Pathogenesis of infertility and recurrent pregnancy loss in thyroid autoimmunity

Twig, Gilad; Shina, Avi; Amital, Howard; Shoenfeld, Yehuda

doi:10.1016/j.jaut.2011.11.014

Cited by 179 publications

(129 citation statements)

References 94 publications

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“…Environmental, occupational or personal habits: It is generally agreed that maternal endocrine disorders should be evaluated and treated [76]. The prevalence of hypothyroidism with or without underlying thyroid autoimmunity is significant among women in fertile age.…”

Section: Hormonal and Metabolic Etiologymentioning

confidence: 99%

“…The prevalence of hypothyroidism with or without underlying thyroid autoimmunity is significant among women in fertile age. There is evidence that thyroid dysfunction and thyroid autoimmunity is associated with infertility and pregnancy loss both in the situation where the woman is euthyroid with thyroid antibodies and in a thyroid antibody negative woman with an elevated level of Thyroid Stimulating Hormone (TSH) [76].…”

Section: Hormonal and Metabolic Etiologymentioning

confidence: 99%

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Recurrent Miscarriage: A Review

Barrenetxea¹

2017

RMGO

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pregnancy events [2]. Clinical miscarriages may be subdivided into early clinical pregnancy losses (before gestational week 12) and late clinical pregnancy losses (gestational weeks 12 to 21). The term miscarriage is preferred rather than abortion both by patients and physicians, although "spontaneous abortion" is still used in scientific literature [3,4].For more than 30 years, controversy has existed on the number of miscarriages required to define RM and when diagnostic testing is warranted [5] EpidemiologyEarly pregnancy loss is perhaps the most common obstetric complication, occurring in over two-thirds of human conceptions. Approximately 15 -20% of all clinically recognized pregnancies will end in a miscarriage [4,9,10]. However, prospective cohort studies using sensitive and specific daily urinary hCG assays in women trying to conceive have demonstrated that only around one-third of conceptions progress to a live birth. Most of the losses occur before the clinical recognition of pregnancy as implantation failures. An estimated 30% of human conceptions are lost prior to implantation and a further 30% following implantation but before the missed menstrual period, that is in the third or fourth week of gestation. These are often termed preclinical losses [11].The risk of sporadic miscarriage between 6 and 12 weeks of gestation in women less than 35 years of age is 9% to 12%. The risk increases with age. In women older than 40 years of age, the sporadic miscarriage rate approaches 50%. Late losses between 12 and 22 weeks occur less frequently and constitute around 4% of pregnancy outcomes [4,9].Compared to sporadic miscarriage the prevalence of RM is considerably lower irrespective of whether biochemical losses are included or not. Approximately 1% of all women trying to conceive have recurrent miscarriage, defined as three previous miscarriages; when recurrent miscarriage is defined as two previous miscarriages, the proportion rises to 3% [12,13]. EtiologyMultiple potential etiologies for RM have been described (Table 1). As a consequence, several recommendations have been published regarding the evaluation and management of RM [3].The potential etiologies of RM can be divided into embryologically driven causes (mainly due to an abnormal embryonic karyotype) and maternally driven causes which affect the endometrium and/or placental development [14,15]. Thus, studies that focus on RM have Barrenetxea G, et al., J Reprod Med Gynecol Obstet 2017 AbstractHuman reproduction is characterized by its inefficiency. The loss of pregnancy at any stage can be a devastating experience and particular sensitivity is required in assessing and counseling couples with Recurrent Miscarriage (RM). Recurrent Miscarriage (RM) represents a clinical challenge for physicians not only because there are multiple possible etiologies, but also because the diagnostic testing is costly and time consuming. Despite several well-known etiologic factors, the cause of RM cannot be determined in almost 50% of cases. Multiple potential etiolo...

