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The role of thyroid autoimmunity in fertility and pregnancy

Nature Clinical Practice Endocrinology & Metabolism volume 4, pages 394–405 (2008)Cite this article

Abstract

The thyroid gland and gonadal axes interact continuously before and during pregnancy. Hypothyroidism influences ovarian function by decreasing levels of sex-hormone-binding globulin and increasing the secretion of prolactin. In women of reproductive age, hypothyroidism can be reversed by thyroxine therapy to improve fertility and avoid the need for use of assisted reproduction technologies. For infertile women, preparation for medically assisted pregnancy comprises controlled ovarian hyperstimulation that substantially increase circulating estrogen concentrations, which in turn can severely impair thyroid function. In women without thyroid autoimmunity these changes are transient, but in those with thyroid autoimmunity estrogen stimulation might lead to abnormal thyroid function throughout the remaining pregnancy period. Prevalence of thyroid autoimmunity is significantly higher among infertile women than among fertile women, especially among those whose infertility is caused by endometriosis or ovarian dysfunction. Presence of thyroid autoimmunity does not interfere with normal embryo implantation, but the risk of early miscarriage is substantially raised. Subclinical and overt forms of hypothyroidism are associated with increased risk of pregnancy-related morbidity, for which thyroxine therapy can be beneficial. Systematic screening for thyroid disorders in pregnant women remains controversial but might be advantageous in women at high risk, particularly infertile women.

Key Points

  • Hypothyroidism is due mainly to chronic autoimmune thyroiditis and is associated with increased morbidity during pregnancy

  • Hypothyroidism associated with infertility seems to be increased only in women with ovulatory dysfunction, whereas the frequency of thyroid autoimmunity is raised in infertile women with endometriosis and ovulatory dysfunction

  • In spontaneous and medically assisted pregnancies the presence of thyroid autoimmunity is associated with a significantly raised frequency of miscarriages, even when thyroid function is apparently normal

  • Screening for thyroid dysfunction, autoimmunity or both should be performed as part of the work-up in women with infertility and other well-defined high-risk conditions

  • Levothyroxine therapy should be administered for subclinical and overt hypothyroidism, especially if menses are irregular, assisted reproductive technologies or controlled ovarian hyperstimulation have been used, and during pregnancy

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References

  1. Jones RL et al. (2004) Identification of chemokines important for leukocyte recruitment to the human endometrium at the times of embryo implantation and menstruation. J Clin Endocrinol Metab 89: 6155–6167

    Article  CAS  PubMed  Google Scholar 

  2. Hollowell JG et al. (2002) Serum TSH, T4, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 87: 489–499

    Article  CAS  PubMed  Google Scholar 

  3. Poppe K and Glinoer D (2003) Thyroid autoimmunity and hypothyroidism before and during pregnancy. Hum Reprod Update 9: 149–161

    Article  PubMed  Google Scholar 

  4. Krassas GE (2000) Thyroid disease and female reproduction. Fertil Steril 74: 1063–1070

    Article  CAS  PubMed  Google Scholar 

  5. Wang X et al. (2003) Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study. Fertil Steril 79: 577–584

    Article  PubMed  Google Scholar 

  6. Gnoth C et al. (2003) Time to pregnancy: results of the German prospective study and impact on the management of infertility. Hum Reprod 18: 1959–1966

    Article  CAS  PubMed  Google Scholar 

  7. Mosher WD and Pratt WF (1991) Fecundity and infertility in the United States: incidence and trends. Fertil Steril 56: 192–193

    Article  CAS  PubMed  Google Scholar 

  8. Healy DL et al. (1994) Female infertility: causes and treatment. Lancet 343: 1539–1544

    Article  CAS  PubMed  Google Scholar 

  9. Schenken RS and Guzick DS (1997) Revised endometriosis classification: 1996. Fertil Steril 67: 815–816

    Article  CAS  PubMed  Google Scholar 

  10. Lunenfeld B and Insler V (1974) Classification of amenorrhoeic states and their treatment by ovulation induction. Clin Endocrinol 3: 223–237

    Article  CAS  Google Scholar 

  11. ESHRE Workshop Group (2004) Diagnosis and management of the infertile couple: missing information. Hum Reprod Update 10: 295–307

