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6. Risk Factors for Thyroid Dysfunction in Pregnancy: An Individual Participant Data Meta-Analysis

Author

Osinga, Joris A.J., primary, Liu, Yindi, additional, Männistö, Tuija, additional, Vafeiadi, Marina, additional, Tao, Fang-Biao, additional, Vaidya, Bijay, additional, Vrijkotte, Tanja G.M., additional, Mosso, Lorena, additional, Bassols, Judit, additional, López-Bermejo, Abel, additional, Boucai, Laura, additional, Aminorroaya, Ashraf, additional, Feldt-Rasmussen, Ulla, additional, Hisada, Aya, additional, Yoshinaga, Jun, additional, Broeren, Maarten A.C., additional, Itoh, Sachiko, additional, Kishi, Reiko, additional, Ashoor, Ghalia, additional, Chen, Liangmiao, additional, Veltri, Flora, additional, Lu, Xuemian, additional, Taylor, Peter N., additional, Brown, Suzanne J., additional, Chatzi, Leda, additional, Popova, Polina V., additional, Grineva, Elena N., additional, Ghafoor, Farkhanda, additional, Pirzada, Amna, additional, Kianpour, Maryam, additional, Oken, Emily, additional, Suvanto, Eila, additional, Hattersley, Andrew, additional, Rebagliato, Marisa, additional, Riaño-Galán, Isolina, additional, Irizar, Amaia, additional, Vrijheid, Martine, additional, Delgado-Saborit, Juana Maria, additional, Fernández-Somoano, Ana, additional, Santa-Marina, Loreto, additional, Boelaert, Kristien, additional, Brenta, Gabriela, additional, Dhillon-Smith, Rima, additional, Dosiou, Chrysoula, additional, Eaton, Jennifer L., additional, Guan, Haixia, additional, Lee, Sun Y., additional, Maraka, Spyridoula, additional, Morris-Wiseman, Lilah F., additional, Nguyen, Caroline T., additional, Shan, Zhongyan, additional, Guxens, Mònica, additional, Pop, Victor J.M., additional, Walsh, John P., additional, Nicolaides, Kypros H., additional, D'Alton, Mary E., additional, Visser, W. Edward, additional, Carty, David M., additional, Delles, Christian, additional, Nelson, Scott M., additional, Alexander, Erik K., additional, Chaker, Layal, additional, Palomaki, Glenn E., additional, Peeters, Robin P., additional, Bliddal, Sofie, additional, Huang, Kun, additional, Poppe, Kris G., additional, Pearce, Elizabeth N., additional, Derakhshan, Arash, additional, and Korevaar, Tim I.M., additional

Published
2024
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7. Risk Factors for Thyroid Dysfunction in Pregnancy:An Individual Participant Data Meta-Analysis

