Thyroid disorders in subfertility and early pregnancy

Area of Science:

• Endocrinology
• Reproductive Medicine
• Obstetrics

Background:

• Thyroid dysfunction is common in pregnancy, impacting both maternal and fetal well-being.
• Thyroid autoimmunity, indicated by anti-thyroid antibodies, correlates with increased miscarriage risk.
• Pregnancy significantly alters thyroid physiology, requiring clinical awareness.

Purpose of the Study:

• To review current knowledge on thyroid disorders in pregnancy and subfertility.
• To summarize clinical guidance for managing thyroid dysfunction in pregnant women, especially those with assisted reproduction.
• To highlight the implications of hypothyroidism for mother and baby.

Main Methods:

• Literature review of current knowledge and international guidelines.
• Analysis of key clinical trials on hypothyroidism and thyroid hormone use.
• Synthesis of information on thyroid physiology changes during pregnancy.

Main Results:

• Existing guidelines for thyroxine use and thyroid function targets are largely based on expert opinion.
• Clinical trials have improved understanding of hypothyroidism consequences and treatment effectiveness.
• Thyroid autoimmunity is linked to miscarriage, though mechanisms require further elucidation.

Conclusions:

• Effective management of thyroid disorders in pregnancy requires understanding physiological changes and current evidence.
• Further research is needed to establish evidence-based practices for thyroid dysfunction in pregnancy and subfertility.
• Clinicians must be aware of the risks associated with thyroid autoimmunity and hypothyroidism during pregnancy.