  12. Rosene-Montella K et al. (2000) Evaluation and management of infertility in women: the internists' role. Ann Intern Med 132: 973–981

    Article  CAS  PubMed  Google Scholar 

  13. Braude P and Rowell P (2003) Assisted conception. II—in vitro fertilization and intracytoplasmic sperm injection. BMJ 327: 852–855

    Article  PubMed  PubMed Central  Google Scholar 

  14. Osmanagaoglu K et al. (2002) Cumulative delivery rates after ICSI in women aged >37 years. Hum Reprod 17: 940–944

    Article  PubMed  Google Scholar 

  15. Glinoer D (1997) The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocr Rev 18: 404–433

    Article  CAS  PubMed  Google Scholar 

  16. Davis LB et al. (2007) The effect of infertility medication on thyroid function in hypothyroid women who conceive. Thyroid 17: 773–777

    Article  CAS  PubMed  Google Scholar 

  17. Alexander EK et al. (2004) Timing and magnitude of increases in levothyroxine requirements during pregnancy in women with hypothyroidism. N Engl J Med 351: 241–249

    Article  CAS  PubMed  Google Scholar 

  18. Muller AF et al. (2000) Decrease of free thyroxine levels after controlled ovarian hyperstimulation. J Clin Endocrinol Metab 85: 545–548

    Article  CAS  PubMed  Google Scholar 

  19. Poppe K et al. (2004) Impact of ovarian hyperstimulation on thyroid function in women with and without thyroid autoimmunity. J Clin Endocrinol Metab 89: 3808–3812

    Article  CAS  PubMed  Google Scholar 

  20. Thomas R and Reid RL (1987) Thyroid disease and reproductive dysfunction: a review. Obstet Gynecol 70: 789–798

    CAS  PubMed  Google Scholar 

  21. Maruo T et al. (1991) Thyroid hormone as a biological amplifier of differentiated trophoblast function in early pregnancy. Acta Endocrinol 125: 58–66

    Article  CAS  Google Scholar 

  22. Cecconi S et al. (1999) Thyroid hormone effects on mouse oocyte maturation and granulosa cell aromatase activity. Endocrinology 140: 1783–1788

    Article  CAS  PubMed  Google Scholar 

  23. Tomer Y and Davies TF (2003) Searching for the autoimmune thyroid disease susceptibility genes: from gene mapping to gene function. Endo Rev 24: 694–717

    Article  CAS  Google Scholar 

  24. Prummel MF et al. (2004) The environment and autoimmune thyroid diseases. Eur J Endocrinol 150: 605–618

    Article  CAS  PubMed  Google Scholar 

  25. Wilson C et al. (1975) Smooth-muscle antibodies in infertility. Lancet 20: 1238–1239

    Article  Google Scholar 

  26. Roussev RG et al. (1996) Laboratory evaluation of women experiencing reproductive failure. Am J Reprod Immunol 35: 415–420

    Article  CAS  PubMed  Google Scholar 

  27. Geva E et al. (1997) The presence of antithyroid antibodies in euthyroid patients with unexplained infertility and tubal obstruction. Am J Reprod Immunol 37: 184–186

    Article  CAS  PubMed  Google Scholar 

  28. Kutteh WH et al. (1999) Increased prevalence of antithyroid antibodies identified in women with recurrent pregnancy loss but not in women undergoing assisted reproduction. Fertil Steril 71: 843–848

    Article  CAS  PubMed  Google Scholar 

  29. Kaider AS et al. (1999) Immunodiagnostic evaluation in women with reproductive failure. Am J Reprod Immunol 42: 335–346

    Article  CAS  PubMed  Google Scholar 

  30. Reimand K et al. (2001) Autoantibody studies of female patients with reproductive failure. J Reprod Immunol 51: 167–176

    Article  CAS  PubMed  Google Scholar 

  31. Poppe K et al. (2002) Thyroid dysfunction and autoimmunity in infertile women. Thyroid 12: 997–1001

    Article  PubMed  Google Scholar 

  32. Janssen OE et al. (2004) High prevalence of autoimmune thyroiditis in patients with polycystic ovary syndrome. Eur J Endocrinol 150: 363–369

