open access

Vol 73, No 4 (2022)
Guidelines / Expert consensus
Submitted: 2022-05-28
Accepted: 2022-05-30
Published online: 2022-08-17
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Thyroid diseases and fertility disorders — Guidelines of the Polish Society of Endocrinology [Choroby tarczycy a zaburzenia płodności — rekomendacje Polskiego Towarzystwa Endokrynologicznego]

Alicja Hubalewska-Dydejczyk1, Małgorzata Gietka-Czernel2, Małgorzata Trofimiuk-Müldner1, Wojciech Zgliczyński2, Marek Ruchała3, Andrzej Lewiński45, Tomasz Bednarczuk6, Anhelli Syrenicz7, Beata Kos-Kudła8, Barbara Jarząb9, Ewelina Szczepanek-Parulska3, Jolanta Krajewska9, Elżbieta Andrysiak-Mamos7, Arkadiusz Zygmunt4, Małgorzata Karbownik-Lewińska510
·
Pubmed: 36059162
·
Endokrynol Pol 2022;73(4):645-679.
Affiliations
  1. Chair and Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Endocrinology, Centre of Postgraduate Medical Education, Warsaw, Poland
  3. Chair and Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
  4. Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland
  5. Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital — Research Institute, Lodz, Poland
  6. Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
  7. Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University, Szczecin, Poland
  8. Division of Endocrinology and Neuroendocrine Tumours, Chair of Pathophysiology and Endocrinology, Medical University of Silesia in Katowice, Katowice, Poland
  9. Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
  10. Department of Oncological Endocrinology, Medical University of Lodz, Lodz, Poland

open access

Vol 73, No 4 (2022)
Guidelines
Submitted: 2022-05-28
Accepted: 2022-05-30
Published online: 2022-08-17

Abstract

Thyroid hormones influence female fertility, directly stimulating oocyte maturation and regulating prolactin and sex hormone binding globulin (SHBG) concentrations. Hyperthyroidism affects 1–2%, overt hypothyroidism 0.3%, and subclinical hypothyroidism up to 15% of women of childbearing age. Approximately 10% of euthyroid women have elevated concentrations of anti-thyroid peroxidase antibodies (aTPO) and/or anti-thyroglobulin (aTg) antibodies. Hypothyroidism can cause menstrual and ovulation disorders, and impact fertility.

Studies carried out to date have not conclusively demonstrated that subclinical hypothyroidism or elevated aTPO/aTg concentrations make it harder to conceive, but they do increase the risk of pregnancy loss. Subclinical hypothyroidism and elevated aTPO/aTg concentrations without thyroid disorders are more common in polycystic ovary syndrome, premature ovarian insufficiency, and idiopathic infertility.

Fertility problems are therefore an indication for screening for thyroid diseases (in females as well as in some males). A thyroid disorder diagnosed in subfertile couples should be treated appropriately, especially before attempting assisted reproductive techniques. These recommendations are intended as a guide for the management of thyroid diseases associated with infertility. 

Abstract

Thyroid hormones influence female fertility, directly stimulating oocyte maturation and regulating prolactin and sex hormone binding globulin (SHBG) concentrations. Hyperthyroidism affects 1–2%, overt hypothyroidism 0.3%, and subclinical hypothyroidism up to 15% of women of childbearing age. Approximately 10% of euthyroid women have elevated concentrations of anti-thyroid peroxidase antibodies (aTPO) and/or anti-thyroglobulin (aTg) antibodies. Hypothyroidism can cause menstrual and ovulation disorders, and impact fertility.

Studies carried out to date have not conclusively demonstrated that subclinical hypothyroidism or elevated aTPO/aTg concentrations make it harder to conceive, but they do increase the risk of pregnancy loss. Subclinical hypothyroidism and elevated aTPO/aTg concentrations without thyroid disorders are more common in polycystic ovary syndrome, premature ovarian insufficiency, and idiopathic infertility.

Fertility problems are therefore an indication for screening for thyroid diseases (in females as well as in some males). A thyroid disorder diagnosed in subfertile couples should be treated appropriately, especially before attempting assisted reproductive techniques. These recommendations are intended as a guide for the management of thyroid diseases associated with infertility. 

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Keywords

fertility; thyroid disorders; anti-thyroid antibodies; hypothyroidism; hyperthyroidism; assisted reproductive techniques

About this article
Title

Thyroid diseases and fertility disorders — Guidelines of the Polish Society of Endocrinology [Choroby tarczycy a zaburzenia płodności — rekomendacje Polskiego Towarzystwa Endokrynologicznego]

Journal

Endokrynologia Polska

Issue

Vol 73, No 4 (2022)

Article type

Guidelines / Expert consensus

Pages

645-679

Published online

2022-08-17

Page views

7612

Article views/downloads

3591

DOI

10.5603/EP.a2022.0069

Pubmed

36059162

Bibliographic record

Endokrynol Pol 2022;73(4):645-679.

Keywords

fertility
thyroid disorders
anti-thyroid antibodies
hypothyroidism
hyperthyroidism
assisted reproductive techniques

Authors

Alicja Hubalewska-Dydejczyk
Małgorzata Gietka-Czernel
Małgorzata Trofimiuk-Müldner
Wojciech Zgliczyński
Marek Ruchała
Andrzej Lewiński
Tomasz Bednarczuk
Anhelli Syrenicz
Beata Kos-Kudła
Barbara Jarząb
Ewelina Szczepanek-Parulska
Jolanta Krajewska
Elżbieta Andrysiak-Mamos
Arkadiusz Zygmunt
Małgorzata Karbownik-Lewińska

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Via MedicaWydawcą jest  VM Media Group sp. z o.o., Grupa Via Medica, ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl