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Updated: Feb 5, 2026

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甲状腺疾病和女性不孕症
David Unuane1, Brigitte Velkeniers1, Kris Gustave Poppe2
1Department of Endocrinology, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
The Journal of clinical endocrinology and metabolism
|February 3, 2026
概括
甲状腺疾病影响女性生育能力和辅助生殖技术 (ART) 的结果. 目前关于亚临床甲状腺功能低下症和甲状腺自身免疫治疗的证据正在讨论中,这促使对女性进行个性化护理.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 免疫学 免疫学 免疫学
- 内分泌学 在内分泌学.
背景情况:
- 甲状腺疾病在生育年龄的女性中很常见,可能通过荷尔蒙和免疫路径影响生育能力.
- 甲状腺功能障碍显著影响生殖健康,但亚临床甲状腺功能低下 (SCH) 和甲状腺自身免疫 (TAI) 的作用仍在争论中.
- 利沃甲氧氨酸 (LT4) 经常用于SCH,通常在TSH水平为2.5mIU/L时开始,尽管对提高生育能力的支持证据有限.
研究的目的:
- 审查当前关于甲状腺功能障碍和TAI对女性生育能力和ART结果影响的证据.
- 探索涉及的潜在荷尔蒙和免疫机制.
- 讨论围绕SCH和TAI在怀孕前设置中的诊断和治疗值的争议.
主要方法:
- 对有关甲状腺疾病,女性生育能力和辅助生殖技术 (ART) 的现有文献进行系统审查.
- 对激素和免疫介导机制的分析,这些机制将甲状腺状况与生殖结果联系起来.
- 评估当前的临床实践和有关治疗指南的新兴数据.
主要成果:
- 明显的甲状腺功能低下明显损害了生殖生理学.
- 亚临床甲状腺功能低下症和euthyroid TAI对生育能力的影响仍然存在争议,目前支持当前治疗值的证据有限.
- 甲状腺状况和自身免疫力可能会影响ART的结果,包括卵巢反应,胚胎质量和怀孕率.
结论:
- 在生育年龄的妇女中,甲状腺功能障碍和TAI的治疗决策应该是个性化的,考虑甲状腺功能,抗体状况和生殖背景.
- 较高的TSH切断值越来越多地被考虑在怀孕前的诊断和治疗中.
- 需要进一步的研究来澄清SCH和TAI在生育和ART中的作用,并建立基于证据的治疗指南.
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