    Article  CAS  PubMed  Google Scholar 

  33. Abalovich M et al. (2007) Subclinical hypothyroidism and thyroid autoimmunity in women with infertility. Gynecol Endocrinol 23: 279–283

    Article  CAS  PubMed  Google Scholar 

  34. Petta CA et al. (2007) Thyroid autoimmunity and thyroid dysfunction in women with endometriosis. Hum Reprod 22: 2693–2697

    Article  CAS  PubMed  Google Scholar 

  35. Gerhard I et al. (1991) Thyroid and ovarian function in infertile women. Hum Reprod 6: 338–345

    Article  CAS  PubMed  Google Scholar 

  36. Matarese G et al. (2003) Pathogenesis of endometriosis: natural immunity dysfunction or autoimmune disease? Trends Mol Med 9: 223–228

    Article  CAS  PubMed  Google Scholar 

  37. Grassi G et al. (2001) Thyroid autoimmunity and infertility. Gynecol Endocrinol 15: 389–396

    Article  CAS  PubMed  Google Scholar 

  38. Poppe K et al. (2003) Assisted reproduction and thyroid autoimmunity: an unfortunate combination? J Clin Endocrinol Metab 88: 4149–4152

    Article  CAS  PubMed  Google Scholar 

  39. Stagnaro-Green A et al. (1990) Detection of at-risk pregnancy by means of highly sensitive assays for thyroid autoantibodies. JAMA 264: 1422–1425

    Article  CAS  PubMed  Google Scholar 

  40. Glinoer D (1991) Pregnancy in patients with mild thyroid abnormalities: maternal and neonatal repercussions. J Clin Endocrinol Metab 73: 421–427

    Article  CAS  PubMed  Google Scholar 

  41. Lejeune B et al. (1993) Antithyroid antibodies underlying thyroid abnormalities and miscarriage or pregnancy induced hypertension. Br J Obstet Gynaecol 100: 669–672

    Article  CAS  PubMed  Google Scholar 

  42. Pratt DE et al. (1993) The association of antithyroid antibodies in euthyroid nonpregnant women with recurrent first trimester abortions in the next pregnancy. Fertil Steril 60: 1001—1005

    Article  CAS  PubMed  Google Scholar 

  43. Singh A et al. (1995) Presence of thyroid antibodies in early reproductive failure: biochemical versus clinical pregnancies. Fertil Steril 63: 277–281

    Article  CAS  PubMed  Google Scholar 

  44. Bussen S and Steck T (1995) Thyroid autoantibodies in euthyroid non-pregnant women with recurrent spontaneous abortions. Hum Reprod 10: 2938–2940

    Article  CAS  PubMed  Google Scholar 

  45. Iijima T et al. (1997) Effects of autoantibodies on the course of pregnancy and fetal growth. Obstet Gynaecol 90: 364–369

    Article  CAS  Google Scholar 

  46. Esplin MS et al. (1998) Thyroid autoantibodies are not associated with recurrent pregnancy loss. Am J Obstet Gynecol 179: 1583–1586

    Article  CAS  PubMed  Google Scholar 

  47. Kim CH et al. (1998) Influence of antithyroid antibodies in euthyroid women on in vitro fertilization-embryo transfer outcome. Am J Reprod Immunol 40: 2–8

    Article  CAS  PubMed  Google Scholar 

  48. Muller AF et al. (1999) Thyroid autoimmunity and abortion: a prospective study in women undergoing in vitro fertilization. Fertil Steril 71: 30–34

    Article  CAS  PubMed  Google Scholar 

  49. Bussen S et al. (2000) Increased prevalence of thyroid antibodies in euthyroid women with a history of recurrent in-vitro fertilization failure. Hum Reprod 15: 545–548

    Article  CAS  PubMed  Google Scholar 

  50. Dendrinos S et al. (2000) Thyroid autoimmunity in patients with recurrent spontaneous miscarriages. Gynecol Endocrinol 14: 270–274

    Article  CAS  PubMed  Google Scholar 

  51. Rushworth FH et al. (2000) Prospective pregnancy outcome in untreated recurrent miscarries with thyroid autoantibodies. Hum Reprod 15: 1637–1639

