High Prevalence of Infertility among Women with Graves’ Disease and Hashimoto’s Thyroiditis

Quintino‐Moro, Alessandra; Zantut-Wittmann, Denise Engelbrecht; Tambascia, Marcos Antônio; Machado, Helymar da Costa; Fernandes, Arlete

doi:10.1155/2014/982705

Cited by 43 publications

(36 citation statements)

References 16 publications

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“…Thyroid cancer incidence has been rising in recent years, and thyroid cancer is the most common cancer in women between the ages of 20 and 39 years (2). Infertility is also quite common in women with Graves' and Hashimoto's disease, affecting *50% of patients (3).…”

Section: Introductionmentioning

confidence: 99%

Thyroid and Fertility: Recent Advances

Dosiou

2020

Thyroid

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Background: Thyroid disease is prevalent in women of reproductive age, while infertility is common in women with thyroid dysfunction. In this study, we review the recent advances in the field of thyroid and fertility since the publication of the 2017 American Thyroid Association pregnancy guidelines. Summary: Recent studies have confirmed associations of thyrotropin (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 in 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.

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Section: Introductionmentioning

confidence: 99%

Thyroid and Fertility: Recent Advances

Dosiou

2020

Thyroid

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“…Assisted reproductive technology (ART) is a group of medical methods for treating the infertile human in which both male and female gametes are used outside the body to achieve pregnancy [1]. To date, approximately 5 million babies are born worldwide via ART [2].…”

Section: Introductionmentioning

confidence: 99%

Assisted reproductive technology and the risk of gestational diabetes mellitus: a systematic review and meta-analysis

Mohammadi

Morasae

Maroufizadeh

et al. 2020

Middle East Fertil Soc J

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Background: The use of assisted reproductive technology (ART) is increasing worldwide, and observational studies have indicated that women who conceived by ART have an increased risk of pregnancy complications including gestational diabetes mellitus (GDM). We aimed to determine the risk of GDM among women who conceived with ART by systematic review and meta-analysis. Main text: A systematic literature search was conducted in ISI Web of Knowledge, MEDLINE, Scopus, and Embase through May 2017 for English-language articles using a list of keywords. All studies comparing GDM in women conceived by ART and those who conceived spontaneously were included. Data extraction was performed by two authors independently and discrepancies were resolved by discussion. In total, 48 studies with 91,487 pregnancies conceived through ART and 2,525,234 spontaneously conceived met the inclusion criteria. There was evidence of substantial heterogeneity among these studies (P < 0.001, I 2 = 98.6%). Random effects meta-analysis showed a significant increase in GDM among those who conceived by ART compared with those who conceived spontaneously (pooled relative risk = 1.51, 95% confidence interval = 1.18-1.93). Visual inspection of the funnel plot did not reveal any publication bias, which was supported by Egger's test and Begg's test. Conclusion: The findings of this systematic review indicate that the use of ART treatment is associated with a 1.51fold increase in GDM. Women need to be counselled carefully before undergoing ART treatment about the possibility and risk of GDM.

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“…Over the last 30 years, it has become clear that thyroid autoimmunity, including Graves' disease, is correlated with a series of maternal and fetal risks during pregnancy and with female infertility [1][2][3][4][5][6][7][8]. Research has led to different proposals for acting on the target of thyroid autoimmunity.…”

Section: Introductionmentioning

confidence: 99%

Selenium supplementation in the management of thyroid autoimmunity during pregnancy: results of the “SERENA study”, a randomized, double-blind, placebo-controlled trial

et al. 2019

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Purpose Selenium is frequently in nutraceuticals for pregnancy, given its role on fertility and thyroid metabolism. However, most evidence rise from non-controlled studies. We aimed to evaluate the protective effect of selenium against thyroid autoimmunity during and after pregnancy. Methods A multicenter, randomized, double-blind, placebo-controlled trial was performed and promoted by the Young Italian Endocrinologists Group (EnGioI)-Italian Society of Endocrinology. Forty-five women with thyroiditis in pregnancy were enrolled and randomly assigned to L-selenomethionine (L-Se-Met) 83 mcg/day or placebo (PLB) and evaluated at 10 ± 2 (T1), 36 ± 2 weeks of gestation (T2) and 6 months after delivery (postpartum, PP). Results We measured a significant reduction of autoantibodies after pregnancy in L-Se-Met group [at PP: TgAb 19.86 (11.59-52.60), p < 0.01; TPOAb 255.00 (79.00-292.00), p < 0.01], and an antibodies titer's rebound in PLB group (TgAb 151.03 ± 182.9, p < 0.01; TPOAb 441.28 ± 512.18, p < 0.01). A significant increase in selenemia was measured in L-Se-Met group at T2 (91.33 ± 25.49; p < 0.01) and PP (93.55 ± 23.53; p = 0.02). Two miscarriage occurred in PLB. No differences were found in thyroid volume, echogenicity, quality of life, maternal/fetal complications. Conclusions SERENA study demonstrated a beneficial effect of L-Se-Met supplementation on autoantibody titer during pregnancy and on postpartum thyroiditis recurrence.

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High Prevalence of Infertility among Women with Graves’ Disease and Hashimoto’s Thyroiditis

Cited by 43 publications

References 16 publications

Thyroid and Fertility: Recent Advances

Thyroid and Fertility: Recent Advances

Assisted reproductive technology and the risk of gestational diabetes mellitus: a systematic review and meta-analysis

Selenium supplementation in the management of thyroid autoimmunity during pregnancy: results of the “SERENA study”, a randomized, double-blind, placebo-controlled trial

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