Thyroid autoimmunity and female infertility

Area of Science:

• Reproductive Endocrinology
• Immunology

Background:

• Thyroid autoimmunity (TAI) is more prevalent in infertile women, particularly those with endometriosis or polycystic ovarian syndrome.
• While TAI doesn't impede implantation or ART success rates, it elevates miscarriage risk in the first trimester, even with normal thyroid function pre-pregnancy.

Purpose of the Study:

• To investigate the impact of TAI on pregnancy outcomes in infertile women undergoing assisted reproductive technology (ART).
• To assess the influence of controlled ovarian hyperstimulation (COH) on thyroid function in women with TAI.
• To establish guidelines for thyroid function monitoring and management in infertile women with TAI.

Main Methods:

• Comparative analysis of pregnancy rates and outcomes in infertile women with and without TAI undergoing ART.
• Monitoring of thyroid function parameters before, during, and after COH and pregnancy in women with TAI.
• Review of existing literature on TAI, infertility, and pregnancy complications.

Main Results:

• TAI is significantly more common in infertile women compared to controls.
• Pregnant women with TAI face a higher risk of miscarriage, irrespective of pre-pregnancy thyroid status.
• Controlled ovarian hyperstimulation (COH) significantly affects thyroid function in women with TAI.

Conclusions:

• Infertile women should be screened for TAI and thyroid function evaluated before ART.
• Post-COH and during pregnancy, thyroid function requires close monitoring in women with TAI.
• Treatment with 1-thyroxine is advised for women with thyroid dysfunction during early gestation to prevent complications. Management of euthyroid women with TAI remains under investigation.