    Article  CAS  PubMed  Google Scholar 

  52. Bagis T et al. (2001) Autoimmune thyroid disease in pregnancy and the postpartum period: relationship to spontaneous abortion. Thyroid 11: 1049–1053

    Article  CAS  PubMed  Google Scholar 

  53. Sieiro Netto L et al. (2004) Influence of thyroid autoimmunity and maternal age on the risk of miscarriage. Am J Reprod Immunol 52: 312–316

    Article  PubMed  Google Scholar 

  54. Negro R et al. (2005) Levothyroxine treatment in thyroid peroxidase antibody-positive women undergoing assisted reproduction technologies: a prospective study. Hum Reprod 20: 1529–1533

    Article  CAS  PubMed  Google Scholar 

  55. Negro R et al. (2007) Euthyroid women with autoimnmune disease undergoing assisted reproduction technologies: the role of autoimmunity and thyroid function. J Endocrinol Invest 30: 3–8

    Article  CAS  PubMed  Google Scholar 

  56. Prummel MF and Wiersinga WM (2004) Thyroid autoimmunity and miscarriage. Eur J Endocrinol 150: 751–755

    Article  CAS  PubMed  Google Scholar 

  57. De Carolis C et al. (2004) Anti-thyroid antibodies and antiphospholipid syndrome: evidence of reduced fecundity and of poor pregnancy outcome in recurrent spontaneous aborters. Am J Reprod Immunol 52: 263–266

    Article  PubMed  Google Scholar 

  58. Stagnaro-Green A and Glinoer D (2004) Thyroid autoimmunity and the risk of miscarriage. Best Pract Res Clin Endocrinol Metab 18: 167–181

    Article  CAS  PubMed  Google Scholar 

  59. Roberts J et al. (1996) Recurrent miscarriage is associated with increased numbers of CD5/20 positive lymphocytes and an increased incidence of thyroid antibodies. Eur J Endocrinol 134: 84–86

    Article  CAS  PubMed  Google Scholar 

  60. Matalon ST et al. (2001) The association between anti-thyroid antibodies and pregnancy loss. Am J Reprod Immunol 45: 72–77

    Article  CAS  PubMed  Google Scholar 

  61. Matalon ST et al. (2003) The pathogenic role of anti-thyroglobulin antibody on pregnancy: evidence from an active immunization model in mice. Hum Reprod 18: 1094–1099

    Article  PubMed  CAS  Google Scholar 

  62. Maruo T et al. (1992) The role of maternal thyroid hormones in maintaining early pregnancy in threatened abortion. Acta Endocrinol 127: 118–122

    Article  CAS  Google Scholar 

  63. Glinoer D et al. (1994) Risk of subclinical hypothyroidism in pregnant women with asymptomatic autoimmune thyroid disorders. J Clin Endocrinol Metab 79: 197–204

    CAS  PubMed  Google Scholar 

  64. Premawardhana LD et al. (2000) Postpartum thyroiditis and long-term thyroid status: prognostic influence of thyroid peroxidase antibodies and ultrasound echogenicity. J Clin Endocrinol Metab 85: 71–75

    Article  CAS  PubMed  Google Scholar 

  65. Parle JV et al. (1993) Thyroxine prescription in the community: serum thyroid stimulating hormone level assays as an indicator of undertreatment or overtreatment. Br J Gen Pract 43: 107–109

    CAS  PubMed  PubMed Central  Google Scholar 

  66. Kiprov DD et al. (1996) The use of intravenous immunoglobulin in recurrent pregnancy loss associated with combined alloimmune and autoimmune abnormalities. Am J Reprod Immunol 36: 228–234

    Article  CAS  PubMed  Google Scholar 

  67. Sher G et al. (1998) The use of combined heparin/aspirin and immunoglobulin G therapy in the treatment of in vitro fertilization patients with antithyroid antibodies. Am J Reprod Immunol 39: 223–225

