Infertility and pregnancy loss in euthyroid women with thyroid autoimmunity

Abstract

Thyroid autoimmunity is the most prevalent autoimmune state that affects up to 5-20% of women during the age of fertility. Prevalence of thyroid autoimmunity is significantly higher among infertile women, especially when the cause of infertility is endometriosis or polycystic ovary syndrome. Presence of thyroid autoimmunity does not interfere with normal embryo implantation and have been observed comparable pregnancy rates after assisted reproduction techniques in patients with or without thyroid autoimmunity. Instead, the risk of early miscarriage is substantially raised with the presence of thyroid autoimmunity, even if there was a condition of euthyroidism before pregnancy. Furthermore the controlled ovarian hyperstimulation, used as preparation for assisted reproduction techniques, can severely impair thyroid function increasing circulating estrogen levels. Systematic screening for thyroid disorders in women with a female cause of infertility is controversial but might be important to detect thyroid autoimmunity before to use assisted reproduction techniques and to follow-up these parameters in these patients after controlled ovarian hyperstimulation and during pregnancy.

Thyroid disorders and fertility

“…Abnormal immune response effects release of cytokines such as interferon-γ, IL-4 and IL-10 and at the same time prevents successful implantation by altering profile of endometrial T-cells. 41 It's known that ATA and some causes of infertility are related. In particular, there are studies reporting a significant and high correlation between ATA and endometriosis.…”

Antithyroid Peroxidase Antibodies in Women with Polycystic Ovary Syndrome

“…Its close association with insulin resistance and thyroid disorders has led to a recent boon in the research and literature in this field. Autoimmune thyroid diseases (AITD) are common autoimmune disorders that affect 5-20 % of women in childbearing age [4]. AITD is the most frequent cause of hypothyroidism in young women and it may present without thyroid dysfunction for many years; hence, it is often ignored and results in hypothyroidism later in life [5].…”

Thyroid disorders in adolescent girls with polycystic ovary syndrome

“…Jak podają dane, aż 5-20% młodych kobiet może cierpieć na tę jednostkę chorobową [7]. Pomimo zidentyfikowania wielu czynników genetycznych oraz środowiskowych, będących mechanizmami spustowymi choroby, ich powiązania oraz interakcje nie są jednak wyjaśnione [8].…”