Author

Osinga, Joris A. J., Liu, Yindi, Männistö, Tuija, Vafeiadi, Marina, Tao, Fang-Biao, Vaidya, Bijay, Vrijkotte, Tanja G. M., Mosso, Lorena, Bassols, Judit, López-Bermejo, Abel, Boucai, Laura, Aminorroaya, Ashraf, Feldt-Rasmussen, Ulla, Hisada, Aya, Yoshinaga, Jun, Broeren, Maarten A. C., Itoh, Sachiko, Kishi, Reiko, Ashoor, Ghalia, Chen, Liangmiao, Veltri, Flora, Lu, Xuemian, Taylor, Peter N., Brown, Suzanne J., Chatzi, Leda, Popova, Polina V., Grineva, Elena N., Ghafoor, Farkhanda, Pirzada, Amna, Kianpour, Maryam, Oken, Emily, Suvanto, Eila, Hattersley, Andrew, Rebagliato, Marisa, Riaño-Galán, Isolina, Irizar, Amaia, Vrijheid, Martine, Delgado-Saborit, Juana Maria, Fernández-Somoano, Ana, Santa-Marina, Loreto, Boelaert, Kristien, Brenta, Gabriela, Dhillon-Smith, Rima, Dosiou, Chrysoula, Eaton, Jennifer L., Guan, Haixia, Lee, Sun Y., Maraka, Spyridoula, Morris-Wiseman, Lilah F., Nguyen, Caroline T., Shan, Zhongyan, Guxens, Mònica, Pop, Victor J. M., Walsh, John P., Nicolaides, Kypros H., D'Alton, Mary E., Visser, W. Edward, Carty, David M., Delles, Christian, Nelson, Scott M., Alexander, Erik K., Chaker, Layal, Palomaki, Glenn E., Peeters, Robin P., Bliddal, Sofie, Huang, Kun, Poppe, Kris G., Pearce, Elizabeth N., Derakhshan, Arash, Korevaar, Tim I. M., Osinga, Joris A. J., Liu, Yindi, Männistö, Tuija, Vafeiadi, Marina, Tao, Fang-Biao, Vaidya, Bijay, Vrijkotte, Tanja G. M., Mosso, Lorena, Bassols, Judit, López-Bermejo, Abel, Boucai, Laura, Aminorroaya, Ashraf, Feldt-Rasmussen, Ulla, Hisada, Aya, Yoshinaga, Jun, Broeren, Maarten A. C., Itoh, Sachiko, Kishi, Reiko, Ashoor, Ghalia, Chen, Liangmiao, Veltri, Flora, Lu, Xuemian, Taylor, Peter N., Brown, Suzanne J., Chatzi, Leda, Popova, Polina V., Grineva, Elena N., Ghafoor, Farkhanda, Pirzada, Amna, Kianpour, Maryam, Oken, Emily, Suvanto, Eila, Hattersley, Andrew, Rebagliato, Marisa, Riaño-Galán, Isolina, Irizar, Amaia, Vrijheid, Martine, Delgado-Saborit, Juana Maria, Fernández-Somoano, Ana, Santa-Marina, Loreto, Boelaert, Kristien, Brenta, Gabriela, Dhillon-Smith, Rima, Dosiou, Chrysoula, Eaton, Jennifer L., Guan, Haixia, Lee, Sun Y., Maraka, Spyridoula, Morris-Wiseman, Lilah F., Nguyen, Caroline T., Shan, Zhongyan, Guxens, Mònica, Pop, Victor J. M., Walsh, John P., Nicolaides, Kypros H., D'Alton, Mary E., Visser, W. Edward, Carty, David M., Delles, Christian, Nelson, Scott M., Alexander, Erik K., Chaker, Layal, Palomaki, Glenn E., Peeters, Robin P., Bliddal, Sofie, Huang, Kun, Poppe, Kris G., Pearce, Elizabeth N., Derakhshan, Arash, and Korevaar, Tim I. M.

Abstract

Background: International guidelines recommend targeted screening to identify gestational thyroid dysfunction. However, currently used risk factors have questionable discriminative ability. We quantified the risk for thyroid function test abnormalities for a subset of risk factors currently used in international guidelines. Methods: We included prospective cohort studies with data on gestational maternal thyroid function and potential risk factors (maternal age, body mass index [BMI], parity, smoking status, pregnancy through in vitro fertilization, twin pregnancy, gestational age, maternal education, and thyroid peroxidase antibody [TPOAb] or thyroglobulin antibody [TgAb] positivity). Exclusion criteria were pre-existing thyroid disease and use of thyroid interfering medication. We analyzed individual participant data using mixed-effects regression models. Primary outcomes were overt and subclinical hypothyroidism and a treatment indication (defined as overt hypothyroidism, subclinical hypothyroidism with thyrotropin >10 mU/L, or subclinical hypothyroidism with TPOAb positivity). Results: The study population comprised 65,559 participants in 25 cohorts. The screening rate in cohorts using risk factors currently recommended (age >30 years, parity ≥2, BMI ≥40) was 58%, with a detection rate for overt and subclinical hypothyroidism of 59%. The absolute risk for overt or subclinical hypothyroidism varied <2% over the full range of age and BMI and for any parity. Receiver operating characteristic curves, fitted using maternal age, BMI, smoking status, parity, and gestational age at blood sampling as explanatory variables, yielded areas under the curve ranging from 0.58 to 0.63 for the primary outcomes. TPOAbs/TgAbs positivity was associated with overt hypothyroidism (approximate risk for antibody negativity 0.1%, isolated TgAb positivity 2.4%, isolated TPOAb positivity 3.8%, combined antibody positivity 7.0%; p < 0.001), subclinical hypothyroidism (r, Background: International guidelines recommend targeted screening to identify gestational thyroid dysfunction. However, currently used risk factors have questionable discriminative ability. We quantified the risk for thyroid function test abnormalities for a subset of risk factors currently used in international guidelines. Methods: We included prospective cohort studies with data on gestational maternal thyroid function and potential risk factors (maternal age, body mass index [BMI], parity, smoking status, pregnancy through in vitro fertilization, twin pregnancy, gestational age, maternal education, and thyroid peroxidase antibody [TPOAb] or thyroglobulin antibody [TgAb] positivity). Exclusion criteria were pre-existing thyroid disease and use of thyroid interfering medication. We analyzed individual participant data using mixed-effects regression models. Primary outcomes were overt and subclinical hypothyroidism and a treatment indication (defined as overt hypothyroidism, subclinical hypothyroidism with thyrotropin >10 mU/L, or subclinical hypothyroidism with TPOAb positivity). Results: The study population comprised 65,559 participants in 25 cohorts. The screening rate in cohorts using risk factors currently recommended (age >30 years, parity ≥2, BMI ≥40) was 58%, with a detection rate for overt and subclinical hypothyroidism of 59%. The absolute risk for overt or subclinical hypothyroidism varied <2% over the full range of age and BMI and for any parity. Receiver operating characteristic curves, fitted using maternal age, BMI, smoking status, parity, and gestational age at blood sampling as explanatory variables, yielded areas under the curve ranging from 0.58 to 0.63 for the primary outcomes. TPOAbs/TgAbs positivity was associated with overt hypothyroidism (approximate risk for antibody negativity 0.1%, isolated TgAb positivity 2.4%, isolated TPOAb positivity 3.8%, combined antibody positivity 7.0%; p < 0.001), subclinical hypothyroidism (risk f