    Article  CAS  PubMed  Google Scholar 

  68. Vaquero E et al. (2001) Pregnancy outcome in recurrent spontaneous abortion associated with anti-phospholipid antibodies: a comparative study of intravenous immunoglobulin versus prednisone plus low-dose aspirin. Am J Reprod Immunol 45: 174–179

    Article  CAS  PubMed  Google Scholar 

  69. Abalovich M et al. (2002) Overt and subclinical hypothyroidism complicating pregnancy. Thyroid 12: 63–68

    Article  CAS  PubMed  Google Scholar 

  70. Negro R et al. (2006) Levothyroxine treatment in euthyroid pregnant women with autoimmune thyroid disease: effects on obstetrical complications. J Clin Endocrinol Metab 91: 2587–2591

    Article  CAS  PubMed  Google Scholar 

  71. Glinoer D (2006) Miscarriage in women with positive anti-TPO antibodies: is thyroxine the answer? (Editorial) J Clin Endocrinol Metab 91: 2500–2502

    Article  CAS  PubMed  Google Scholar 

  72. Allan WC et al. (2000) Maternal thyroid deficiency and pregnancy complications: implications for population screening. J Med Screen 7: 127–130

    Article  CAS  PubMed  Google Scholar 

  73. Joshi JV et al. (1993) Menstrual irregularities and lactation failure may precede thyroid dysfunction or goitre. Postgrad Med 39: 137–141

    CAS  Google Scholar 

  74. Krassas GE et al. (1999) Disturbances of menstruation in hypothyroidism. Clin Endocrinol 50: 655–659

    Article  CAS  Google Scholar 

  75. Ansell JE (1996) The blood in hypothyroidism. In Werner SC and Ingbar SH, The Thyroid: a Fundamental and Clinical Text, 821–825 (Eds Braverman LE and Utiger RD). Philadelphia, PA: Lippincott Williams & Wilkins

    Google Scholar 

  76. Wakim AN et al. (1993) Thyroid hormones in human follicular fluid and thyroid hormone receptors in human granulosa cells. Fertil Steril 59: 1187–1190

    Article  CAS  PubMed  Google Scholar 

  77. Cramer DW et al. (2003) Serum prolactin and TSH in an in vitro population: is there a link between fertilization and thyroid function? J Assist Reprod Genet 20: 210–215

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. Andersen S et al. (2002) Narrow individual variations in serum T(4) and T(3) in normal subjects: a clue to the understanding of subclinical thyroid disease. J Clin Endocrinol Metab 87: 1068–1072

    Article  CAS  PubMed  Google Scholar 

  79. Brabant G et al. (2006) Is there a need to redefine the upper normal limit of TSH? Eur J Endocrinol l54: 633–637

    Article  CAS  Google Scholar 

  80. Bohnet HG et al. (1981) Subclinical hypothyroidism and infertility. Lancet 5: 1278

    Article  Google Scholar 

  81. Shalev E et al. (1994) Routine thyroid function tests in infertile women: are they necessary? Am J Obstet Gynecol 171: 1191–1192

    Article  CAS  PubMed  Google Scholar 

  82. Arojoki M et al. (2000) Hypothyroidism among infertile women in Finland. Gynecol Endocrinol 14: 127–131

    Article  CAS  PubMed  Google Scholar 

  83. Raber W et al. (2003) Thyroxine treatment modified in infertile women according to thyroxine-releasing hormone testing: 5 year follow-up of 283 women referred after exclusion of absolute causes of infertility. Hum Reprod 18: 707–714

    Article  CAS  PubMed  Google Scholar 

  84. Mandel SJ (2004) Hypothyroidism and chronic autoimmune thyroiditis in the pregnant state: maternal aspects. Best Pract Res Clin Endocrinol Metab 18: 213–224

    Article  CAS  PubMed  Google Scholar 

  85. Casey BM et al. (2005) Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol 105: 239–245

    Article  PubMed  Google Scholar 

  86. Glinoer D and Delange F (2000) The potential repercussions of maternal, fetal, and neonatal hypothyroxinemia on the progeny. Thyroid 10: 871–887

    Article  CAS  PubMed  Google Scholar 

  87. Morreale GM et al. (2004) Maternal thyroid hormones early in pregnancy and fetal brain development. Best Pract Res Clin Endocrinol Metab 18: 225–248

