Abstract：
Thyroid hormones influence female fertility, directly stimulating oocyte maturation and regulating prolactin and sex hormone binding globulin (SHBG) concentrations. Hyperthyroidism affects 1-2%, overt hypothyroidism 0.3%, and subclinical hypothyroidism up to 15% of women of childbearing age. Approximately 10% of euthyroid women have elevated concentrations of anti-thyroid peroxidase antibodies (aTPO) and/or anti-thyroglobulin (aTg) antibodies. Hypothyroidism can cause menstrual and ovulation disorders, and impact fertility. Studies carried out to date have not conclusively demonstrated that subclinical hypothyroidism or elevated aTPO/aTg concentrations make it harder to conceive, but they do increase the risk of pregnancy loss. Subclinical hypothyroidism and elevated aTPO/aTg concentrations without thyroid disorders are more common in polycystic ovary syndrome, premature ovarian insufficiency, and idiopathic infertility. Fertility problems are therefore an indication for screening for thyroid diseases (in females as well as in some males). A thyroid disorder diagnosed in subfertile couples should be treated appropriately, especially before attempting assisted reproductive techniques. These recommendations are intended as a guide for the management of thyroid diseases associated with infertility.
摘要：
甲状腺激素影响女性生育能力，直接刺激卵母细胞成熟并调节催乳素和性激素结合球蛋白（SHBG）浓度。甲状腺功能亢进影响1-2%，明显的甲状腺功能减退症0.3%，亚临床甲状腺功能减退症高达15%的育龄妇女。大约10％的甲状腺功能正常的妇女的抗甲状腺过氧化物酶抗体（aTPO）和/或抗甲状腺球蛋白（aTg）抗体浓度升高。甲状腺功能减退会导致月经和排卵障碍，影响生育率。迄今为止进行的研究尚未最终证明亚临床甲状腺功能减退症或aTPO/aTg浓度升高使其更难受孕，但它们确实会增加怀孕失败的风险。亚临床甲状腺功能减退症和无甲状腺疾病的aTPO/aTg浓度升高在多囊卵巢综合征中更为常见，卵巢早衰,和特发性不孕症。因此，生育问题是筛查甲状腺疾病的指标（女性和某些男性）。在低生育能力夫妇中诊断出的甲状腺疾病应该得到适当的治疗，特别是在尝试辅助生殖技术之前。这些建议旨在指导与不孕症相关的甲状腺疾病的管理。
