Risk stratification for women undergoing in-vitro fertilisation treatment

Dhillon, Rima Kaur (2016). Risk stratification for women undergoing in-vitro fertilisation treatment. University of Birmingham. Ph.D.

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Abstract

The aim of this thesis was to explore three factors that are easily available and contribute important information for women before commencing in-vitro fertilisation (IVF) treatment: ethnicity, body-mass index (BMI) and thyroid disease. Results of the systematic review, cohort study and meta-analysis investigating ethnicity and IVF outcome showed South Asian and Black women have lower adjusted live-birth (LB) rates, after fresh cycle treatment, compared with White women. The relationship between BMI and IVF outcome was explored in a prediction model estimating chances of LB following first cycle. The model found BMI has reduced effect on IVF outcome when adjusting for other confounders such as age. The prevalence of thyroid dysfunction and thyroid peroxidase antibodies (TPOAb) was examined across the UK in >7000 women of reproductive age, and a cohort study investigating the effect of subclinical hypothyroidism (SCH) on IVF outcome was also performed. The prevalence of overt thyroid disease was 0.38% and subclinical disease 3.45%. Using an upper limit cut off for thyroid-stimulating hormone of 2.5mU/L the prevalence of SCH was 19.64%. The overall prevalence of TPOAb was 9.11%; this was 7.98% in euthyroid women. Finally, there were no significant differences in LB between euthyroid women and women with SCH.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):