Subclinical hypothyroidism in the infertile female population: a guideline

doi:10.1016/j.fertnstert.2023.12.038

Cited by 2 publications

(6 citation statements)

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“…Demographic information is presented in Table 1 values for pregnant and nonpregnant patients. When no reference range is available, a TSH of 4.12 mIU/L can be used as the upper limit of normal for nonpregnant patients; the limit should be reduced by 0.5 mIU/L for pregnant patients in the fi rst trimester [3].…”

Section: Resultsmentioning

confidence: 99%

“…It remains controversial whether subclinical hypothyroidism has an impact on conception and pregnancy outcomes. Treatment recommendations for SCH in a preconception period and early pregnancy vary between different professional societies [3,5,11]. In accordance with the 2015 ASRM guidelines, our clinical practice had been to test TSH in infertile women and women with recurrent pregnancy loss attempting pregnancy and to consider treatment for SCH in the preconception period and the fi rst trimester until the recent release of the updated ASRM guidelines in 2024 [2,3].…”

Section: Resultsmentioning

confidence: 99%

“…Treatment recommendations for SCH in a preconception period and early pregnancy vary between different professional societies [3,5,11]. In accordance with the 2015 ASRM guidelines, our clinical practice had been to test TSH in infertile women and women with recurrent pregnancy loss attempting pregnancy and to consider treatment for SCH in the preconception period and the fi rst trimester until the recent release of the updated ASRM guidelines in 2024 [2,3]. After reviewing available data on the role of SCH in reproduction, ASRM concluded that SCH had not been associated with an increased risk of miscarriage, adverse obstetric outcomes, and suboptimal neurodevelopment in the offspring; thus, maternal thyroid function should not be routinely checked [3,12].…”

Section: Resultsmentioning

confidence: 99%

“…In accordance with the 2015 ASRM guidelines, our clinical practice had been to test TSH in infertile women and women with recurrent pregnancy loss attempting pregnancy and to consider treatment for SCH in the preconception period and the fi rst trimester until the recent release of the updated ASRM guidelines in 2024 [2,3]. After reviewing available data on the role of SCH in reproduction, ASRM concluded that SCH had not been associated with an increased risk of miscarriage, adverse obstetric outcomes, and suboptimal neurodevelopment in the offspring; thus, maternal thyroid function should not be routinely checked [3,12]. Per the updated ASRM guidelines, SCH should not be treated with levothyroxine in a preconception period and early pregnancy with the goal of reducing the risk for pregnancy loss or improving life-birth outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…The guidelines on the defi nition, screening, and treatment of Subclinical Hypothyroidism (SCH) have been evolving over time based on available evidence [2,3]. Furthermore, the challenge of managing SCH in infertility and early pregnancy lies in frequently suboptimal patient understanding of the condition Citation: Navitski A, Joseph R, Riedel A, Kennedy K, Reinhardt C, Gavrilova-Jordan L. (2024) Patient education about subclinical hypothyroidism in preconception and early pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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Patient education about subclinical hypothyroidism in preconception and early pregnancy

Anastasia,

Rebecca,

Alexandria

et al. 2024

Open J Thyroid Res

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Introduction: The diagnosis and treatment of Subclinical Hypothyroidism (SCH) in preconception and early pregnancy has been an area of debate. The challenge of managing SCH further lies in often suboptimal patient understanding of the condition given its asymptomatic state. This study aimed to assess whether patient education materials could improve patient knowledge about SCH and encourage compliance with clinical management. Furthermore, we reviewed the current recommendations for the diagnosis and treatment of SCH in preconception and pregnancy. Methods: Patients who presented to the Reproductive Medicine and Infertility Clinic, Augusta University, Georgia, USA between July 2023 and February 2024, who were attempting to conceive or in early pregnancy, and who met the SCH diagnostic criteria were invited to participate in this prospective cohort study. The study participants completed a pre-education and demographic questionnaire, underwent a brief consultation with a provider who reviewed the SCH information sheet, and then completed the post-education questions. Paired Wilcoxon rank-sum tests of significance were used to evaluate the change in pre- and post-education scores. Results: Thirteen patients completed the survey. There was a range of pre-existing knowledge about SCH in our study population. Most patients acquired knowledge about SCH diagnosis (Q1: P = 0.013) during the counseling. Patient education improved their attitudes about the treatment of SCH with levothyroxine (Q3: P = 0.029). Conclusion: While the clinical guidelines on diagnosis and treatment of SCH in preconception and early pregnancy continue to evolve as more research becomes available, patient education can significantly improve their knowledge about the condition and encourage compliance with treatment if indicated.

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Section: Resultsmentioning

confidence: 99%