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Section: Hormonal and Metabolic Etiologymentioning

confidence: 99%

Section: Hormonal and Metabolic Etiologymentioning

confidence: 99%

Recurrent Miscarriage: A Review

Barrenetxea¹

2017

RMGO

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“…Ti ro id oto im mü ni te si; in fer ti li te, tek rar la yan abortus, fib rom yal ji, re kür ren af töz sto ma tit gi bi çok sayı da has ta lık la iliş ki len di ril miş tir. [5][6][7] Da ha ön ce ya pıl mış ça lış ma lar da ti ro id oto an ti kor la rı nın; i) tiro id fonk si yon la rın dan ba ğım sız ola rak T hüc re lerin den IL-2, TNF-α ve IFN sa lı nı mı nı ar tı ra rak pro inf la ma tu var bir et ki ya ra ta rak, ii) B hüc re le rini uya ra rak or gan spe si fik ol ma yan oto im mü ni te yi uya ra rak, ii i) ti ro id dı şı di ğer do ku lar la çap raz re aksi yo na gi re rek, di ğer do ku lar da ha sar yap tı ğı gös-te ril miş tir. Twig ve ark.…”

Section: Tar Tiş Maunclassified

“…ti ro id oto an ti kor la rı nın zo na pel lu si da ve pla sen tal an ti jen ler le çap raz reak si yo na gi rip bu do ku la rı ha sa ra uğ ra ta rak, in ferti li te ve tek rar la yan abor tus la ra yol aç tı ğı nı öne sür müş tür. 5 Lud ga te ve ark. ti rog lo bu lin ve göz kasla rın da ki ase til ko li nin ya pı sal ben zer li ği ol du ğu nu, Gra ves has ta lı ğın da ki of tal mo lo jik tu tu lu mun bu du ru ma bağ lı ol du ğu nu gös ter miş ler dir.…”

Section: Tar Tiş Maunclassified

Evaluation of Thyroid Autoimmunity in Female Patients with Telogen Effluvium

Güngör¹,

Topal²,

Gökdemir³

2014

Turkiye Klinikleri J Med Sci

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“…Production of specific antibodies, i.e., auto antibodies, is an integral part of response. Autoimmune thyroid disease is common, affecting approximately 1 % of the population, while subclinical, focal thyroiditis, and circulating thyroid antibodies can be found in about 15 % of otherwise healthy subjects who are euthyroid [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Pregnancy Outcome in Euthyroid Women with Anti-Thyroid Peroxidase Antibodies

Meena

Nagar

2015

J Obstet Gynecol India

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Objective The aim of this study was to compare pregnancy outcomes in euthyroid women who were anti-TPO Ab ? with those who were anti-TPO Ab -. Design This observational study comprised 1,000 women in the age group of 25-35 years, having normal thyroid function tests, normotensive, non-diabetic, singleton pregnancy and attending Gyn. OPD/ANC up to 20 weeks' gestation and those who were already in the process of abortion. anti-TPO Ab levels of[50 IU/ml were considered as anti-TPO Ab ? . Setting This study was conducted in the SMS Medical College's attached hospital, Jaipur from April 2012 to September 2013. Main Outcome The estimation of the proportion of anti-TPO Abs in the hospital-based population and the comparison of pregnancy and neonatal outcomes in anti-TPO Ab ? and Ab -euthyroid women were done. Results The main result showed increased rates in miscarriages (13.33 vs. 2.34 %, P \ 0.001), LBWs (25 vs. 5.12 %, P \ 0.001), preterm deliveries [\34 weeks] (5 vs. 1.80 %, P [ 0.05) in anti-TPO Ab ? women. Conclusions The current study revealed that anti-TPO Abs are strongly associated with miscarriage and LBW irrespective of their gestational age. However, we did not find any correlation with the other complication as found in the studies by Abbassi-Ghanavati, Negro et al.

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Pathogenesis of infertility and recurrent pregnancy loss in thyroid autoimmunity

Cited by 179 publications

References 94 publications

Recurrent Miscarriage: A Review

Recurrent Miscarriage: A Review

Evaluation of Thyroid Autoimmunity in Female Patients with Telogen Effluvium

Pregnancy Outcome in Euthyroid Women with Anti-Thyroid Peroxidase Antibodies

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