Endocrine Abstracts

Thyroid autoimmunity (TAI) and thyroid dysfunction are prevalent among women of reproductive age, significantly impacting fertility and pregnancy outcomes. This talk explores the intricate relationship between thyroid health and female reproductive function, emphasizing the role of thyroid hormones in ovarian regulation. The discovery of thyroid-stimulating hormone (TSH) and its receptors on ovarian surface epithelium and oocytes underscores the importance of thyroid hormones in reproductive physiology. While overt hypothyroidism is widely recognized as a risk factor for infertility and adverse pregnancy outcomes, the association between subclinical hypothyroidism (SCH) and infertility remains inconsistent across literature. This inconsistency is partly due to varying TSH cut-offs and a lack of robust prospective studies. The talk will address the current lack of consensus on initiating levothyroxine treatment for SCH to prevent fertility issues, highlighting the methodological limitations and small sample sizes of existing studies. Additionally, the diverse population of women with thyroid autoimmunity and dysfunction, influenced by factors such as age and co-existing health conditions, complicates uniform treatment recommendations. The presentation will delve into thyroid hormone-dependent mechanisms, including ovarian function regulation and endometrial quality, as well as thyroid hormone-independent mechanisms like immunological dysfunction and direct infiltration of reproductive organs by thyroid autoantibodies. Understanding these mechanisms is crucial for developing targeted treatment strategies to improve fertility outcomes in women with TAI. This talk aims to provide a comprehensive overview of the current state of research, identify gaps, and propose directions for future studies.