TSH has been suggested to be involved in reproductive challenges such as ovulatory issues, infertility, miscarriage, and maternal complications for many years.

Multiple studies have associated thyroid function with ovarian function and reproductive physiology. The thyroid hormone can impact follicle development, as well as the metabolism of estrogen and androgen, the menstrual cycle, and the receptivity of the endometrium

In a region with adequate iodine levels, a TSH threshold of 4.12 mIU/L should be regarded as the upper limit of normal. The Chinese Society for Reproductive Medicine suggests that infertile women and those trying to conceive should consider a TSH level between 4-4.5 mIU/L for subclinical hypothyroidism.

Hence, it is recommended that women aiming for in vitro fertilization (IVF) should have a TSH level of 4 mIU/L or lower. Studies have shown that infertile patients with untreated TSH levels >2.5 mIU/L before IVF/intracytoplasmic sperm injection (ICSI) had better pregnancy results when their TSH levels were <2.5 mIU/L compared to those with TSH >2.5 mIU/L.

In this study the aim was to Examine the clinical characteristics and results in infertile individuals with varying thyroid stimulating hormone (TSH) levels during ICSI, and determining which TSH levels cutoff impact the outcomes of ICSI or not.

Inclusion Criteria:

• Body mass index (BMI): women with BMI 18 : 30 kg/m2.
• Favorable (average) responders to IVF stimulation: Anti-mullirian hormone (AMH) level >1.0 ng/mL but <3.5 ng/mL and antral follicular count (AFC) 5-10.
• The embryos were transferred freshly or frozen .
• Medically free

Exclusion Criteria:

• Women with polycystic ovary syndrome (PCOS).
• Poor ovarian response.
• Severe teratoathenospermia.
• women with chronic disease

Infertile women attended at El Kasr Al Ainy IVF unit