Positive effects of thyroid replacement therapy on assisted reproductive technology outcomes in women with subclinical hypothyroidism with positive thyroid peroxidase autoantibodies

Arora, Himanshu; Collazo, Ineabelle; Palmerola, Katherine L.; Parmar, Madhumita; Narasimman, Manish; Hendon, Nicholas; Eisermann, Juergen; Bustillo, María

doi:10.1016/j.xfre.2021.11.006

Cited by 2 publications

(1 citation statement)

References 37 publications

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“…Due to insufficient evidence, the ATA did not make any recommendations for or against levothyroxine therapy in infertile women with TPOAb-positive SCH seeking natural conception [2,60]. On the other hand, in patients undergoing artificial reproductive techniques, in vitro fertilization or intracytoplasmic sperm injection, evidence from RCT emphasize that LT4 therapy improves pregnancy and miscarriage rates in women with SCH, with or without autoimmunity [60][61][62][63][64][65]. Consequently, levothyroxine treatment is strongly recommended in order to maintain a TSH level <2.5 mU/L in these patients [2].…”

Section: Who and How To Treat?mentioning

confidence: 99%

Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity

et al. 2022

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Preconception counseling is an essential tool for preventing adverse pregnancy outcomes associated with thyroid dysfunction. The high prevalence of thyroid disease among women of reproductive age, and the increased risk of adverse pregnancy outcomes associated with thyroid dysfunction, emphasize the necessity for well-established screening and treatment criteria in the preconception period. We therefore conducted a literature review for relevant information on the screening, diagnosis and treatment of subclinical and overt hypothyroidism in women seeking pregnancy. While screening for thyroid disease is recommended only in the presence of risk factors, iodine supplementation should be recommended in most regions, with higher doses in areas with severe deficiency. Known hypothyroid women should be counseled about increasing their levothyroxine dose by 20–30% in the case of suspected or confirmed pregnancy (missed menstrual cycle or positive pregnancy test). Treating subclinical hypothyroidism appears to be beneficial, especially in the presence of autoimmunity or in patients undergoing artificial reproductive techniques. Regarding the management of TPOAb negative SCH women or euthyroid women with positive TPOAb, further research is necessary in order to make evidence-based recommendations.

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Section: Who and How To Treat?mentioning

confidence: 99%

Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity

et al. 2022

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2023 Revised Korean Thyroid Association Guidelines for the Diagnosis and Management of Thyroid Disease during Pregnancy and Postpartum

Ahn

Kim

et al. 2023

Int J Thyroidol

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Thyroid hormone plays an important role in the process of implantation of a fertilized egg in the endometrium, as well as in the division and development of the fertilized egg. In addition, maternal thyroid hormone is essential for the formation and development of the fetal brain, nervous system, and bones. Therefore, when maternal thyroid hormone is insufficient, complications such as miscarriage, stillbirth, low birth weight and preeclampsia increase. Guidelines for the diagnosis and treatment of thyroid dysfunction during pregnancy were established and published by the American Endocrine Society, the American Thyroid Association, and the European Thyroid Society. The Korean Thyroid Society also published recommendations for diagnosis and treatment of thyroid disease during pregnancy and postpartum in 2014. However, since the revised guidelines of the American Thyroid Association were published in 2017, many studies, including large-scale randomized controlled trials, have been published in relation to thyroid and pregnancy, and the need to revise the existing recommendations has emerged in Korea. The main revisions of this recommendation are changes in the normal range of TSH during pregnancy, detailed description of treatment policies according to pregnant women's autoantibodies and thyroid function status. Also, a description of the effect of thyroid autoantibodies on assisted reproductive procedures has been added.

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Positive effects of thyroid replacement therapy on assisted reproductive technology outcomes in women with subclinical hypothyroidism with positive thyroid peroxidase autoantibodies

Cited by 2 publications

References 37 publications

Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity

Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity

2023 Revised Korean Thyroid Association Guidelines for the Diagnosis and Management of Thyroid Disease during Pregnancy and Postpartum

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