- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04249271
Antithyroidal Antibodies With or Without Subclinical Hypothyroidism During Pregnancy in Infertile Women (Anti-TPO)
Antithyroidale Antikörper Mit Oder Ohne Subklinische Hypothyreose Bei Weiblicher Infertilität in Der Schwangerschaft Und im Wochenbett.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Exclusion of thyroid disease has long been an integral part of a comprehensive infertility work-up, because thyroid function disorders are also associated with disturbances in the menstrual cycle and can cause complications during pregnancy. Subclinical hypothyroidism is the most frequent disease of the thyroid in women of reproductive age (affecting 5 to 10 %). For a long time, measurement of TSH concentration was the only screening parameter used to exclude thyroid disorders. Not only has the differentiation of normal thyroid function (euthyroidism) from the pathological range been controversial for some years but, recently, the role of an elevated anti-TPO antibody titre has also been identified as a significant and independent risk factor for miscarriages and for complications during late pregnancy, even in otherwise euthyroid women. This discovery implies that solely determining the TSH concentration is insufficient. The mechanism underlying the increased rate of complications during pregnancy is also unclear.
The investigators therefore performed a double study to clarify the relative importance of the various possible parameters of thyroid function in the context of an infertility work-up:
- Prevalence study: Measurement of TSH and anti-TPO concentrations in 175 women who present with infertility at the Infertility Clinic at the Women's Hospital, University Hospital Basel. In addition, each participant underwent an ultrasound scan of the thyroid. Control group: 175 healthy women of reproductive age and with regular menstrual cycles, but not currently wishing to have children (recruited via posters in the university and Blood Donor Centre). This study has been finished in 2010. The data of the prevalence study were used to carry out the prospective sampling of the serum samples.
- Prospective measurement of fluctuations in thyroid function during pregnancy and post-partum in a group of euthyroid women and/or those with subclinical hypothyroidism (TSH > 4.5 mIU/l) with/without anti-TPO antibodies. Two different euthyroid groups were defined for the study: Euthyroidism I = TSH 0.3-2.5 mIU/l; Euthyroidism II = TSH 2.5-4.5 mIU/l. Six groups, each with 16 women, divided according to TSH concentration and anti-TPO antibody status, will be required (total 96). All female participants with subclinical hypothyroidism (TSH concentration > 4.5 mIU/l, normal values of peripheral thyroid hormones) receive a T4 supplementation dose. Serum samples will be collected each week from the start of pregnancy up to the 12th week and stored frozen at -80 °C. Thereafter, a serum sample will be collected once a month (up to the 38th week) and stored frozen at -80 °C. Finally, one serum sample post-partum (4 to 6 weeks after delivery) and freeze it. A total of 96 women (16 in each group) were recruited to participate in this study.
After conclusion of the observation period, levels of the following hormones will be measured in the total of 1120 serum samples: TSH, total and free l-thyroxine and fT4 index, total and free triiodothyronine, thyroid autoantibodies (TPO antibodies), hCG, 17β-oestradiol, progesterone, prolactin.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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-
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Basel, Switzerland, 4031
- Klinik für Gyn. Endokrinologie und Reproduktionsmedizin der Frauenklinik des Universitätsspitals
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- previous infertility with known thyroidal function (TSH, anti-TPO)
Exclusion Criteria:
- other endocrine pathology, such as Addison, diabetes mellitus
- manifest thyroidal pathology, such as Graves disease
- contraindication against pregnancy
- after repeated miscarriage (3 or more)
- heavy smokers (20 cig per day or more)
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
euthyroid, no antibodies
TSH 0.3 to 2.5 mIU/l and anti-TPO <100 IU/ml repeated serum sampling
|
repeated serum sampling during pregnancy and thereafter
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borderline euthyroid, no antibodies
TSH 2.5 to 4.5 mIU/l and anti-TPO <100 IU/l repeated serum sampling
|
repeated serum sampling during pregnancy and thereafter
|
hypothyroidism, no antibodies
TSH >4.5 mIU/l and anti-TPO <100 IU/ml repeated serum sampling
|
repeated serum sampling during pregnancy and thereafter
|
euthyroid, with antibodies
TSH 0.3 to 2.5 mIU/l and anti-TPO >100 IU/ml repeated serum sampling
|
repeated serum sampling during pregnancy and thereafter
|
borderline euthyroid, with antibodies
TSH 2.5 to 4.5 mIU/l and anti-TPO >100 IU/l repeated serum sampling
|
repeated serum sampling during pregnancy and thereafter
|
hypothyroidism, with antibodiesal
TSH >4.5 mIU/l and anti-TPO >100 IU/ml repeated serum sampling
|
repeated serum sampling during pregnancy and thereafter
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Deviations from euthyroid function as given by serum levels of TSH (expressed in mIU/l) during pregnancy and after birth.
Time Frame: 12 months
|
Impact of antibodies on thyroid function during pregnancy.
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12 months
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Collaborators and Investigators
Investigators
- Principal Investigator: Christian De Geyter, Prof., University of Basel
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- EKNZ 39-009 00960
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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