DOI QR코드

DOI QR Code

Thyroid dysfunction and subfertility

  • Cho, Moon Kyoung (Department of Obstetrics and Gynecology, Chonnam National University Medical School)
  • 투고 : 2015.10.28
  • 심사 : 2015.12.09
  • 발행 : 2015.12.31

초록

The thyroid hormones act on nearly every cell in the body. Moreover, the thyroid gland continuously interacts with the ovaries, and the thyroid hormones are involved in almost all phases of reproduction. Thyroid dysfunctions are relatively common among women of reproductive age, and can affect fertility in various ways, resulting in anovulatory cycles, high prolactin levels, and sex hormone imbalances. Undiagnosed and untreated thyroid disease can be a cause of subfertility. Subclinical hypothyroidism (SCH), also known as mild thyroid failure, is diagnosed when peripheral thyroid hormone levels are within the normal reference laboratory range, but serum thyroid-stimulating hormone levels are mildly elevated. Thyroid autoimmunity (TAI) is characterized by the presence of anti-thyroid antibodies, which include anti-thyroperoxidase and anti-thyroglobulin antibodies. SCH and TAI may remain latent, asymptomatic, or even undiagnosed for an extended period. It has also been demonstrated that controlled ovarian hyperstimulation has a significant impact on thyroid function, particularly in women with TAI. In the current review, we describe the interactions between thyroid dysfunctions and subfertility, as well as the proper work-up and management of thyroid dysfunctions in subfertile women.

키워드

참고문헌

  1. Zhang C, Guo L, Zhu B, Feng Y, Yu S, An N, et al. Effects of 3, 5, 3'-triiodothyronine (t3) and follicle stimulating hormone on apoptosis and proliferation of rat ovarian granulosa cells. Chin J Physiol 2013;56:298-305.
  2. Koot YE, Teklenburg G, Salker MS, Brosens JJ, Macklon NS. Molecular aspects of implantation failure. Biochim Biophys Acta 2012;1822:1943-50. https://doi.org/10.1016/j.bbadis.2012.05.017
  3. Aghajanova L, Stavreus-Evers A, Lindeberg M, Landgren BM, Sparre LS, Hovatta O. Thyroid-stimulating hormone receptor and thyroid hormone receptors are involved in human endometrial physiology. Fertil Steril 2011;95:230-7.e1-2. https://doi.org/10.1016/j.fertnstert.2010.06.079
  4. Oki N, Matsuo H, Nakago S, Murakoshi H, Laoag-Fernandez JB, Maruo T. Effects of 3,5,3'-triiodothyronine on the invasive potential and the expression of integrins and matrix metalloproteinases in cultured early placental extravillous trophoblasts. J Clin Endocrinol Metab 2004;89:5213-21. https://doi.org/10.1210/jc.2004-0352
  5. Poppe K, Velkeniers B. Female infertility and the thyroid. Best Pract Res Clin Endocrinol Metab 2004;18:153-65. https://doi.org/10.1016/j.beem.2004.03.004
  6. Joshi JV, Bhandarkar SD, Chadha M, Balaiah D, Shah R. Menstrual irregularities and lactation failure may precede thyroid dysfunction or goitre. J Postgrad Med 1993;39:137-41.
  7. Poppe K, Glinoer D, Van Steirteghem A, Tournaye H, Devroey P, Schiettecatte J, et al. Thyroid dysfunction and autoimmunity in infertile women. Thyroid 2002;12:997-1001. https://doi.org/10.1089/105072502320908330
  8. Krassas GE, Pontikides N, Kaltsas T, Papadopoulou P, Paunkovic J, Paunkovic N, et al. Disturbances of menstruation in hypothyroidism. Clin Endocrinol (Oxf) 1999;50:655-9. https://doi.org/10.1046/j.1365-2265.1999.00719.x
  9. Poppe K, Velkeniers B, Glinoer D. Thyroid disease and female reproduction. Clin Endocrinol (Oxf) 2007;66:309-21. https://doi.org/10.1111/j.1365-2265.2007.02752.x
  10. De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L, Cobin RH, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2012;97:2543-65. https://doi.org/10.1210/jc.2011-2803
  11. Cramer DW, Sluss PM, Powers RD, McShane P, Ginsburgs ES, Hornstein MD, et al. Serum prolactin and TSH in an in vitro fertilization population: is there a link between fertilization and thyroid function? J Assist Reprod Genet 2003;20:210-5. https://doi.org/10.1023/A:1024151210536
  12. Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, Mechanick JI, et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract 2012;18:988-1028. https://doi.org/10.4158/EP12280.GL
  13. 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;95:1650-4. https://doi.org/10.1016/j.fertnstert.2010.12.004
  14. Abdel Rahman AH, Aly Abbassy H, Abbassy AA. Improved in vitro fertilization outcomes after treatment of subclinical hypothyroidism in infertile women. Endocr Pract 2010;16:792-7. https://doi.org/10.4158/EP09365.OR
  15. Poppe K, Velkeniers B, Glinoer D. The role of thyroid autoimmunity in fertility and pregnancy. Nat Clin Pract Endocrinol Metab 2008;4:394-405. https://doi.org/10.1038/ncpendmet0846
  16. van den Boogaard E, Vissenberg R, Land JA, van Wely M, van der Post JA, Goddijn M, et al. Significance of (sub) clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: a systematic review. Hum Reprod Update 2011;17:605-19. https://doi.org/10.1093/humupd/dmr024
  17. Prummel MF, Wiersinga WM. Thyroid autoimmunity and miscarriage. Eur J Endocrinol 2004;150:751-5. https://doi.org/10.1530/eje.0.1500751
  18. Monteleone P, Parrini D, Faviana P, Carletti E, Casarosa E, Uccelli A, et al. Female infertility related to thyroid autoimmunity: the ovarian follicle hypothesis. Am J Reprod Immunol 2011;66:108-14. https://doi.org/10.1111/j.1600-0897.2010.00961.x
  19. Twig G, Shina A, Amital H, Shoenfeld Y. Pathogenesis of infertility and recurrent pregnancy loss in thyroid autoimmunity. J Autoimmun 2012;38:J275-81. https://doi.org/10.1016/j.jaut.2011.11.014
  20. Kelkar RL, Meherji PK, Kadam SS, Gupta SK, Nandedkar TD. Circulating auto-antibodies against the zona pellucida and thyroid microsomal antigen in women with premature ovarian failure. J Reprod Immunol 2005;66:53-67. https://doi.org/10.1016/j.jri.2005.02.003
  21. Kiprov DD, Nachtigall RD, Weaver RC, Jacobson A, Main EK, Garovoy MR. The use of intravenous immunoglobulin in recurrent pregnancy loss associated with combined alloimmune and autoimmune abnormalities. Am J Reprod Immunol 1996;36:228-34. https://doi.org/10.1111/j.1600-0897.1996.tb00168.x
  22. Sher G, Maassarani G, Zouves C, Feinman M, Sohn S, Matzner W, et al. The use of combined heparin/aspirin and immunoglobulin G therapy in the treatment of in vitro fertilization patients with antithyroid antibodies. Am J Reprod Immunol 1998;39:223-5. https://doi.org/10.1111/j.1600-0897.1998.tb00357.x
  23. Stricker RB, Steinleitner A, Bookoff CN, Weckstein LN, Winger EE. Successful treatment of immunologic abortion with low-dose intravenous immunoglobulin. Fertil Steril 2000;73:536-40. https://doi.org/10.1016/S0015-0282(99)00572-5
  24. 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;91:2587-91. https://doi.org/10.1210/jc.2005-1603
  25. Negro R, Mangieri T, Coppola L, Presicce G, Casavola EC, Gismondi R, et al. Levothyroxine treatment in thyroid peroxidase antibody-positive women undergoing assisted reproduction technologies: a prospective study. Hum Reprod 2005;20:1529-33. https://doi.org/10.1093/humrep/deh843
  26. Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 2011;21:1081-125. https://doi.org/10.1089/thy.2011.0087
  27. Poppe K, Glinoer D, Tournaye H, Schiettecatte J, Devroey P, van Steirteghem A, et al. Impact of ovarian hyperstimulation on thyroid function in women with and without thyroid autoimmunity. J Clin Endocrinol Metab 2004;89:3808-12. https://doi.org/10.1210/jc.2004-0105
  28. Alexander EK, Marqusee E, Lawrence J, Jarolim P, Fischer GA, Larsen PR. Timing and magnitude of increases in levothyroxine requirements during pregnancy in women with hypothyroidism. N Engl J Med 2004;351:241-9. https://doi.org/10.1056/NEJMoa040079