Published
2024

11. Micronized Vaginal Progesterone to Prevent Miscarriage: A Critical Evaluation of Randomized Evidence

Author

Coomarasamy, Arri, Devall, Adam J., Brosens, Jan J., Quenby, Siobhan, Stephenson, Mary D., Sierra, Sony, Christiansen, Ole B., Small, Rachel, Brewin, Jane, Roberts, Tracy E., Dhillon-Smith, Rima, Harb, Hoda, Noordali, Hannah, Papadopoulou, Argyro, Eapen, Abey, Prior, Matt, Di Renzo, Gian Carlo, Hinshaw, Kim, Mol, Ben W., Lumsden, Mary Ann, Khalaf, Yacoub, Shennan, Andrew, Goddijn, Mariette, van Wely, Madelon, Al-Memar, Maya, Bennett, Phil, Bourne, Tom, Rai, Raj, Regan, Lesley, and Gallos, Ioannis D.

Published
2020
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12. Myoinositol or D-chiro-inositol for PCOS symptoms in adolescents: a narrative review.

Author

Sairally, Bibi Zeyah Fatemah, Dhillon-Smith, Rima K., Jethwani, Geetu, and Latthe, Pallavi

Abstract

Polycystic ovary syndrome (PCOS) treatment in adolescents currently focuses on lifestyle interventions, with pharmacological treatment options often limited to hormonal contraceptives. Several of these carry broad side-effect profiles and are not always accepted by young girls. There is growing interest in non-hormonal therapies for PCOS. We aimed to collate the evidence on the use of myoinositol or D-chiro-inositol in the improvement of PCOS symptoms in symptomatic adolescents. A systematic literature review identifying key articles from inception to March 2023. Participants: Female adolescents (aged 12–19 years) with PCOS or PCOS-like features. Intervention: Myoinositol or D-chiro-inositol with or without additional interventions. Comparison: Any other treatment, including lifestyle interventions, hormonal therapy, metformin or no treatment. The main outcome measure were improvement in symptoms, quality of life and adverse effects. Eight studies were included: two randomised open-label trials, one quasi-randomised and three non-randomised interventional studies, one case-control study and one cohort study. All studies showed improvements in some biochemical markers, metabolic parameters or clinical symptoms, but these were not reproducible across all studies. The benefit of myoinositol in adolescents with PCOS remains unclear, with limited high-quality evidence. This review highlights the need for robustly conducted research to inform clinical practice. [ABSTRACT FROM AUTHOR]

Published
2024
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13. A comparison of morphokinetic models and morphological selection for prioritizing euploid embryos: a multicentre cohort study.

