Thyroid Dysfunction and Infertility of Women of Reproductive Age
Ekaterina Andreevna Sterlyova *
Stavropol State Medical University, Russia.
Tatiana Kharitonovna Timokhina
Tyumen State Medical University, Tyumen, Russian Federation, Russia.
Yuriy Viktorovich Sivkov
Tyumen Industrial University, Tyumen, Russian Federation, Russia.
Alexandr Anatolyevich Markov
Tyumen State Medical University, Tyumen, Russian Federation, Russia. and Tyumen Industrial University, Tyumen, Russian Federation, Russia.
. Huldani
Department of Physiology, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, South Kalimantan, Indonesia.
Vitaly V. Goncharov
Department of State and International Law, Kuban State Agrarian University Named after I. T. Trubilin, Krasnodar, Russia.
Harun Achmad
Department of Pediatric Dentistry, Faculty of Dentistry, Hasanuddin University, Indonesia.
*Author to whom correspondence should be addressed.
Abstract
Autoimmunity of the thyroid gland (TAI) or its dysfunction is quite common among women of reproductive age, and there are suggestions in the literature that they are associated with an unfavorable level of fertility and a negative outcome of pregnancy, as in the case of spontaneous conception or after assisted reproductive technologies (ART).
This assumption makes it necessary to screen autoantibodies to thyrotropin (TSH) and thyroid peroxidase among infertile women who have made a number of attempts to become pregnant.
Some authors have conducted a number of studies where they have examined the relationship between autoimmunity of the thyroid gland, thyroid function, and fertility. However, there is currently no consensus on the upper limit of the norm for TSH to determine thyroid dysfunction and the limits for intervention. Despite the recent update of the American thyroid Association (ATA) on guidelines for the diagnosis and treatment of thyroid diseases during pregnancy and the postpartum period, many issues remain unresolved in ART. The author came to the following conclusions: open thyroid dysfunction often leads to menstrual disorders, fertility problems, and pregnancy complications, and therefore should be treated accordingly. Currently, there is little evidence to recommend treatment with levothyroxine at TSH levels between 2.5 and 4.0 MMU / l, given the possible side effects of overtreatment, especially in patients with mild thyroid dysfunction. We suggest careful longitudinal monitoring, especially in the presence of thyroid antibodies in women undergoing ART. The 4 MMU / l limit for TSH appears as the intervention level for SCH treatment in women with and without transabdominal utrasound in ART.
Keywords: Thyroid, autoimmunity, infertility, assisted reproductive technologies.