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DOI: 10.1055/s-0036-1593487
The Impact and Management of Subclinical Hypothyroidism for Improving Reproductive Outcomes such as Fertility and Miscarriage
Publikationsverlauf
Publikationsdatum:
14. Oktober 2016 (online)
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Abstract
Subclinical hypothyroidism has been found to be associated with adverse reproductive outcomes, such as infertility, miscarriage, preterm birth, and complications of pregnancy. Multiple studies have investigated the relationships between thyroid function, thyroid antibodies, fertility, and pregnancy. Thyroid autoimmunity is the most common cause of hypothyroidism in iodine-sufficient locations. Thyroid antibodies have been associated with adverse reproductive outcomes such as miscarriage and infertility. Debate exists regarding the method of identification of thyroid dysfunction in pregnancy, which can be conducted by targeted screening or by universal screening. Multiple professional societies have issued recommendations for the evaluation and treatment of thyroid dysfunction and pregnancy.
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References
- 1 Colicchia M, Campagnolo L, Baldini E, Ulisse S, Valensise H, Moretti C. Molecular basis of thyrotropin and thyroid hormone action during implantation and early development. Hum Reprod Update 2014; 20 (6) 884-904
- 2 van den Boogaard E, Vissenberg R, Land JA , et al. Significance of (sub)clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: a systematic review. Hum Reprod Update 2011; 17 (5) 605-619
- 3 Hollowell JG, Staehling NW, Flanders WD , et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 2002; 87 (2) 489-499
- 4 Cooper DS, Biondi B. Subclinical thyroid disease. Lancet 2012; 379 (9821) 1142-1154
- 5 Moog NK, Entringer S, Heim C, Wadhwa PD, Kathmann N, Buss C. Influence of maternal thyroid hormones during gestation on fetal brain development. Neuroscience 2015; (October) S0306-4522(15)00897-0
- 6 Aghajanova L, Stavreus-Evers A, Lindeberg M, Landgren B-M, Sparre LS, Hovatta O. Thyroid-stimulating hormone receptor and thyroid hormone receptors are involved in human endometrial physiology. Fertil Steril 2011; 95 (1) 230-237 , 237.e1–237.e2
- 7 Detti L, Uhlmann RA, Fletcher NM, Diamond MP, Saed GM. Endometrial signaling pathways during ovarian stimulation for assisted reproduction technology. Fertil Steril 2013; 100 (3) 889-894
- 8 Glinoer D. The regulation of thyroid function during normal pregnancy: importance of the iodine nutrition status. Best Pract Res Clin Endocrinol Metab 2004; 18 (2) 133-152
- 9 Loubière LS, Vasilopoulou E, Glazier JD , et al. Expression and function of thyroid hormone transporters in the microvillous plasma membrane of human term placental syncytiotrophoblast. Endocrinology 2012; 153 (12) 6126-6135
- 10 de Escobar GM, Obregón MJ, del Rey FE. Maternal thyroid hormones early in pregnancy and fetal brain development. Best Pract Res Clin Endocrinol Metab 2004; 18 (2) 225-248
- 11 Stagnaro-Green A, Abalovich M, Alexander E , et al; American Thyroid Association Taskforce on Thyroid Disease During Pregnancy and Postpartum. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 2011; 21 (10) 1081-1125
- 12 Maraka S, O'Keeffe DT, Montori VM. Subclinical hypothyroidism during pregnancy—should you expect this when you are expecting? a teachable moment. JAMA Intern Med 2015; 175 (7) 1088-1089
- 13 Korevaar TIM, Muetzel R, Medici M , et al. Association of maternal thyroid function during early pregnancy with offspring IQ and brain morphology in childhood: a population-based prospective cohort study. Lancet Diabetes Endocrinol 2016; 4 (1) 35-43
- 14 Alexander EK. Defining and achieving normal thyroid function during pregnancy. Lancet Diabetes Endocrinol 2016; 4 (1) 3-5
- 15 Blatt AJ, Nakamoto JM, Kaufman HW. National status of testing for hypothyroidism during pregnancy and postpartum. J Clin Endocrinol Metab 2012; 97 (3) 777-784
- 16 Negro R, Schwartz A, Gismondi R, Tinelli A, Mangieri T, Stagnaro-Green A. Universal screening versus case finding for detection and treatment of thyroid hormonal dysfunction during pregnancy. J Clin Endocrinol Metab 2010; 95 (4) 1699-1707
- 17 Granfors M, Åkerud H, Skogö J, Stridsberg M, Wikström A-K, Sundström-Poromaa I. Targeted thyroid testing during pregnancy in clinical practice. Obstet Gynecol 2014; 124 (1) 10-15
- 18 Casey BM. The debate on thyroid screening during pregnancy continues. Obstet Gynecol 2014; 124 (1) 8-9
- 19 Reh A, Grifo J, Danoff A. What is a normal thyroid-stimulating hormone (TSH) level? Effects of stricter TSH thresholds on pregnancy outcomes after in vitro fertilization. Fertil Steril 2010; 94 (7) 2920-2922
- 20 Karmon AE, Batsis M, Chavarro JE, Souter I. Preconceptional thyroid-stimulating hormone levels and outcomes of intrauterine insemination among euthyroid infertile women. Fertil Steril 2015; 103 (1) 258-63.e1
