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Consider thyroid disorders, such as hyperthyroidism, when evaluating women with fertility problems and recurrent early pregnancy loss.
Women facing fertility problems are more likely to have thyroid disease, a review published in the journal The Obstetrician & Gynaecologist found.
Hyperthyroidism is found in approximately 2.3% of women presenting with fertility problems, compared with 1.5% of women in the general population, the authors reported.
- Thyroid disease occurs at a higher rate in women who have trouble conceiving or staying pregnant than the general population.
- Thyroid disease is associated with increased pregnancy loss as well as infertility issues.
- Women with unexplained infertility or recurring miscarriages should be screened for thyroid disease.
In addition to fertility problems, women with thyroid disease also had an increased likelihood of recurrent early pregnancy loss, the authors suggested. Hyperthyroidism was also linked with menstrual irregularity. The disease affects around 0.5% of women of reproductive age, according to the authors.
While thyroid disease has long been linked to fertility problems, the authors noted that national guidelines do not recommend clinicians check for the disease when evaluating asymptomatic women presenting with fertility challenges. In presenting the data, the authors suggest that thyroid disease be considered by clinicians when women report fertility problems and recurrent pregnancy loss. In addition, the authors highlight that there is evidence to suggest that routine screening of the general population for thyroid dysfunction at the start of pregnancy may be beneficial.
"Abnormalities in thyroid function can have an adverse effect on reproductive health and result in reduced rates of conception, increased miscarriage risk, and adverse pregnancy and neonatal outcomes,” said Amanda Jefferys, from the Bristol Centre for Reproductive Medicine, Southmead Hospital, Bristol, United Kingdom, and coauthor of the study, in a news release. "However, with appropriate screening and prompt management, these risks can be significantly reduced."