Prediction of early pregnancy maternal thyroid impairment in women affected with unexplained recurrent miscarriage

Abstract

A transient impairment of thyroid function in early pregnancy may cause an inadequate adaptation to the increased thyroid requirement and may be implicated in RM. The evaluation of the proposed iTSHa index, if validated in a larger cohort of patients, may provide information useful to identifying a subset of healthy women, without evidence of thyroid dysfunction or autoimmunity and a TSH in the low-normal reference range, who may be at risk of RM.

Peripheral blood natural killer cells and mild thyroid abnormalities in women with reproductive failure

“…This may be related to the use of both the cutoff of 2.5 mIU/L for normal basal TSH and the TRH stimulation test to define SCH in our study groups. 21,22 Differently from other authors, we reported a similar frequency of TAI between the infertile and the RSA women as well as between the women with primary and secondary RSA. 33 Moreover, we found the same prevalence of TAI in infertile/RSA women and in controls suggesting that this autoimmune condition is not strictly associated with a poor pregnancy outcome in our study population.…”

“…Taken together, these data may suggest that SCH may represent not only an element potentially responsible for the poor pregnancy outcome, but also a marker of preexisting immune abnormalities which can participate to the pathologic condition in a manner that they can be the cause or the consequence of a thyroid impairment. 21,23,29,30,34,44 In this context, the TRH stimulation test, by highlighting the latent capacity of the pituitary gland to respond to exogenous TRH, can improve both the assessment of the thyroid function and the management of the pregnancy impairment in women with unexplained reproductive failure. 21,34 As a remark, we reported very few patients with positive ANA titer in our study population.…”

“…21,23,29,30,34,44 In this context, the TRH stimulation test, by highlighting the latent capacity of the pituitary gland to respond to exogenous TRH, can improve both the assessment of the thyroid function and the management of the pregnancy impairment in women with unexplained reproductive failure. 21,34 As a remark, we reported very few patients with positive ANA titer in our study population. All of them were RSA women and they showed a similar prevalence of positive ANA titer in both the groups with and without TAI, confirming the poor association reported in the literature between TAI and ANA in women with unexplained reproductive failure.…”

“…Thyroid disorders can be associated with infertility/RSA and the morbidity of pregnancies. [19][20][21] It is reported that mild thyroid abnormalities are associated with an increased rate of miscarriage and this poor obstetrical prognosis seems to be related to an impaired thyroid adaptation to pregnancy. 22 Subclinical hypothyroidism (SCH) of the mother may impair the course of pregnancy and may disturb the normal development of the fetus.…”

“…22 Subclinical hypothyroidism (SCH) of the mother may impair the course of pregnancy and may disturb the normal development of the fetus. [19][20][21] Moreover, it has been reported that the presence of thyroid autoimmunity (TAI) leads to an increased risk of infertility and RSA even in the absence of clinically overt hypothyroidism. [23][24][25][26] Abnormalities in number and activation of NK cells have been related to RSA and several studies aimed at addressing the cutoff values for peripheral blood NK cell levels in this context.…”