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甲状腺功能障碍与生育力低下。

Thyroid dysfunction and subfertility.

作者信息

Cho Moon Kyoung

机构信息

Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju, Korea.

出版信息

Clin Exp Reprod Med. 2015 Dec;42(4):131-5. doi: 10.5653/cerm.2015.42.4.131. Epub 2015 Dec 31.

Abstract

The thyroid hormones act on nearly every cell in the body. Moreover, the thyroid gland continuously interacts with the ovaries, and the thyroid hormones are involved in almost all phases of reproduction. Thyroid dysfunctions are relatively common among women of reproductive age, and can affect fertility in various ways, resulting in anovulatory cycles, high prolactin levels, and sex hormone imbalances. Undiagnosed and untreated thyroid disease can be a cause of subfertility. Subclinical hypothyroidism (SCH), also known as mild thyroid failure, is diagnosed when peripheral thyroid hormone levels are within the normal reference laboratory range, but serum thyroid-stimulating hormone levels are mildly elevated. Thyroid autoimmunity (TAI) is characterized by the presence of anti-thyroid antibodies, which include anti-thyroperoxidase and anti-thyroglobulin antibodies. SCH and TAI may remain latent, asymptomatic, or even undiagnosed for an extended period. It has also been demonstrated that controlled ovarian hyperstimulation has a significant impact on thyroid function, particularly in women with TAI. In the current review, we describe the interactions between thyroid dysfunctions and subfertility, as well as the proper work-up and management of thyroid dysfunctions in subfertile women.

摘要

甲状腺激素作用于人体几乎每一个细胞。此外,甲状腺不断与卵巢相互作用,甲状腺激素几乎参与生殖的所有阶段。甲状腺功能障碍在育龄女性中相对常见,可通过多种方式影响生育能力,导致无排卵周期、高催乳素水平和性激素失衡。未诊断和未治疗的甲状腺疾病可能是生育力低下的一个原因。亚临床甲状腺功能减退症(SCH),也称为轻度甲状腺功能衰竭,是在外周甲状腺激素水平在实验室正常参考范围内,但血清促甲状腺激素水平轻度升高时被诊断出来的。甲状腺自身免疫(TAI)的特征是存在抗甲状腺抗体,其中包括抗甲状腺过氧化物酶抗体和抗甲状腺球蛋白抗体。SCH和TAI可能会长期潜伏、无症状,甚至未被诊断出来。也有研究表明,控制性卵巢过度刺激对甲状腺功能有显著影响,尤其是对患有TAI的女性。在本综述中,我们描述了甲状腺功能障碍与生育力低下之间的相互作用,以及对生育力低下女性甲状腺功能障碍的适当检查和管理。

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