The impact of Hashimoto’s disease on female fertility: a systematic review

Abstract

Hashimoto’s disease (HT) is the most common autoimmune disease, affecting 5–15% of women of reproductive age. Recent studies have shown that Hashimoto’s thyroiditis can be a risk factor for infertility in women. The aim of the present study is to explore the impact of Hashimoto’s disease on female fertility. This systematic review followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Databases searched included Medline, PubMed, EMBASE and Google Scholar. Search terms included Hashimoto’s disease, Hashimoto’s thyroiditis, thyroid autoimmunity, autoimmune thyroiditis, women, females, infertility and every possible combination of them. The exclusion criteria of this systematic review involved articles written in a language other than English, other disorders that also affect the female fertility, women with infertile partners, with abnormal karyotype or/and with abnormal body mass index (BMI). The search strategy identified 150 unique items. After the initial screening process, 50 studies underwent full text review and 5 studies were finally included in the systematic review, since they met all the inclusion criteria. Four of the included studies found that Hashimoto’s thyroiditis can have a negative effect on female fertility and especially in patients of advanced age. Women with autoimmune thyroiditis might be at risk of ovarian insufficiency because of the decline in ovarian reserve. Consequently, patients with positive anti-thyroid peroxidase (TPO) antibody findings, who wish to start a family, should be aware of their lower reproductive life span. Further randomized controlled trials can clarify the impact of Hashimoto’s disease on female fertility.