Structural changes and changes in the hormone-producing function of the thyroid gland during pregnancy in the natural cycle and with the use of additional reproductive technologies

Authors

  • O.O. Kyrylchuk Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine

DOI:

https://doi.org/10.15574/HW.2023.165.40

Keywords:

thyroid dysfunction, thyroid hormones, pregnancy, assisted reproductive technologies

Abstract

Purpose - to evaluate changes in thyroid function that occur during normal pregnancy and in the use of assisted reproductive technologies, various disorders with their consequences for the mother and fetus, laboratory diagnosis and the best ways to treat these conditions.

Common abnormalities of thyroid function, such as hypothyroidism, thyrotoxicosis and benign thyroid neoplasms, which disrupt menstrual cycles and female fertility, are considered, which, in turn, directly affect the course of pregnancy, and can lead to pregnancy termination, placental abruption, pre-eclampsia, preterm labor, neonatal morbidity, including reduced fetal neurological development. It has been suggested that the harmful effects of thyroid dysfunction may also extend not only to pregnancy and childbirth, but also affect the neuro-intellectual development of a child at an early age. Early diagnosis of thyroid dysfunction in pregnant women and treatment of thyroid dysfunction during pregnancy is an important and cost-effective aspect aimed at avoiding the occurrence of secondary complications in both the fetus and the mother caused by thyroid dysfunction.

No conflict of interests was declared by the authors.

References

Ajmani NS, Sarbhai V, Yadav N, Paul M, Ahmad A, Ajmani AK. (2016 Apr). Role of 138 thyroid dysfunction in patients with menstrual disorders in Tertiary Care Center of Walled City of Delhi. J Obstet Gynaecol India. 66(2): 115-119. https://doi.org/10.1007/s13224-014-0650-0; PMid:27046965 PMCid:PMC4818825

Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C et al. (2017, Mar). 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid. 27(3): 315-389. Erratum in: Thyroid. 2017 Sep; 27(9): 1212. https://doi.org/10.1089/thy.2016.0457; PMid:28056690

Alkafajei A, Amarin Z, Alazaizeh W, Khader Y, Marji M. (2012). Prevalence and risk factors for hypothyroidism in Jordanian women: comparison between different reference ranges. East Med Health J. 18: 2. https://doi.org/10.26719/2012.18.2.132; PMid:22571089

Beniuk VO, Vyhivska LM, Maidannyk IV, Oleshko VF. (2019). Stan hormonalnoho homeostazu v i trymestri vahitnosti pry zastosuvannia dopomizhnykh reproduktyvnykh tekhnolohii. Repozytarii Natsionalnoho medychnoho universytetu imeni O. O. Bohomoltsia. Kafedra akusherstva i hinekolohii No. 3, m. Kyiv. URL: http://ir.librarynmu.com/handle/123456789/1834.

Berghout A, Wiersinga W. (1998). Thyroid size and thyroid function during pregnancy An analysis. Eur J Endocrinol. 138: 536-542. https://doi.org/10.1530/eje.0.1380536; PMid:9625365

Brent GA. (2012). The debate over thyroid-function screening in pregnancy. New Eng J Med. 366: 562-563. https://doi.org/10.1056/NEJMe1112591; PMid:22316450

Budenhofer BK, Ditsch N, Jeschke U et al. (2013). Thyroid (dys-) function in normal and disturbed pregnancy. Arch Gynecol Obstet. 287: 1-7. https://doi.org/10.1007/s00404-012-2592-z; PMid:23104052

Casey B, Leveno K. (2006). Thyroid disease in pregnancy. Obstet Gynecol. 108: 1283-1292. https://doi.org/10.1097/01.AOG.0000244103.91597.c5; PMid:17077257

Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd W, Leveno KJ et al. (2005). Subclinical hypothyroidism and pregnancy outcomes. Am Col Obstet Gynecol. 105: 239-245. https://doi.org/10.1097/01.AOG.0000152345.99421.22; PMid:15684146

Condorelli RA, La Vignera S, Mongioì LM et al. (2019). Thyroid hormones and spermatozoa: in vitro efects on sperm mitochondria, viability and DNA integrity. J Clin Med 8: 756. https://doi.org/10.3390/jcm8050756; PMid:31137924 PMCid:PMC6571713

