Contemporary perspectives on the role of hormonal changes and extragenital diseases in women with infertility and in pregnant women using assisted reproductive technologies: a literature review
DOI:
https://doi.org/10.15574/HW.2025.5(180).6167Keywords:
female infertility, hormonal disorders, extragenital pathology, thyroid gland, breast diseases, fibroadenoma, assisted reproductive technologiesAbstract
Female infertility remains a significant problem in modern reproductive medicine and is increasingly recognized as a multifactorial condition. Growing evidence indicates that hormonal disturbances and concomitant extragenital diseases play an important role in impaired fertility and influence the outcomes of assisted reproductive technologies (ART).
Aim - to analyze current scientific data on the impact of hormonal alterations and extragenital pathology, particularly thyroid and breast disorders, on female fertility, pregnancy course, and ART effectiveness. A systematic analysis of domestic and international publications on infertility, endocrine disorders, autoimmune diseases, hormone-dependent mammary gland pathology, and their relationship with natural fertility and ART was conducted. Thyroid dysfunction, including subclinical forms and autoimmune thyroid disease, is associated with ovulatory disorders, reduced ovarian reserve, impaired oocyte quality, and an increased risk of adverse obstetric and perinatal outcomes. Controlled ovarian stimulation protocols used in ART may further disrupt thyroid homeostasis, highlighting the need for careful preconception screening and monitoring. Benign hormone-dependent breast diseases, especially fibroadenoma, are frequently observed in infertile women and may reflect underlying systemic hormonal imbalance. Although most available studies do not confirm a direct causal relationship between ART and breast cancer development, conflicting evidence persists, emphasizing the importance of individualized risk assessment. Overall, female infertility should be regarded not as an isolated reproductive disorder but as a manifestation of systemic hormonal and somatic dysregulation.
A comprehensive multidisciplinary approach, including early detection and management of extragenital diseases, may improve ART outcomes and optimize reproductive and perinatal results.
The authors declare no conflict of interest.
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