Abstract
The second most prevalent endocrine condition affecting women of reproductive age is thyroid disease. The difference between an increased thyroid-stimulating hormone (TSH) concentration and a normal free thyroxine hormone level is used to identify subclinical hypothyroidism. Thyroid autoantibodies, independent of thyroid hormone levels, are used to diagnose autoimmune thyroid disease (ATD). Thyroxine can help infertile women with these two types of thyroid illnesses have better birth outcomes during fertility treatment. We performed a systematic review using PubMed (Medline) as a major database and some other sources EMBASE, the Cochrane Library, Web of Science, Scopus, and Science Direct. We concentrated on four studies, including 806 patients. Our goal is to investigate the efficacy and risks of levothyroxine therapy in infertile women who are receiving fertility treatments and have subclinical hypothyroidism or adequate thyroid function as well as thyroid autoimmunity (euthyroid autoimmune thyroid disorder). Thyroid activity in hypothyroid women should be tracked at pregnancy confirmation and closely monitored during the pregnancy. Early in pregnancy, the dosage of levothyroxine (LT4) can be raised. To ensure optimum TSH levels during breastfeeding, we recommend that patients who are followed in the primary sector have their LT4 dose increased by their general practitioner before their first referral to an endocrinological outpatient clinic. It's important to pay more attention to and track pregnant women with hypothyroidism, who consider pregnancy, to get the best results. LT4 therapy can help subfertile women with subclinical hypothyroidism who are having in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) since it improves embryo growth, implantation rate, and live birth rate.
Highlights
BackgroundThyroid disease is the second most common endocrinopathy among women of reproductive age
After screening 33 full-text articles dealt with levothyroxine treatment in subclinical hypothyroidism and autoimmune thyroiditis in pregnant women were finalized
The dosage of levothyroxine was increased by 50% in the first trimester and had to be increased by 5% per trimester after that
Summary
Thyroid disease is the second most common endocrinopathy among women of reproductive age. When peripheral thyroid hormones are within the standard recommended ranges but serum thyroid-stimulating hormone (TSH) levels are slightly high, subclinical hypothyroidism, known as mild thyroid insufficiency, is diagnosed. Thyroid peroxidase antibodies (TPOAb) are used to diagnose autoimmune thyroid illness. TPOAb are antibodies to an enzyme located in the thyroid gland that plays a key part in the production of thyroid hormones [1,2,3]. Existing guidelines indicate a maximum serum TSH level of 2.5 mIU/L for the first trimester and 3.0 mIU/L for the second and third trimesters of pregnancy [1]. The correlation of SCH with an elevated risk of one or more undesirable pregnancy effects, most notably miscarriage, preterm labor, gestational hypertension, and low birth weight, has been observed in many retrospective trials comparing euthyroid pregnant women with those with uncontrolled SCH [2,4]
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