De Escobar GM, Obregón MJ, del Rey FE. (2004). Maternal thyroid hormones early in pregnancy and fetal brain development. Best Pract Res Clin Endocrinol Metab. 18: 225-248. https://doi.org/10.1016/j.beem.2004.03.012; PMid:15157838

Dosiou C. (2020). Thyroid and fertility: recent advances. Thyroid. 30: 479-486. https://doi.org/10.1089/thy.2019.0382; PMid:31903865

Dunn D, Turner C. (2016, Feb-Mar). Hypothyroidism in women. Nurs Womens Health. 20(1): 93-98. https://doi.org/10.1016/j.nwh.2015.12.002; PMid:26902444

Gizzo S, Noventa M, Quaranta M, Vitagliano A, Esposito F, Andrisani A et al. (2016). The potential role of GnRH agonists and antagonists in inducing thyroid physiopathological changes during IVF. Reprod Sci. 23 (4): 515-523. https://doi.org/10.1177/1933719115608000; PMid:26445999

Glinoer D. (1997). The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocr Rev. 18: 404. https://doi.org/10.1210/edrv.18.3.0300; PMid:9183570

Glinoer D. (1998). Thyroid Hyper function during pregnancy. Thyroid. 8: 859-864. https://doi.org/10.1089/thy.1998.8.859; PMid:9777758

Haddow JE, Palomaki GE, All an WC, Williams JR, Knight GJ, Gagnon J et al. (1999). Maternal thyroid deficincy during pregnancy and subsequent neuropsychological development of the child. N Engl J Med. 341: 549-555. https://doi.org/10.1056/NEJM199908193410801; PMid:10451459

Hoyda TD, Samson WK, Ferguson AV. (2009, Feb). Adiponectin depolarizes parvocellular paraventricular nucleus neurons controlling neuroendocrine and autonomic function. Endocrinology. 150(2): 832-840. https://doi.org/10.1210/en.2008-1179; PMid:18948398 PMCid:PMC2646535

Indra R, Patil SS, Joshi R, Pai M, Kalantri SP. (2004). Accuracy of physical examination in the diagnosis of hypothyroidism: a cross sectional, double-blind study. J Postgrad Med. 50: 7-11.

Kilby MD. (2003). Thyroid hormones and fetal brain development. Clin Endocrinol. 59: 280-281. https://doi.org/10.1046/j.1365-2265.2003.01804.x; PMid:12919149

Klein RZ, Haddow JE, Faix JD, Brown RS, Hermos RJ, Pulkkinen A et al. (1991). Prevalence of thyroid deficiency in pregnant women. Clin Endocrinol. 35: 41-46. https://doi.org/10.1111/j.1365-2265.1991.tb03494.x; PMid:1889138

Lazarus J, Brown RS, Daumerie C, Hubalewska-Dydejczyk A, Negro R, Vaidya B. (2014, Jun). 2014 European thyroid association guidelines for the management of subclinical hypothyroidism in pregnancy and in children. Eur Thyroid J. 3(2): 76-94. https://doi.org/10.1159/000362597; PMid:25114871 PMCid:PMC4109520

Mandel SJ. (2004). Hypothyroidism and chronic autoimmune thyroiditis in the pregnant state: maternal aspects. Best Pract Res Clin Endocrinol Metab. 18: 213-224. https://doi.org/10.1016/j.beem.2004.03.006; PMid:15157837

Marvisi M, Brianti M, Marani G, Del Borello R, Bortesi ML, Guariglia A. (2002). Hypothyroidism and pulmonary hypertension. Respire Med. 96: 215-220. https://doi.org/10.1053/rmed.2001.1260; PMid:11999999

Marx H, Amin P, Lazarus JH. (2008). Hyperthyroidism and pregnancy. BMJ. 336: 663-667. https://doi.org/10.1136/bmj.39462.709005.AE; PMid:18356235 PMCid:PMC2270981

Okosieme OE, Marx H, Lazarus JH. (2008). Medical management of thyroid dysfunction in pregnancy and the postpartum. Expert Opin Pharmacother. 9: 2281-2293. https://doi.org/10.1517/14656566.9.13.2281; PMid:18710353

Oubeid WS, Salih HH, Hadry DH, Jasim NA. (2017). Effect of using combined oral contraceptive on thyroid hormones and lipid profile in female. Tikrit J Pharm Sci. 12: 2.

