Thyroid disorders and fertility

Karaca, Nilay; Akpak, Yaşam Kemal

doi:10.18203/2320-6012.ijrms20150135

Cited by 11 publications

(9 citation statements)

References 49 publications

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“…Thyroid dysfunction in pregnant women can affect both mother and her fetus throughout pregnancy. This condition is associated with higher prevalence of abortions, still births, maternal anemia, pregnancy-induced hypertension, postpartum hemorrhage, preterm labor, fetal distress, low birth weight, and neuropsychological impairment ( Hallengren, Lantz, Andreasson, & Grennert, 2009 ; Karaca & Akpak, 2015 ; LaFranchi, Haddow, & Hollowell, 2005 ; Wasserstrum & Anania, 1995 ). However, it has been documented that if maternal hypothyroidism is managed appropriately, it will have no side effect on maternal or developing fetus throughout the pregnancy ( Tan, Cheng, & Caughey, 2006 ; L. Yassa, E. Marqusee, R. Fawcett, & E. K. Alexander, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

Levothyroxine Dosage Requirement During Pregnancy in Well-Controlled Hypothyroid Women: A Longitudinal Study

Kashi¹,

Aydınlı²,

Akha³

et al. 2015

GJHS

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Background:Untreated maternal hypothyroidism can have adverse effects on both the mother and fetus, but it can potentially be prevented by adequate levothyroxine replacement. This study was conducted to determine what percentage of hypothyroid pregnant women who were taking levothyroxine needed to adjust their medication dosage, and when and how much it should be increased.Methods:In this longitudinal study, 81 well-controlled hypothyroid women (TSH≤ 2.5 mIU/L) were monitored throughout pregnancy. Thyroid function tests were performed before conception, after the first missed menstrual period, in the second and third trimesters of pregnancy and one month after delivery. Levothyroxine dosage was adjusted according to TSH levels measured.Results:Of the 81 pregnancies studied, the pregnancy outcomes were 74 full-term births, six abortions and one pre-term birth. The levothyroxine dosage needed to be increased in 84% (CI95%= 74-90) of the pregnancies (OR=5.2, CI95%= 2.9-9.4). Most levothyroxine dose adjustments were made in the first trimester of gestation. The levothyroxine requirement increased 50% (CI95%= 41-59) in the first trimester, 55% (CI95%= 45-64) in the second trimester and 62% (CI95%= 52-72) in the third trimester. Levothyroxine dosage was decreased for 6 cases (7.4%), and no adjustment was made for 7 women (8.6%).Conclusions:Increases in levothyroxine dosage administered in pregnancy appear to be indispensible in the majority of patients with well-controlled hypothyroidism, especially in the first trimester. However, this change was not universal and levothyroxine dosage decreased in a few cases and remained unchanged in others.

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Section: Introductionmentioning

confidence: 99%

Levothyroxine Dosage Requirement During Pregnancy in Well-Controlled Hypothyroid Women: A Longitudinal Study

Kashi¹,

Aydınlı²,

Akha³

et al. 2015

GJHS

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“…The results are: menstrual abnormalities, infertility, increased incidence of spontaneous abortions and complications, related to a future pregnancy. 12,13 During pregnancy thyroid dysfunction leads to several complications including preeclampsia, prematurity and intellectual impairment in the offspring. 14 It is crucial that patients with proven hypothyroidism (as is the case with our patient) have frequent thyroid hormone control and adequate dose titration of levothyroxine in order to maintain the recommended targets for pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Polyglandular Syndrome Type 2 and Pregnancy

Yanachkova¹,

Chaveeva²,

Staynova³

et al. 2020

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Autoimmune polyglandular syndromes are combinations of various endocrine and nonendocrine autoimmune diseases, as well as the presence of elevated organ-specific antibody titers. We present a clinical case of a 41-year-old pregnant patient with type 2 autoimmune polyglandular syndrome, combining Addison’s disease, Hashimoto’s thyroiditis and hypogonadism. The pregnancy was achieved after the use of assisted reproductive technology. During the pregnancy the patient was strictly monitored. Glucocorticoid and mineralocorticoid replacement therapy was adjusted according to the electrolyte profile and general condition of the patient. Management during pregnancy was difficult due to fluctuations in electrolyte levels, thyroid hormones and orthostatic manifestations. Prior to delivery adrenal crisis occurred, but the condition was successfully managed. No complications were reported for the mother and the newborn.

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“…The metabolic clearance of estrone and androstenedione may get reduced and aromatization of peripheral estrogen may get increased [66,67]. The receptor-mediated action of estrogen gets reduced due to inhibition in binding activity of estrogen with its receptor by hypothyroidism [68]. A variety of dysfunctions which are adversely manipulated by hypothyroidism are menstrual irregularities, recurrent (higher) miscarriage rates, altered ovarian function and subfertility [69].…”

Section: Effect Of Thyroid Disorder On Estrogen Depletionmentioning

confidence: 99%

A Review: Mechanistic Insights Into the Effect of Thyroid Disorders on Estrogen Level and Bone Mineral Density

Joshi

Bisht

Singh

2019

Int J Pharm Pharm Sci

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Thyroid hormone serves as an indispensable component for the optimum functioning of various biological systems. They curb body’s metabolism, regulates the estrogen level, regulates bone turnover, essential for skeletal development and mineralization. Within the scope of knowledge, it is intimately familiar that thyroid disorders have widespread systemic manifestations, among which in hypothyroidism, even though elevated TSH (thyroid-stimulating hormone) may reduce estrogen level which in turn stimulates osteoclasts and thus cause osteoporosis, while hyperthyroidism accelerates bone turnover. Hypothyroidism does not directly interfere with the skeletal integrity, but treatment with levothyroxine for the suppression of TSH to bring the hypothyroid patient to euthyroid state for a long haul; lead to simultaneous reduction in bone mass and in (bone mineral density) BMD. After the initial relevation of the correlation between thyroid disorders and osteoporosis in numerous studies have emphasized that both hypo and hyperthyroidism either directly or indirectly affects the bone mineral density or leads to the progression of osteoporosis. Therefore the present study is aimed and so designed to review all the possible associations between them and the impact of thyroid disorders on estrogen level and bone mineral density. The main findings of this review indicate that both excesses as well as deficiency of thyroid hormone can be potentially deleterious for bone tissue.

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Thyroid disorders and fertility

Cited by 11 publications

References 49 publications

Levothyroxine Dosage Requirement During Pregnancy in Well-Controlled Hypothyroid Women: A Longitudinal Study

Levothyroxine Dosage Requirement During Pregnancy in Well-Controlled Hypothyroid Women: A Longitudinal Study

Autoimmune Polyglandular Syndrome Type 2 and Pregnancy

A Review: Mechanistic Insights Into the Effect of Thyroid Disorders on Estrogen Level and Bone Mineral Density

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