Author

Bamford, Thomas, Smith, Rachel, Young, Selina, Evans, Amy, Lockwood, Megan, Easter, Christina, Montgomery, Sue, Barrie, Amy, Dhillon-Smith, Rima, Coomarasamy, Arri, and Campbell, Alison

Subjects
EMBRYOS, FERTILITY clinics, COHORT analysis, EMBRYO transfer, TIMESTAMPS
Abstract

STUDY QUESTION Are morphokinetic models better at prioritizing a euploid embryo for transfer over morphological selection by an embryologist? SUMMARY ANSWER Morphokinetic algorithms lead to an improved prioritization of euploid embryos when compared to embryologist selection. WHAT IS KNOWN ALREADY PREFER (predicting euploidy for embryos in reproductive medicine) is a previously published morphokinetic model associated with live birth and miscarriage. The second model uses live birth as the target outcome (LB model). STUDY DESIGN, SIZE, DURATION Data for this cohort study were obtained from 1958 biopsied blastocysts at nine IVF clinics across the UK from January 2021 to December 2022. PARTICIPANTS/MATERIALS, SETTING, METHODS The ability of the PREFER and LB models to prioritize a euploid embryo was compared against arbitrary selection and the prediction of four embryologists using the timelapse video, blinded to the morphokinetic time stamp. The comparisons were made using calculated percentages and normalized discounted cumulative gain (NDCG), whereby an NDCG score of 1 would equate to all euploid embryos being ranked first. In arbitrary selection, the ploidy status was randomly assigned within each cycle and the NDGC calculated, and this was then repeated 100 times and the mean obtained. MAIN RESULTS AND THE ROLE OF CHANCE Arbitrary embryo selection would rank a euploid embryo first 37% of the time, embryologist selection 39%, and the LB and PREFER ploidy morphokinetic models 46% and 47% of the time, respectively. The AUC for LB and PREFER model was 0.62 and 0.63, respectively. Morphological selection did not significantly improve the performance of both morphokinetic models when used in combination. There was a significant difference between the NDGC metric of the PREFER model versus embryologist selection at 0.96 and 0.87, respectively (t  = 14.1, P  < 0.001). Similarly, there was a significant difference between the LB model and embryologist selection with an NDGC metric of 0.95 and 0.87, respectively (t  = 12.0, P  < 0.001). All four embryologists ranked embryos similarly, with an intraclass coefficient of 0.91 (95% CI 0.82–0.95, P  < 0.001). LIMITATIONS, REASONS FOR CAUTION Aside from the retrospective study design, limitations include allowing the embryologist to watch the time lapse video, potentially providing more information than a truly static morphological assessment. Furthermore, the embryologists at the participating centres were familiar with the significant variables in time lapse, which could bias the results. WIDER IMPLICATIONS OF THE FINDINGS The present study shows that the use of morphokinetic models, namely PREFER and LB, translates into improved euploid embryo selection. STUDY FUNDING/COMPETING INTEREST(S) This study received no specific grant funding from any funding agency in the public, commercial or not-for-profit sectors. Dr Alison Campbell is minor share holder of Care Fertility. All other authors have no conflicts of interest to declare. Time lapse is a technology for which patients are charged extra at participating centres. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Published
2024
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15. A core outcome set for trials in miscarriage management and prevention: An international consensus development study

Author

Dhillon‐Smith, Rima K., primary, Melo, Pedro, additional, Devall, Adam James, additional, Smith, Paul Philip, additional, Al‐Memar, Maya, additional, Barnhart, Kurt, additional, Condous, George, additional, Christiansen, Ole Bjarne, additional, Goddijn, Mariëtte, additional, Jurkovic, Davor, additional, Lissauer, David, additional, Maheshwari, Abha, additional, Oladapo, Olufemi T., additional, Preisler, Jessica, additional, Regan, Lesley, additional, Small, Rachel, additional, Stephenson, Mary, additional, Wijeyaratne, Chandrika, additional, Quenby, Siobhan, additional, Bourne, Tom, additional, and Coomarasamy, Arri, additional

Published
2023
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20. Subclinical hypothyroidism and antithyroid autoantibodies in women with subfertility or recurrent pregnancy loss: Scientific Impact Paper No. 70 June 2022: Scientific Impact Paper No. 70 June 2022.