Pankiv VI. (2016). Vplyv dysfunktsii shchytopodibnoi zalozy na reproduktyvnu systemu zhinky. Suchasni mozhlyvosti fitoterapii. Reproduktyv. эndokrynolohyia. (1): 52-57.

Pasiechko NV, Hnat SV, Svystun II, Naumova LV. (2015). Vplyv subklinichnoho hipotyreozu na reproduktyvnu funktsiiu zhinky ta efektyvnist yoho korektsii. Mizhnar. endokrynol. zhurn. (1): 98-101. https://doi.org/10.22141/2224-0721.1.65.2015.75910

Pasqualetti G, Pagano G, Rengo G, Ferrara N, Monzani F. (2015, Nov). Subclinical hypothyroidism and cognitive impairment: systematic review and meta-analysis. JClin Endocrinol Metab. 100(11): 4240-4248. https://doi.org/10.1210/jc.2015-2046; PMid:26305618

Polyzos NP, Sakkas E, Vaiarelli A, Poppe K, Camus M, Tournaye H. (2015, Jul). Thyroid autoimmunity, hypothyroidism and ovarian reserve: a cross-sectional study of 5000 women based on age-specific AMH values. Hum Reprod. 30(7): 1690-1696. https://doi.org/10.1093/humrep/dev089; PMid:25948573

Poppe K, Bisschop P, Fugazzola L et al. (2021). 2021 European thyroid association guideline on thyroid disorders prior to and during assisted reproduction. Eur Thyroid J. 9: 281-295. https://doi.org/10.1159/000512790; PMid:33718252 PMCid:PMC7923920

Roberts CG, Ladenson PW. (2004). Hypothyroidism. Lancet. 363: 793-803. https://doi.org/10.1016/S0140-6736(04)15696-1; PMid:15016491

Roneé EW, Hamisu MS, Maureen WG, Dagne G, O'Rourke K, Alfred KM. (2003). Impact of Maternal Thyroperoxidase Status on Fetal Body and Brain Size. Thyroid. 3: 340-356.

Ryan EA, Ennis L. (1988). Role of gestational hormones in the induction of insulin resistance. J Clin Endocrinol Metab. 67 (2): 341-347. https://doi.org/10.1210/jcem-67-2-341; PMid:3292560

Santin AP, Furlanetto TW. (2011). Role of estrogen in thyroid function and growth regulation. J Thyroid Res: 1-7. https://doi.org/10.4061/2011/875125; PMid:21687614 PMCid:PMC3113168

Sinha RA, Singh BK, Yen PM. (2014, Oct). Thyroid hormone regulation of hepatic lipid and carbohydrate metabolism. Trends Endocrinol Metab. 25(10): 538-545. https://doi.org/10.1016/j.tem.2014.07.001; PMid:25127738

Skjoldebrand L, Brundin J, Carlstrom A, Pettersson T. (1982). Thyroid associated components in serum during normal pregnancy. Acta Endocrinol. 100: 504-511. https://doi.org/10.1530/acta.0.1000504; PMid:6812340

Stan M. (2010, Nov). Clinical management of thyroid disease. Mayo Clin Proc. 85(11): e85. https://doi.org/10.4065/mcp.2010.0648; PMCid:PMC2966383

Syvolap VD, Hura EIu. (2018). Osnovy diahnostyky zakhvoriuvan shchytopodibnoi zalozy. Navch. posib. Zaporizhzhia: ZDMU: 91.

Tal R, Taylor HS et al. (2021, Mar 18). Endocrinology of Pregnancy. In: Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E et al. Endotext. South Dartmouth (MA): MDText.com, Inc. URL: https://www.ncbi.nlm.nih.gov/books/NBK278962/.

Wang W, Teng W, Shan Z, Wang S, Li J, Zhu L et al. (2011). The prevalence of thyroid disorders during early pregnancy in China: the benefits of universal screening in the first trimester of pregnancy. Eur J Endocrinol. 164: 263-268. https://doi.org/10.1530/EJE-10-0660; PMid:21059864

Yassa L, Marqusee E, Fawcett R, Alexander EK. (2010, Jul). Thyroid hormone early adjustment in pregnancy (the THERAPY) trial. J Clin Endocrinol Metab. 95(7): 3234-3241. https://doi.org/10.1210/jc.2010-0013; PMid:20463094

Published

2023-04-28