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Objective: Unexplained infertility affects nearly one‐third of infertile couples. Women with unexplained infertility are more likely to have a high‐normal thyroid‐stimulating hormone level (TSH: 2.5–5 mIU/L) compared to women with severe male factor infertility. Practice guidelines vary on whether treatment should be initiated for TSH levels >2.5 mIU/L in women attempting conception because the effects of treating a high‐normal TSH level with levothyroxine are not known. We evaluated conception and live birth rates in women with unexplained infertility and high‐normal TSH levels. Design, Patients and Measurements: Retrospective study including 96 women evaluated for unexplained infertility at a large academic medical centre between 1 January 2000 and 30 June 2017 with high‐normal TSH (TSH: 2.5–5 mIU/L and within the normal range of the assay) who were prescribed (n = 31) or not prescribed (n = 65) levothyroxine. Conception and live birth rates were assessed. Results: The conception rate in the levothyroxine group was 100% compared to 90% in the untreated group (p =.086 unadjusted; p <.05 adjusted for age; p =.370 adjusted for TSH; p =.287 adjusted for age and TSH). The live birth rate was lower in the levothyroxine group (63%) compared to the untreated group (84%) (p =.05 unadjusted; p =.094 adjusted for age; p =.035 adjusted for TSH; p =.057 adjusted for age and TSH). Conclusions: Women with unexplained infertility and high‐normal TSH levels treated with levothyroxine had a higher rate of conception but lower live birth rate compared to untreated women, with the limitation of a small sample size. These findings assert the need for prospective, randomized studies to determine whether treatment with levothyroxine in women with unexplained infertility and high‐normal TSH is beneficial. [ABSTRACT FROM AUTHOR]

Background Organ donation after cardiac death (DCD) is not optimal but still remains a valuable source of organ donation in trauma donors. The aim of this study was to assess national trends in DCD from trauma patients. Methods A 12-year (2002 to 2013) retrospective analysis of the United Network for Organ Sharing database was performed. Outcome measures were the following: proportion of DCD donors over the years and number and type of solid organs donated. Results DCD resulted in procurement of 16,248 solid organs from 8,724 donors. The number of organs donated per donor remained unchanged over the study period (P = .1). DCD increased significantly from 3.1% in 2002 to 14.6% in 2013 (P = .001). There was a significant increase in the proportion of kidney (2002: 3.4% vs 2013: 16.3%, P = .001) and liver (2002: 1.6% vs 2013: 5%, P = .041) donation among DCD donors over the study period. Conclusions DCD from trauma donors provides a significant source of solid organs. The proportion of DCD donors increased significantly over the last 12 years. [ABSTRACT FROM AUTHOR]