Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity

Area of Science:

• Endocrinology
• Reproductive Medicine
• Women's Health

Background:

• Thyroid dysfunction is common in women of reproductive age.
• Thyroid dysfunction increases the risk of adverse pregnancy outcomes.
• Effective preconception screening and treatment are crucial.

Purpose of the Study:

• To review current literature on screening, diagnosis, and treatment of hypothyroidism in women planning pregnancy.
• To provide evidence-based recommendations for preconception thyroid management.

Main Methods:

• Literature review of studies on subclinical and overt hypothyroidism in women seeking pregnancy.
• Analysis of screening guidelines, diagnostic criteria, and treatment protocols.

Main Results:

• Thyroid screening is recommended for women with risk factors; iodine supplementation is widely advised.
• Known hypothyroid women should increase levothyroxine by 20-30% upon suspected or confirmed pregnancy.
• Treatment of subclinical hypothyroidism may benefit women with autoimmunity or undergoing ART.

Conclusions:

• Preconception counseling and management of thyroid dysfunction are vital for optimizing pregnancy outcomes.
• Further research is needed for evidence-based recommendations on TPOAb-positive euthyroid women and TPOAb-negative SCH management.