The role of thyroid function in female and male infertility: a narrative review

Abstract

Purpose We herein aimed to review the new insights into the impact of impaired thyroid function on male and female fertility, spacing from spontaneous pregnancy to ART, with the objective of providing an updated narrative revision of the literature. Methods This narrative review was performed for all available prospective, retrospective and review articles, published up to 2021 in PubMed. Data were extracted from the text and from the tables of the manuscript. Results Thyroid dysfunction is frequently associated with female infertility, whereas its link with male infertility is debated. Female wise, impaired function is detrimental to obstetric and fetal outcomes both in spontaneous pregnancies and in those achieved thanks to assisted reproduction technologies (ART). Furthermore, the reference range of TSH in natural pregnancy and ART procedures has recently become a matter of debate following recent reports in this field. On the other hand, the impact of thyroid function on the male reproductive system is less clear, although a possible role is suggested via modulation of Sertoli and Leydig cells function and spermatogenesis. Conclusion Thyroid function should be carefully monitored in both male and female, in couples seeking spontaneous pregnancy as well as ART, as treatment is generally immediate and likely to improve chances of success.

Leveraging Electronic Medical Records from Two Hospital Systems Identifies Male Infertility Associated Comorbidities Across Time

“…Thyroid dysfunction, including hypothyroidism, may adversely affect female and male fertility, though this has been less established for MI. 29 Rodent studies suggest that hypothyroidism may affect spermatogenesis. 30 Consistent with this, a few small studies in humans suggest that hypothyroidism may be associated with compromised sperm quality, including increased abnormal morphology, decreased volume, and decreased motility.…”

“…30,35 Hypothyroidism has been hypothesized to decrease sperm quality through the dysregulation of Sertoli cell differentiation, leading to their overproliferation and a delay in sperm maturation. 29 Additionally, hypothyroidism may potentially lead to dysregulated androgen hormone levels due to compromised Leydig cell function. 29 However, studies on the effect of hypothyroidism on MI are inconclusive, particularly in humans.…”

Male factor infertility and assisted reproductive technologies: indications, minimum access criteria and outcomes

“…cortisone treatment) [ 50 ], sexual/ejaculatory dysfunctions [ 51 , 52 ], as well as other endocrine dysfunction (i.e. thyroid or adrenal dysfunctions) [ 53 , 54 ], are therefore encouraged. In this regard, for instance, Duca et al showed that in a setting of 320 couples candidates for IVF, whose female partner was younger than 35 years, a "treatable" male factor was noticed in 56% of cases (i.e., OAT with FSH values < 8 mIU/ml, or leukocytospermia/urogenital infections not treated with antibiotic/anti-inflammatory or without eradication, severe varicocele).…”

Female Autoimmune Disorders with Infertility: A Narrative Review

“…ATA (anti-thyroglobulin and thyroid peroxidase antibodies) have been present in healthy females and are more frequent in those of reproductive (childbearing age) [17]. ATA accounted for 16%-20% of typical pregnant females and ladies undergoing assisted reproductive techniques (ARTs) compared to 20%-24% in females with recurrent pregnancy loss [32] and 45% of pregnant females with hypothyroidism [40].…”