Thyroid autoimmunity and hypothyroidism before and during pregnancy

Area of Science:

• Endocrinology
• Reproductive Medicine
• Immunology

Background:

• Thyroid autoimmunity (TAI) and hypothyroidism are increasingly recognized as factors influencing reproductive health.
• The complex interplay between immune function, thyroid status, and fertility outcomes requires further elucidation.

Purpose of the Study:

• To review current knowledge on the relationship between TAI, hypothyroidism, and infertility in both females and males.
• To examine the impact of TAI and hypothyroidism on pregnancy outcomes, including pregnancy loss and maternal/fetal complications.
• To discuss the implications for offspring neurodevelopment.

Main Methods:

• Comprehensive literature review of studies investigating TAI, hypothyroidism, infertility, and pregnancy outcomes.
• Analysis of existing data on maternal thyroid function and fetal development.
• Synthesis of current concepts and clinical relevance.

Main Results:

• TAI may serve as a marker for immune abnormalities in unexplained female infertility, independent of thyroid function.
• TAI is associated with a significantly increased risk of miscarriage, although causality is not fully established.
• Maternal hypothyroidism and TAI increase risks for obstetric complications and adverse fetal neurodevelopment, including impaired brain development and lower IQ.

Conclusions:

• TAI is a significant factor in infertility and pregnancy loss.
• Systematic screening for TAI and hypothyroidism in early pregnancy is crucial for adequate management.
• Maternal thyroid dysfunction poses risks to fetal neurodevelopment, necessitating careful monitoring and treatment throughout gestation.