Author

Dhillon‐Smith, Rima K., Boelaert, Kristien, Jeve, Yadava B., Maheshwari, Abha, Coomarasamy, Arri, Dhillon-Smith, Rima K, and Royal College of Obstetricians and Gynaecologists

Abstract

The thyroid is a gland located in the neck and is important for many processes in the body. Problems with the thyroid gland are common in women of reproductive age. It is essential to have a normal working thyroid gland in order to achieve a successful pregnancy. One of the most common problems with the thyroid is underactivity (known as hypothyroidism). An early, mild form of an underactive thyroid is called subclinical hypothyroidism. Often people with this condition do not have any symptoms. Another common problem is thyroid autoimmunity. Here, the immune system attacks the thyroid gland, sometimes leading to the development of abnormal thyroid function. This can be diagnosed by the presence of proteins in the bloodstream called antibodies. Mild thyroid problems and the presence of high levels of thyroid antibodies have been linked to miscarriage and premature birth. There is debate in medicine about whether there should be routine testing of thyroid function both in the general population and in individuals who are trying for a baby. In addition, the strategies used to manage certain thyroid problems are questioned. Discussions around testing and subsequent management particularly relate to women with a history of subfertility or repeated miscarriages. This Scientific Impact Paper provides information on thyroid testing and the management of mild thyroid problems and thyroid antibodies in women with a history of subfertility or recurrent miscarriages, using the latest evidence and guidelines. It concludes that there may be a role for treating these women with thyroxine tablets (the hormone produced by the thyroid gland) when subclinical hypothyroidism is present, and gives guidance on the cut-off levels for treatment. [ABSTRACT FROM AUTHOR]

Published
2022
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26. Evaluating the Progression to Hypothyroidism in Preconception Euthyroid Thyroid Peroxidase Antibody--Positive Women.

Author

Gill, Sofia, Cheed, Versha, Morton, Victoria A. H., Gill, Dayna, Boelaert, Kristien, Chan, Shiao, Coomarasamy, Arri, and Dhillon-Smith, Rima K.

Subjects
HYPOTHYROIDISM, PEROXIDASE
Abstract

Context: Thyroid peroxidase antibody (TPOAb) positivity is prevalent in women of reproductive age and predisposes to thyroid dysfunction, particularly hypothyroidism, which has adverse effects on pregnancy. Objective: This study aimed to report the rate of development of abnormal thyroid function among initially euthyroid TPOAb-positive women recruited into the TABLET trial, to identify factors associated with the development of hypothyroidism, and to compare outcomes between euthyroid and treated hypothyroid individuals. Methods: This observational cohort study, conducted at 49 UK hospitals between 2011 and 2016, included euthyroid TPOAb-positive women 16 to 40 years of age with a history of miscarriage or subfertility, planning pregnancy, randomized to levothyroxine 50 mcg daily or placebo. Abnormal thyroid function, conception rate, and live birth rate (LBR) ≥34 weeks were analyzed. Results: Among the women, 70/940 (7.4%) developed subclinical (SCH) or overt (OH) hypothyroidism: 27/470 taking levothyroxine and 43/470 placebo (relative risk [RR] 0.63; 95% CI, 0.39-1.00; P=0.05); 83% of cases emerged prepregnancy. Baseline median serum TSH concentrations and TPOAb titers were significantly higher in those who developed hypothyroidism vs those who did not (P<0.001). Treated SCH/OH demonstrated a higher failure-to-conceive rate compared with euthyroid women (adjusted RR 2.02 [1.56-2.62]; P< 0.001). The LBR ≥ 34 weeks was similar in the treated SCH/OH and euthyroid groups (adjusted RR 1.09 [0.77-1.55]; P=0.6). Conclusion: Approximately 7% of euthyroid TPOAb-positive women will develop hypothyroidism within 1 year preconception or in pregnancy. Conception rates are lower in women with treated SCH/OH compared with euthyroid women, but LBR are comparable. Thyroid function in TPOAb-positive women should be monitored regularly, when trying to conceive, to ensure prompt diagnosis and appropriate treatment initiation. [ABSTRACT FROM AUTHOR]

Published
2023
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31. Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss

