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Thyroid Diseases and Female Infertility

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Reproductive Medicine for Clinical Practice

Part of the book series: Reproductive Medicine for Clinicians ((REMECL,volume 1))

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Abstract

Thyroid diseases in women of reproductive age are associated with a broad spectrum of disorders, from menstrual irregularities, infertility to pregnancy loss. Negative association exist between thyroid autoimmunity without thyroid dysfunction and infertility and early miscarriage. Thyroid hormones play an important role in reproductive function, with direct effects on the ovarian follicles, endometrium, implantation and placentation. Both primary hypothyroidism and hyperthyroidism in women of reproductive age can produce altered sex hormones metabolism, disrupting the hypothalamic-pituitary-ovarian axis and resulting in inadequate ovulation. The prevalence of hypothyroidism overt or subclinical in women with infertility is increased. Autoimmune thyroid disease affect 5–20% of women in the childbearing period. Many studies indicate an increased prevalence of thyroid autoimmunity among women with infertility, especially in patients with ovulatory dysfunction, and significant increased risk of miscarriage in euthyroid women with thyroid autoimmunity following assisted reproduction technology. Women with infertility should be screened for thyroid dysfunction and thyroid antibodies. Treatment of thyroid dysfunction and restoration of euthyroidism can improve fertility. The upper limit of TSH of 2.5 mIU/L is proposed as a cut-off before assisted reproduction procedures, independent of thyroid antibody status, but controversies persist in treating subclinical hypothyroidism women.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Carol Davila”, University Hospital, Bucharest, Romania

    Petrache Vartej

  2. Altnagelvin Area Hospital Western Trust HSC, Londonderry, Northern Ireland, UK

    Ioana Vartej

Authors
  1. Petrache Vartej
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  2. Ioana Vartej
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Editor information

Editors and Affiliations

  1. Department Obstetrics and Gynecology, Hadassah Medical Center, Jerusalem, Israel

    Joseph G. Schenker

  2. Department of Obstetrics and Gynecology, Northwestern Medical Faculty Foundation, Chicago, USA

    John J. Sciarra

  3. Obstetrics and Gynaecology, University Hospital Schleswig-Holst, Kiel, Germany

    Liselotte Mettler

  4. International Society of Gynecological Endocrinology, Pisa, Italy

    Andrea R. Genazzani

  5. Professor emeritus of Gynaecological Endocrinology and Reproductive Medicine, University of Bern, Bern, Switzerland

    Martin Birkhaeuser

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© 2018 IAHR (International Academy of Human Reproduction)

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Vartej, P., Vartej, I. (2018). Thyroid Diseases and Female Infertility. In: Schenker, J., Sciarra, J., Mettler, L., Genazzani, A., Birkhaeuser, M. (eds) Reproductive Medicine for Clinical Practice. Reproductive Medicine for Clinicians, vol 1. Springer, Cham. https://doi.org/10.1007/978-3-319-78009-2_5

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  • DOI: https://doi.org/10.1007/978-3-319-78009-2_5

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  • Online ISBN: 978-3-319-78009-2

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