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Study question Does Preconception TSH levels affect the clinical outcomes of Infertile Women Undergoing Fresh Embryo Transfer Cycle? Summary answer Among euthyroid patients, preconceptional TSH values in the high-normal range (between 2.5 and 4.0 mIU/L) are associated with adverse clinical outcomes. What is known already Serum thyroid-stimulating hormone (TSH) levels are routinely screened in women with infertility given the negative impact of thyroid disease on ovarian function and pregnancy is associated with poor outcomes.In fact, an underlying thyroid abnormality was found in 46% for women experiencing IVF failure and TSH levels were inversely proportional to the fertilization rate at IVF. While it is clear that pregnancies complicated by subclinical hypothyroidism in the fertile population have poor outcomes, the relevance of preconception subclinical hypothyroidism in infertile patients undergoing ART has not been thoroughly examined. Study design, size, duration Outcomes of all fresh IVF patients with an embryo transfer from from January 2019 to August 2021 within 1 yr of TSH screening at a our center were studied. IVF cycles using donor oocyte, TESE sperm, PGT, or those lacking follow-up were excluded. For patients with more than one Preconception TSH measurement prior IVF, the most recent measurement before the IVF cycle was used. Participants/materials, setting, methods Cycles were categorized into two groups based on preconceptional TSH values: Euthyroid (0.4–2.5 μIU/mL), subclinical hypothyroidism (>2.5-4.0 μIU/mL). All women underwent standard IVF protocols following usual individualized practice in our IVF clinic. Chi-square test was used to evaluate the differences between the patient cohorts. Main results and the role of chance A total of 2,669 fresh-ET cycles were reviewed retrospectively by dividing them into a euthyroid group (0.4-2.5 uIU/mL, n = 2397) and subclinical hypothyroidism group (2.5-4.0 uIU/mL, n=272). The overall biochemical pregnancy rate and clinical pregnancy rate was significantly lower in women with subclinical hypothyroidism (50.0% vs 43.4%, 40.0% vs 30.9%, p Limitations, reasons for caution This is a retrospective study and results must be confirmed on a well-designed randomized controlled study. Correlations must be considered with caution since the role of TSH is under study, especially when considering LBR outcome. Wider implications of the findings Among euthyroid patients, preconceptional TSH values in the high-normal range (between 2.5 and 4.0 mIU/L) are associated with adverse clinical outcomes. Our findings suggest that subclinical hypothyroidism may affect clinical outcomes. Trial registration number not applicable

Purpose: Left ventricular hypertrophy (LVH) is an independent risk factor for morbidity and mortality in patients with end stage renal disease. This study aimed to evaluate pattern of LV remodeling according to dialysis modality in patients with end stage renal disease. Methods: We retrospectively evaluated change in LV mass index (LVMI), relative wall thickness (RWT) and LV geometry, assessed by 2D transthoracic echocardiography, in patients starting dialysis while hospitalized from 2000 to 2012. Patients were classified into hemodialysis (HD) group and peritoneal dialysis (PD) group. Follow-up duration of performing echocardiogram was 11.6±4.5 months. LV geometry was divided into 4 groups as normal LV geometry, concentric remodeling, concentric LVH and eccentric LVH according to LVMI and RWT using cutoff values of 131 (men) or 100 (women) g/m2 for LVMI and 0.45 for RWT, both men and women. The multivariate analysis was performed to evaluate the independent predictors of change in LV geometry among the patients who showed the change of LV geometry. Results: 74 patients with HD (age 54.9±13.0 years, 50.0% male) and 34 patients with PD (age 48±15.1 years, 58.8% male) were enrolled. Before initiation of dialysis, there were no significant difference of ejection fraction, LVMI, RWT (56.1±14.0% vs. 55.8±14.2%, p=0.898; 169.0±47.9g/m2 vs. 168.5±57.3g/m2, p=0.964; 0.46±0.1 vs. 0.46±0.1, p=0.937, respectively). There was no difference of geometry distribution between two groups (4.1% vs. 5.9% concentric remodeling, 51.4% vs. 50.0% concentric LVH, 37.8% vs. 32.4% eccentric LVH, respectively). Follow-up echocardiogram revealed that LVMI and RWT in both groups were not significantly different (166.4±44.4g/m2 vs. 154.5±49.0g/m2, p=0.221; 0.47±0.10 vs. 0.48±0.12, p=0.287). LVMI and RWT showed no significant difference over time in both groups (p=0.63 vs. p=0.22; p=0.31 vs. 0.93, respectively). However, the geometric change of LV was significantly different between two groups. Change to eccentric LVH from the other LV geometries was significantly higher in PD group (37.8% vs. 87.5%, p=0.001, Odds ratio [OR] 11.5, 95% Confidence interval [CI] 2.3-58.3). Change to concentric LVH from the other geometries was not significantly different. PD was associated with increase of LVMI (OR 2.88 95% CI 0.86-9.96). HD was associated with reduction of LVMI (OR 1.89 95% CI 0.94-3.97). Conclusion: Otherwise there was no difference in prevalence of LV geometry pattern at the time of initiating dialysis, PD was an independent predictor for LVMI increment and HD was an independent predictor for LVMI reduction.

and 26 out of 84 (31%) mucosal remission defined as SES CD = 0 points. 2 out of 45 (4%) pts in Group I and 2 out of 39 pts (5%) in Group II had loss of clinical response at Week 54 (non significant NS). The increase/change of maintenance therapy was necessary in 13 out of 45 pts (29%) in Group I and 11 out of 39 (28%) in Group II (NS). Mucosal deterioration (increase of SES CD score) was found in 13 out of 45 pts in Group I (29%) and 11 out of 39 pts in Group II (28%) (NS). Conclusions: Both regimens of infliximab maintenance therapy with and without concomitant immunomodulator are equally efficient in the clinical and endoskcopic response rate in children with moderate to severe active CD.