Author

Quenby, Siobhan, primary, Gallos, Ioannis D, additional, Dhillon-Smith, Rima K, additional, Podesek, Marcelina, additional, Stephenson, Mary D, additional, Fisher, Joanne, additional, Brosens, Jan J, additional, Brewin, Jane, additional, Ramhorst, Rosanna, additional, Lucas, Emma S, additional, McCoy, Rajiv C, additional, Anderson, Robert, additional, Daher, Shahd, additional, Regan, Lesley, additional, Al-Memar, Maya, additional, Bourne, Tom, additional, MacIntyre, David A, additional, Rai, Raj, additional, Christiansen, Ole B, additional, Sugiura-Ogasawara, Mayumi, additional, Odendaal, Joshua, additional, Devall, Adam J, additional, Bennett, Phillip R, additional, Petrou, Stavros, additional, and Coomarasamy, Arri, additional

Published
2021
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32. Sporadic miscarriage: evidence to provide effective care

Author

Coomarasamy, Arri, primary, Gallos, Ioannis D, additional, Papadopoulou, Argyro, additional, Dhillon-Smith, Rima K, additional, Al-Memar, Maya, additional, Brewin, Jane, additional, Christiansen, Ole B, additional, Stephenson, Mary D, additional, Oladapo, Olufemi T, additional, Wijeyaratne, Chandrika N, additional, Small, Rachel, additional, Bennett, Phillip R, additional, Regan, Lesley, additional, Goddijn, Mariëtte, additional, Devall, Adam J, additional, Bourne, Tom, additional, Brosens, Jan J, additional, and Quenby, Siobhan, additional

Published
2021
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33. Recurrent miscarriage: evidence to accelerate action

Author

Coomarasamy, Arri, primary, Dhillon-Smith, Rima K, additional, Papadopoulou, Argyro, additional, Al-Memar, Maya, additional, Brewin, Jane, additional, Abrahams, Vikki M, additional, Maheshwari, Abha, additional, Christiansen, Ole B, additional, Stephenson, Mary D, additional, Goddijn, Mariëtte, additional, Oladapo, Olufemi T, additional, Wijeyaratne, Chandrika N, additional, Bick, Debra, additional, Shehata, Hassan, additional, Small, Rachel, additional, Bennett, Phillip R, additional, Regan, Lesley, additional, Rai, Raj, additional, Bourne, Tom, additional, Kaur, Rajinder, additional, Pickering, Oonagh, additional, Brosens, Jan J, additional, Devall, Adam J, additional, Gallos, Ioannis D, additional, and Quenby, Siobhan, additional

Published
2021
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35. JCEMPrevalence_supplementary tablesS1-S3.pdf

Author

Smith, Rima, Tobias, Aurelio, Smith, Paul Philip, Middleton, Lee, Kirandeep Sunner, Baker, Krystyna, Farrell-Carver, Samantha, Bender-Atik, Ruth, Agrawal, Rina, Kalsang Bhatia, Chu, Justin J., Edi-Osagie, Edmond, Ewies, Ayman A.A., Ghobara, Tarek, Gupta, Pratima, Jurkovic, Davor, Yakoub Khalaf, Khashia Mulbagal, Nunes, Natalie, Overton, Caroline, Quenby, Siobhan, Rai, Rajendra, Raine-Fenning, Nick, Robinson, Lynne, Ross, Jackie, Sizer, Andrew, Small, Rachel, Underwood, Martyn, Kilby, Mark D., Daniels, Jane, Thangaratinam, Shakila, Shiao-Yng Chan, Boelaert, Kristien, and Arri Coomarasamy

Subjects
endocrine system, endocrine system diseases, education, humanities
Abstract

Supplementary tables for manuscript "The prevalence of thyroid dysfunction and autoimmunity in women with history of miscarriage or subfertility".

Published
2020
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37. Micronized vaginal progesterone to prevent miscarriage: a critical evaluation of randomized evidence

Author

Coomarasamy, Arri, primary, Devall, Adam J., additional, Brosens, Jan J., additional, Quenby, Siobhan, additional, Stephenson, Mary D., additional, Sierra, Sony, additional, Christiansen, Ole B., additional, Small, Rachel, additional, Brewin, Jane, additional, Roberts, Tracy E., additional, Dhillon-Smith, Rima, additional, Harb, Hoda, additional, Noordali, Hannah, additional, Papadopoulou, Argyro, additional, Eapen, Abey, additional, Prior, Matt, additional, Di Renzo, Gian Carlo, additional, Hinshaw, Kim, additional, Mol, Ben W., additional, Lumsden, Mary Ann, additional, Khalaf, Yacoub, additional, Shennan, Andrew, additional, Goddijn, Mariette, additional, van Wely, Madelon, additional, Al-Memar, Maya, additional, Bennett, Phil, additional, Bourne, Tom, additional, Rai, Raj, additional, Regan, Lesley, additional, and Gallos, Ioannis D., additional

