Preconceptional thyroid stimulating hormone level and fecundity: a community-based cohort study of time to pregnancy

Abstract

Objective: To investigate the association between preconception thyroid stimulating hormone (TSH) level and time to pregnancy within a community-based population.

Design: A community-based cohort study.

Setting: Two free preconception check-up centers.

Patient(s): Women who enrolled in the National Free Preconception Check-up Projects from January 1, 2018 to December 31, 2018 in Tianhe and Zengcheng districts of Guangzhou city.

Intervention(s): None.

Main outcome measure(s): Time to pregnancy.

Result(s): A total of 1,478 women were eligible for the analysis; of these, 1,401 had a preconception TSH level within the range of 0.50 and 5.59 mIU/L (2.5th-97.5th percentiles) were taken as target study population. Among them, 968 (69.1%) couples achieved pregnancy within the first 6 months and 1,082 (77.2%) within 12 months. Dichotomized by the recommended cut-off value of 2.5 mIU/L, the percentage of women conceived in the high TSH level category (2.50-5.59 mIU/L) was comparable to that of the low category (0.50-2.49 mIU/L) (79.0% vs. 78.1%), with a crude fecundity odd ratio of 0.99 (95% confidence interval at 0.87-1.13). No statistically significant difference was observed after the adjustment in all models. Continuous TSH level was further examined, and the nonlinear association between TSH level and fecundity odds ratios was of no statistical significance.

Conclusion(s): Preconception TSH level was not associated with fecundity in a healthy community-based population. Women attempting pregnancy with a TSH level ≥ 2.5 mIU/L can be reassured that they are unlikely to have an increased time to pregnancy.

Keywords: Thyroid; fecundity; preconception; thyroid stimulating hormone; time to pregnancy.