关于在不孕症患者中治疗亚临床甲状腺功能低下症的最新情况
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Updated: May 9, 2025

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Fertility Preservation in Patients with Severe Ovarian Dysfunction
Published on: March 25, 2021
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Arielle S Yeshua1, Benjamin S Harris1, Alexander M Quaas2
1Shady Grove Fertility - Jones Institute at Eastern Virginia Medical School (EVMS), Norfolk, Virginia.
Current opinion in obstetrics & gynecology
|April 30, 2025
概括
目前的证据不支持在不孕妇女中对亚临床甲状腺功能低下症 (SCH) 的普遍查或治疗. 更新的指导方针建议根据个体风险因素进行选择性查,而不是进行例行管理.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 甲状腺学 甲状腺学
- 临床指南 临床指南
背景情况:
- 亚临床甲状腺功能低下症 (SCH) 曾在不孕症管理中被考虑.
- 最近的指南更新需要重新评估SCH查和治疗方案.
- 关键的随机对照试验被排除在外,促使推方法发生了转变.
研究的目的:
- 审查和分析最近关于不孕妇女亚临床甲状腺功能障碍症的指南更新.
- 检查排除关键随机对照试验对SCH管理建议的影响.
- 为SCH和不孕症之间的关联提供一个最新的视角.
主要方法:
- 对最近的指导方针更新进行文献综述.
- 关于SCH和不孕不育的证据分析.
- 随机对照试验和元分析的评估.
主要成果:
- 缺乏足够的数据将亚临床甲状腺功能低下与不孕症联系起来.
- 对SCH的Levothyroxine治疗不会改善怀孕结果或减少怀孕流产.
- SCH与流产风险的增加没有显著关联.
- 不建议在不孕妇女中进行甲状腺抗体的常规查.
结论:
- 目前的证据不支持普遍查或治疗不育妇女的SCH.
- 更新的指导方针提倡根据特定的风险因素对SCH进行选择性查.
- 建议在不育人群中采用个性化的方法,而不是在SCH的常规管理中采用个性化的方法.
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