Published
2020
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38. The Prevalence of Thyroid Dysfunction and Autoimmunity in Women With History of Miscarriage or Subfertility

Author

Dhillon-Smith, Rima K, primary, Tobias, Aurelio, additional, Smith, Paul P, additional, Middleton, Lee J, additional, Sunner, Kirandeep K, additional, Baker, Krystyna, additional, Farrell-Carver, Samantha, additional, Bender-Atik, Ruth, additional, Agrawal, Rina, additional, Bhatia, Kalsang, additional, Chu, Justin J, additional, Edi-Osagie, Edmond, additional, Ewies, Ayman, additional, Ghobara, Tarek, additional, Gupta, Pratima, additional, Jurkovic, Davor, additional, Khalaf, Yacoub, additional, Mulbagal, Khashia, additional, Nunes, Natalie, additional, Overton, Caroline, additional, Quenby, Siobhan, additional, Rai, Raj, additional, Raine-Fenning, Nick, additional, Robinson, Lynne, additional, Ross, Jackie, additional, Sizer, Andrew, additional, Small, Rachel, additional, Underwood, Martyn, additional, Kilby, Mark D, additional, Daniels, Jane, additional, Thangaratinam, Shakila, additional, Chan, Shiao, additional, Boelaert, Kristien, additional, and Coomarasamy, Arri, additional

Published
2020
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40. Vitamin D and assisted reproductive treatment outcome: A prospective cohort study

Author

Tobías, Aurelio [0000-0001-6428-6755], Chu, Justin J., Gallos, Ioannis D., Tobías, Aurelio, Robinson, Lynne L.L., Kirkman-Brown, Jackson C., Dhillon-Smith, Rima K., Harb, Hoda Maaly, Eapen, Abey K., Rajkhowa, Madhurima, Coomarasamy, Arri, Tobías, Aurelio [0000-0001-6428-6755], Chu, Justin J., Gallos, Ioannis D., Tobías, Aurelio, Robinson, Lynne L.L., Kirkman-Brown, Jackson C., Dhillon-Smith, Rima K., Harb, Hoda Maaly, Eapen, Abey K., Rajkhowa, Madhurima, and Coomarasamy, Arri

Abstract

Background: Vitamin D deficiency has been associated with an increased risk of abnormal pregnancy implantation leading to obstetric complications such as pre-eclampsia and fetal growth restriction. However, the effect of vitamin D on reproductive treatment outcomes in couples undergoing assisted reproductive treatment is poorly understood. This study investigates the association between vitamin D and reproductive treatment outcomes in women undergoing assisted reproductive treatments? Methods: A prospective cohort study conducted at a large tertiary teaching hospital, United Kingdom. Five hundred women undergoing assisted reproductive treatment were recruited between September 2013 and September 2015. All participants had their serum vitamin D measured and their reproductive treatment outcomes collated. Women were categorised in to three groups: vitamin D replete (> 75 nmol/L), insufficient (50-75 nmol/L) and deficient (< 50 nmol/L) according to Endocrine Society guidance. The primary outcome was live birth. Secondary outcomes included biochemical pregnancy, clinical pregnancy and pregnancy loss rates. Results: Vitamin D deficiency was found in 53.2% (266/500) of participants and vitamin D insufficiency was found in 30.8% (154/500) of participants. Only 16% (80/500) of women were vitamin D replete. The live birth rates for vitamin D deficient, insufficient and replete women were 23.2% (57/246), 27.0% (38/141) and 37.7% (29/77) respectively (p = 0.04). The respective live birth rates for vitamin D deficient, insufficient and replete women were 24.3, 27.1, 34.4% after adjustment for key prognostic factors (p = 0.25). Conclusions: Vitamin D deficiency and insufficiency are common in women undergoing assisted reproductive treatments. The crude live birth rate achieved in women undergoing assisted reproductive treatments are associated with serum vitamin D, although statistical significance is lost when adjusting for important prognostic variables. Vitamin D deficiency c

