Prevalence of disease-related infertility in Hashimoto thyroiditis

What is the prevalence of disease-related infertility in women with Hashimoto thyroiditis?

Luigi Bartalena: It is known that infertility is so-called idiopathic in about 30% of cases. Some of these cases may be really related to thyroid autoimmune disorders or to thyroid dysfunction. It is known that one disease associated with anovulation and infertility, polycystic ovary syndrome, is associated with a high prevalence of thyroid autoantibodies, that is to say, thyroid autoimmune disease. This is less clear in women with endometriosis and really negligible in women who have tubal disorders.

Therefore, it is now widely accepted that [as part of] screening in women who present for infertility problems, a thyroid-stimulating hormone (TSH) measurement to assess thyroid function and the measurement of thyroid autoantibodies to evaluate whether autoimmune disease is present or not should be performed. Whether infertility is related to thyroid autoimmunity or is simply a reflection of a general problem of autoimmunity – which may include thyroid but in this case thyroid might not be responsible for infertility – is really unclear.