Thyroid and Fertility: Recent Advances. Thyroid : official journal of the American Thyroid Association Dosiou, C. 2020


BACKGROUND: Thyroid disease is quite prevalent in women of reproductive age, while infertility is common in women with thyroid dysfunction. In this study we will review the recent advances in the field of thyroid and fertility since the publication of the 2017 American Thyroid Association (ATA) pregnancy guidelines.SUMMARY: Recent studies have confirmed associations of thyroid-stimulating hormone (TSH) elevation and/or thyroid autoimmunity with infertility and low ovarian reserve in subsets of women and have led to a better understanding of the pathogenesis linking thyroid autoimmunity with infertility. Even though the benefit of treating patients with TSH > 4 mIU/L has been confirmed in a large retrospective cohort study, two large randomized controlled trials have failed to show benefit of thyroid hormone on obstetrical outcomes in euthyroid women with thyroid autoimmunity. New data have emerged regarding the potential gonadal toxicity of radioactive iodine (RAI), based on its impact on ovarian reserve and sperm chromosomal abnormalities.CONCLUSIONS: There is continued evidence supporting an important role of thyroid hormone on regulation of reproductive tissues, at many levels. Recent randomized trials have failed to identify a benefit of thyroid hormone in euthyroid women with thyroid autoimmunity. Further research in the field is needed to more completely delineate the relevant pathways and identify women who may benefit from levothyroxine treatment. The impact of RAI on fertility also merits further investigation.

View details for DOI 10.1089/thy.2019.0382

View details for PubMedID 31903865