Published
2019

42. Levothyroxine to increase live births in euthyroid women with thyroid antibodies trying to conceive: the TABLET RCT

Author

Dhillon-Smith, Rima K, primary, Middleton, Lee J, additional, Sunner, Kirandeep K, additional, Cheed, Versha, additional, Baker, Krys, additional, Farrell-Carver, Samantha, additional, Bender-Atik, Ruth, additional, Agrawal, Rina, additional, Bhatia, Kalsang, additional, Edi-Osagie, Edmond, additional, Ghobara, Tarek, additional, Gupta, Pratima, additional, Jurkovic, Davor, additional, Khalaf, Yacoub, additional, MacLean, Marjory, additional, McCabe, Chris, additional, Mulbagal, Khashia, additional, Nunes, Natalie, additional, Overton, Caroline, additional, Quenby, Siobhan, additional, Rai, Rajendra, additional, Raine-Fenning, Nick, additional, Robinson, Lynne, additional, Ross, Jackie, additional, Sizer, Andrew, additional, Small, Rachel, additional, Tan, Alex, additional, Underwood, Martyn, additional, Kilby, Mark D, additional, Boelaert, Kristien, additional, Daniels, Jane, additional, Thangaratinam, Shakila, additional, Chan, Shiao-Yng, additional, and Coomarasamy, Arri, additional

Published
2019
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45. Levothyroxine in Women with Thyroid Peroxidase Antibodies before Conception

Author

Dhillon-Smith, Rima K., primary, Middleton, Lee J., additional, Sunner, Kirandeep K., additional, Cheed, Versha, additional, Baker, Krys, additional, Farrell-Carver, Samantha, additional, Bender-Atik, Ruth, additional, Agrawal, Rina, additional, Bhatia, Kalsang, additional, Edi-Osagie, Edmond, additional, Ghobara, Tarek, additional, Gupta, Pratima, additional, Jurkovic, Davor, additional, Khalaf, Yacoub, additional, MacLean, Marjory, additional, McCabe, Christopher, additional, Mulbagal, Khashia, additional, Nunes, Natalie, additional, Overton, Caroline, additional, Quenby, Siobhan, additional, Rai, Raj, additional, Raine-Fenning, Nick, additional, Robinson, Lynne, additional, Ross, Jackie, additional, Sizer, Andrew, additional, Small, Rachel, additional, Tan, Alex, additional, Underwood, Martyn, additional, Kilby, Mark D., additional, Boelaert, Kristien, additional, Daniels, Jane, additional, Thangaratinam, Shakila, additional, Chan, Shiao Y., additional, and Coomarasamy, Arri, additional

Published
2019
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46. OR11-1 A Randomized Trial of Preconception Levothyroxine in Euthyroid Women with Thyroid Peroxidase Antibodies

Author

Dhillon-Smith, Rima, primary, Middleton, Lee, additional, Sunner, Kirandeep, additional, Cheed, Versha, additional, Baker, Krys, additional, Farrell-Carver, Samantha, additional, Bender-Atik, Ruth, additional, Agrawal, Rina, additional, Bhatia, Kalsang, additional, Edi-Osagie, Edmond, additional, Ghobara, Tarek, additional, Gupta, Pratima, additional, Jurkovic, Davor, additional, Khalaf, Yacoub, additional, MacLean, Marjory, additional, McCabe, Christopher, additional, Mulbagal, Khashia, additional, Nunes, Natalie, additional, Overton, Caroline, additional, Quenby, Siobhan, additional, Rai, Raj, additional, Raine-Fenning, Nick, additional, Robinson, Lynne, additional, Ross, Jackie, additional, Sizer, Andrew, additional, Small, Rachel, additional, Tan, Alex, additional, Underwood, Martyn, additional, Kilby, Mark, additional, Boelaert, Kristien, additional, Daniels, Jane, additional, Thangaratinam, Shakila, additional, Chan, Shiao, additional, and Coomarasamy, Arri, additional

Published
2019
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50. THE AUTHORS REPLY.

Author

Dhillon-Smith, Rima K. and Coomarasamy, Arri

Subjects
*LEVOTHYROXINE, *DABIGATRAN, *HIGH-risk pregnancy
Published
2019
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