tendency was confirmed in newborns. However, levels of T4 and TSH in the frozen ET group were nearer to that of the NC group. Furthermore, levels of T4 and FT4 in fresh ET were positively correlated with maternal serum levels of E2 during early pregnancy.

ConclusionsThe maternal high E2 environment in the first trimester is correlated with increased risk of thyroid dysfunction. Frozen ET could reduce risks of thyroid damage in children conceived by IVF. Further studies are needed to confirm these findings and to better determine the underlying molecular mechanisms and clinical significance.

Trial registrationChicCTR-OCC-14004682 22-05-2014

KeywordsEarly pregnancy Embryo transfer Estradiol Intrauterine environment In vitro fertilization Offspring Thyroid hormone Thyroid-stimulating hormone AbbreviationsARTAssisted reproduction technology

COHControlled ovarian hyperstimulation


ETEmbryo transfer


IVFIn vitro fertilization

Electronic supplementary materialThe online version of this article doi:10.1186-s12916-014-0240-0 contains supplementary material, which is available to authorized users.

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Autor: Ping-Ping Lv - Ye Meng - Min Lv - Chun Feng - Ye Liu - Jing-Yi Li - Dan-Qin Yu - Yan Shen - Xiao-Lin Hu - Qian Gao - Sha


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