피인용 문헌

  1. Molecular cytogenetic characterization of two Turner syndrome patients with mosaic ring X chromosome vol.33, pp.9, 2016, https://doi.org/10.1007/s10815-016-0761-x
  2. The impact of thyroid autoimmunity on IVF/ICSI outcome: a systematic review and meta-analysis vol.22, pp.6, 2016, https://doi.org/10.1093/humupd/dmw019
  3. Plasma Perfluoroalkyl and Polyfluoroalkyl Substances Concentration and Menstrual Cycle Characteristics in Preconception Women vol.125, pp.6, 2015, https://doi.org/10.1289/ehp1203
  4. Subclinical Hypothyroidism in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis vol.9, pp.None, 2015, https://doi.org/10.3389/fendo.2018.00700
  5. Follicular fluid thyroid autoantibodies, thyrotropin, free thyroxine levels and assisted reproductive technology outcome vol.13, pp.10, 2015, https://doi.org/10.1371/journal.pone.0206652
  6. SUCCESSFUL PREGNANCY ON A GLUTEN-FREE DIET IN A WOMAN WITH SEVEN MISCARRIAGES AND NONCELIAC GLUTEN SENSITIVITY vol.4, pp.6, 2015, https://doi.org/10.4158/accr-2018-0095
  7. Diffusive non-toxic goiter and purbatic course in girls vol.49, pp.None, 2015, https://doi.org/10.18370/2309-4117.2019.49.29-33
  8. Screening assessment of thyroid-stimulating hormone and prolactin levels and their effect on ART outcomes in women of young reproductive age vol.26, pp.6, 2020, https://doi.org/10.17116/repro20202606170
  9. Both Matricaria chamomilla and Metformin Extract Improved the Function and Histological Structure of Thyroid Gland in Polycystic Ovary Syndrome Rats through Antioxidant Mechanism vol.10, pp.1, 2015, https://doi.org/10.3390/biom10010088
  10. Infertility: Understanding investigation and treatment options vol.13, pp.7, 2015, https://doi.org/10.1177/1755738020923714
  11. Long-Term Effects of Radioiodine Treatment on Female Fertility in Survivors of Childhood Differentiated Thyroid Carcinoma vol.30, pp.8, 2015, https://doi.org/10.1089/thy.2019.0560
  12. Use of assisted reproductive technologies in euthyroid women with antibodies to the thyroid gland. A literature review vol.69, pp.5, 2020, https://doi.org/10.17816/jowd69599-104
  13. The Efficacy of Assisted Reproduction in Women with a Wide Spectrum of Chronic Diseases - A Review vol.13, pp.None, 2015, https://doi.org/10.2147/clep.s310795