Subclinical hypothyroidism is a condition of mild thyroid insufficiency that does not cause symptoms. This disorder is detected by a blood test, showing elevated concentrations of thyrotropin (TSH) in the presence of normal concentrations of free thyroxine (free T4). It is a common disorder in the general population and usually does not require any type of treatment. However, it is a disorder that can have a significant impact on reproductive outcomes and therefore must be taken into account by women of childbearing age seeking pregnancy.
Complications of subclinical hypothyroidism on reproductive outcome may include an increased incidence of infertility, recurrent miscarriage, and adverse obstetric and fetal outcomes.
For many years there has been debate among medical-scientific societies about when to treat or whether to treat sterile or infertile patients with this type of disorder or not, since the treatment is not free of adverse effects.
This month, the American Society for Reproductive Medicine (ASRM) published a medical guide in the scientific journal Fertility and Sterility, which establishes the most advisable guidelines to follow for infertile women with respect to this issue. Among other things, it recommends performing a blood test for TSH (thyrotropin or thyroid-stimulating hormone) on all women with sterility or infertility problems who are trying to get pregnant. If these valuesare altered, they recommend starting treatment with the appropriate subsequent controls for a good result from a reproductive, obstetric and perinatal point of view.