Thyroid autoimmunity and miscarriage

Abstract

The relation of thyroid autoimmunity to miscarriage is an important issue that has attracted the interest of many investigators. A number of papers have been published so far, which include healthy women, women with recurrent miscarriage and those undergoing assisted reproductive techniques. Most studies have shown a significant positive association between the presence of thyroid autoantibodies and miscarriage rate. It is of interest that women with high titers do not show a higher miscarriage rate when compared with women having low titers, although, there is no general agreement on this issue. There are three possible explanations for the assumed association of thyroid autoimmunity with miscarriage: 1) pregnancy loss is an epiphenomenon and not a direct effect of the thyroid autoantibodies, the presence of thyroid autoantibodies reflecting a generalized activation of the immune system; 2) delayed conception from the presence of thyroid autoantibodies; hence, when women with thyroid autoimmunity become pregnant, face a higher risk of miscarriage because of older age; and 3) the pregnancy loss is secondary to a subtle deficiency in thyroid hormone concentrations or a lower capacity of the thyroid to adequately adapt to the demands of pregnancy.

Thyroid Function and Human Reproductive Health

“…Taken together, however, most studies showed an increased prevalence of AITD among women attending infertility clinics (183,184). Some outstanding features of these studies are summarized below.…”

The influence of visual impairment on pregnancy outcomes

“…There are autoimmune diseases that can have an adverse effect on pregnancy and perinatal outcome, including recurrent spontaneous miscarriages, premature deliveries, and perinatal mortality [7][8][9]. Systemic lupus erythematosus (SLE) is association with perinatal morbidity and mortality [10].…”

Thrombophilia and Recurrent Pregnancy Loss : Is Heparin Still the Drug of Choice ? = أهبة التخثر و فقدان الحمل المتكرر : هل الهيبارين لايزال العلاج المفضل ؟

“…10,11 When investigating patients with RPL, it is very important to exclude other possible causes of the losses, such as uterine malformation; diabetes mellitus; connective tissue diseases such as systemic lupus erythematosus (SLE); chromosomal abnormalities, and thyroid dysfunction. [12][13][14][15] Currently, many clinicians treat RPL-either associated with all types of thrombophilia or unexplained-with low-molecular-weight heparin (LMWH) combined with low-dose aspirin (LDA). This treatment became popular in the late 1990s, after Sanson et al reported that thrombophilia is associated with the high risk of fetal loss in early and late pregnancy.…”