- 21 Michalakis KG, Mesen TB, Brayboy LM , et al. Subclinical elevations of thyroid-stimulating hormone and assisted reproductive technology outcomes. Fertil Steril 2011; 95 (8) 2634-2637
- 22 Kim CH, Ahn JW, Kang SP, Kim SH, Chae HD, Kang BM. Effect of levothyroxine treatment on in vitro fertilization and pregnancy outcome in infertile women with subclinical hypothyroidism undergoing in vitro fertilization/intracytoplasmic sperm injection. Fertil Steril 2011; 95 (5) 1650-1654
- 23 Gracia CR, Morse CB, Chan G , et al. Thyroid function during controlled ovarian hyperstimulation as part of in vitro fertilization. Fertil Steril 2012; 97 (3) 585-591
- 24 Reh A, Chaudhry S, Mendelsohn F , et al. Effect of autoimmune thyroid disease in older euthyroid infertile woman during the first 35 days of an IVF cycle. Fertil Steril 2011; 95 (3) 1178-1181
- 25 Plowden TC, Schisterman EF, Sjaarda LA , et al. Subclinical hypothyroidism and thyroid autoimmunity are not associated with fecundity, pregnancy loss or live birth. J Clin Endocrinol Metab 2016; 101 (6) 2358-2365
- 26 Casey BM, Dashe JS, Wells CE , et al. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol 2005; 105 (2) 239-245
- 27 Tudela CM, Casey BM, McIntire DD, Cunningham FG. Relationship of subclinical thyroid disease to the incidence of gestational diabetes. Obstet Gynecol 2012; 119 (5) 983-988
- 28 Wilson KL, Casey BM, McIntire DD, Halvorson LM, Cunningham FG. Subclinical thyroid disease and the incidence of hypertension in pregnancy. Obstet Gynecol 2012; 119 (2, Pt 1): 315-320
- 29 Negro R, Schwartz A, Gismondi R, Tinelli A, Mangieri T, Stagnaro-Green A. Increased pregnancy loss rate in thyroid antibody negative women with TSH levels between 2.5 and 5.0 in the first trimester of pregnancy. J Clin Endocrinol Metab 2010; 95 (9) E44-E48
- 30 Negro R, Schwartz A, Gismondi R, Tinelli A, Mangieri T, Stagnaro-Green A. Thyroid antibody positivity in the first trimester of pregnancy is associated with negative pregnancy outcomes. J Clin Endocrinol Metab 2011; 96 (6) E920-E924
- 31 Twig G, Shina A, Amital H, Shoenfeld Y. Pathogenesis of infertility and recurrent pregnancy loss in thyroid autoimmunity. J Autoimmun 2012; 38 (2–3) J275-J281
- 32 Thangaratinam S, Tan A, Knox E, Kilby MD, Franklyn J, Coomarasamy A. Association between thyroid autoantibodies and miscarriage and preterm birth: meta-analysis of evidence. BMJ 2011; 342: d2616
- 33 Negro R, Mangieri T, Coppola L , et al. Levothyroxine treatment in thyroid peroxidase antibody-positive women undergoing assisted reproduction technologies: a prospective study. Hum Reprod 2005; 20 (6) 1529-1533
- 34 Poppe K, Glinoer D, Tournaye H , et al. Impact of ovarian hyperstimulation on thyroid function in women with and without thyroid autoimmunity. J Clin Endocrinol Metab 2004; 89 (8) 3808-3812
- 35 Negro R, Formoso G, Mangieri T, Pezzarossa A, Dazzi D, Hassan H. Levothyroxine treatment in euthyroid pregnant women with autoimmune thyroid disease: effects on obstetrical complications. J Clin Endocrinol Metab 2006; 91 (7) 2587-2591
- 36 Negro R, Stagnaro-Green A. Thyroid autoantibodies, preterm birth, and miscarriage. BMJ 2011; 342: d2260
- 37 Poppe K, Unuane D, D'Haeseleer M , et al. Thyroid function after controlled ovarian hyperstimulation in women with and without the hyperstimulation syndrome. Fertil Steril 2011; 96 (1) 241-245
- 38 Kumru P, Erdogdu E, Arisoy R , et al. Effect of thyroid dysfunction and autoimmunity on pregnancy outcomes in low risk population. Arch Gynecol Obstet 2015; 291 (5) 1047-1054
- 39 Balthazar U, Steiner AZ. Periconceptional changes in thyroid function: a longitudinal study. Reprod Biol Endocrinol 2012; 10: 20
- 40 Turhan Iyidir O, Konca Degertekin C, Sonmez C , et al. The effect of thyroid autoimmunity on T-cell responses in early pregnancy. J Reprod Immunol 2015; 110: 61-66
- 41 Vissenberg R, Manders VD, Mastenbroek S , et al. Pathophysiological aspects of thyroid hormone disorders/thyroid peroxidase autoantibodies and reproduction. Hum Reprod Update 2015; 21 (3) 378-387
- 42 Haddow JE, Palomaki GE, Allan WC , et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med 1999; 341 (8) 549-555
- 43 Lazarus JH, Bestwick JP, Channon S , et al. Antenatal thyroid screening and childhood cognitive function. N Engl J Med 2012; 366 (6) 493-501
- 44 Su PY, Huang K, Hao JH , et al. Maternal thyroid function in the first twenty weeks of pregnancy and subsequent fetal and infant development: a prospective population-based cohort study in China. J Clin Endocrinol Metab 2011; 96 (10) 3234-3241
- 45 De Groot L, Abalovich M, Alexander EK , et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2012; 97 (8) 2543-2565
- 46 American College of Obstetricians and Gynecologists. Practice Bulletin No. 148: Thyroid disease in pregnancy. Obstet Gynecol 2015; 125 (4) 996-1005
- 47 Practice Committee of the American Society for Reproductive Medicine. Subclinical hypothyroidism in the infertile female population: a guideline. Fertil Steril 2015; 104 (3) 545-553