    Article  CAS  Google Scholar 

  88. Haddow JE et al. (1999) Maternal thyroid deficiency during pregnancy and subsequent neuro-psychological development of the child. N Engl J Med 341: 549–555

    Article  CAS  PubMed  Google Scholar 

  89. Pop VJ et al. (2003) Maternal hypothyroxinaemia during early pregnancy and subsequent child development: a 3-year follow-up study. Clin Endocrinol 59: 282–288

    Article  Google Scholar 

  90. Wilson JMG and Jungner G (1968) Principles and practice of screening for disease, 473. Geneva: 55 WHO

    Google Scholar 

  91. Sapin R et al. (2004) Free thyroxine measured with equilibrium dialysis and nine immunoassays decreases in late pregnancy. Clin Lab 50: 581–584

    CAS  PubMed  Google Scholar 

  92. Kahric-Janicic N et al. (2007) Tandem mass spectrometry improves the accuracy of free thyroxine measurements during pregnancy. Thyroid 17: 303–311

    Article  CAS  PubMed  Google Scholar 

  93. Panesar NS et al. (2001) Reference intervals for thyroid hormones in pregnant Chinese women. Ann Clin Biochem 38: 329–332

    Article  CAS  PubMed  Google Scholar 

  94. Dashe JS et al. (2005) Thyroid-stimulating hormone in singleton and twin pregnancy: importance of gestational age-specific reference ranges. Obstet Gynecol 106: 753–757

    Article  CAS  PubMed  Google Scholar 

  95. Glinoer D and Abalovich M (2007) Unresolved questions in managing hypothyroidism during pregnancy. BMJ 335: 300–302

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  96. Abalovich M et al. (2007) Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 92 (Suppl 8): S1–S47

    Article  CAS  PubMed  Google Scholar 

  97. Committee on Patient Safety and Quality Improvement; Committee on Professional Liability (2007) ACOG Committee Opinion No. 381: Subclinical hypothyroidism in pregnancy. Obstet Gynecol 110: 959–960

  98. Glinoer D (1998) The systematic screening and management of hypothyroidism and hyperthyroidism during pregnancy. Trends Endocrinol Metab 9: 403–411

    Article  CAS  PubMed  Google Scholar 

  99. Haddow JE et al. (2006) Screening for thyroid disorders during pregnancy: results of a survey in Maine. Am J Obstet Gynecol 194: 471–474

    Article  PubMed  Google Scholar 

  100. Vaidya B et al. (2007) Detection of thyroid dysfunction in early pregnancy: universal screening or targeted high-risk case finding? J Clin Endocrinol Metab 92: 203–207

    Article  CAS  PubMed  Google Scholar 

  101. Davies TF (2007) Time for the American thyroid association to lead on thyroid screening in pregnancy. Thyroid 17: 697–698

    Article  PubMed  Google Scholar 

  102. Poppe K et al. (2007) Thyroid disease and female reproduction. Clin Endocrinol 66: 309–321

    Article  CAS  Google Scholar 

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Acknowledgements

Personal studies included in this Review were made possible thanks to support to K Poppe from the Willy Gepts Foundation. D Glinoer acknowledges the support of the Ministère de la Communauté Française (Administration Générale de l'Enseignement et Recherche Scientifique) within the framework of Actions de Recherche Concertée. We thank all our colleagues from the Center for Reproductive Medicine, Brussels, Belgium, for providing study data. Charles P Vega, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.

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Authors and Affiliations

  1. K Poppe is Coordinator of the Thyroid Clinic and B Velkeniers is Head of the Department of Internal Medicine and Endocrinology at the University Hospital UZ Brussel, Brussels, Belgium.,

    Kris Poppe & Brigitte Velkeniers

  2. D Glinoer is Head of the Endocrine Division, University Hospital Saint Pierre, Brussels, Belgium.,

    Daniel Glinoer

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Correspondence to Kris Poppe.

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Poppe, K., Velkeniers, B. & Glinoer, D. The role of thyroid autoimmunity in fertility and pregnancy. Nat Rev Endocrinol 4, 394–405 (2008). https://doi.org/10.1038/ncpendmet0846

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