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Background: Higher levels of thyroid autoantibodies in follicular fluid (FF) of thyroid autoimmunity (TAI) positive women are strongly correlated with serum levels and may have effect on the post-implantation embryo development. Literature highlights that levothyroxine (LT4) treatment may attenuate the risk of adverse pregnancy outcomes. The aim of the study was to estimate the pregnancy and newborn outcomes in women with FF thyroid autoantibodies undergoing assisted reproductive technology (A RT). Methods: The study population included 24 women with confirmed clinical pregnancy, 8 TAI positive and 16 TAI negative women. LT4 supplementation was applied in 20.8% patients, TAI positive. Results: Pregnancy outcomes were: twin pregnancy rate 4 1 .7 % , early miscarriage rate 8.3% , late miscarriage rate 4.2% , preterm birth rate 16.7% , term birth rate 70.8% , live birth rate 96.0% . There was significant difference in serum and in FF TgAbs (p< 0.001)betw een the groups according to TAI, while serum fT 3 was lower in the group with TAI (p = 0 .0 4 7 ). Serum P 4 was higher in LT4 treated group (p = 0 .0 0 5 ), with TAI, and newborns in this group had higher birth weight (p = 0.001) and height (p = 0 .0 0 8 ). Maternal complications occurred in 23.8% of patients. No congenital malformations in newborns were noted. Conclusions: Thyroid autoantibodies present in FF may have an effect on the post-implantation embryo development, but have no effect on further course of pregnancy. The special benefit of LT4 treatment for successful A R T outcome was demonstrated for newborn anthropometric parameters.

Hyperandrogenism is a condition in which the levels of androgen hormones in the blood are significantly increased and could be of an adrenal or ovarian origin. The adrenal androgens, normally secreted by the zona reticularis, are steroid hormones with weak androgen activity. The causes of hyperandrogenism are diverse and could be endogenous and exogenous. Androgen excess affecting different tissues and organs results in clinical features such as acne, hirsutism, virilization, and reproductive dysfunction such as oligomenorrhoea/amenorrhoea. Although androgen excess is rarely associated with adrenal tumours, it is important as it could be predictive of malignancy. A careful evaluation of the androgen pattern, also in patients with clear signs of hyperandrogenism, could be useful. Laboratory evaluation should focus on measuring total testosterone levels, followed by the estimation of other androgens such as dehydroepiandrosterone and androstenedione, and using visualisation procedures in the further management. The treatment of adrenal hyperandrogenism is eminently surgical, in consideration of the frequent malignant origin. The aim of this review is to elaborate and summarize the prevalence and clinical management of hyperandrogenism of an adrenal origin by describing the physiological mechanisms of adrenal androgen steroidogenesis, the clinical manifestations of hyperandrogenism with a special reference to hyperandrogenism in adrenal adenomas and carcinomas, and the diagnostic methods that will lead us to establishing the correct diagnosis and different treatment options to manage this condition according to the clinical presentation of the patient. [ABSTRACT FROM AUTHOR]

Obesity is an epidemic that has led to a rise in the incidence of many comorbidities: among others, reduced fertility is often under‐evaluated in clinical practice. The mechanisms underlying the link between reduced fertility and obesity are numerous, with insulin resistance, hyperglycaemia and the frequent coexistence of polycystic ovary syndrome being the most acknowledged. However, several other factors concur, such as gut microbiome alterations, low‐grade chronic inflammation and oxidative stress. Not only do women with obesity take longer to conceive, but in vitro fertilization (IVF) is also less likely to succeed. We herein provide an updated state‐of‐the‐art regarding the molecular bases of what we could define as dysmetabolic infertility, focusing on the clinical aspects, as well as possible treatment. [ABSTRACT FROM AUTHOR]

Today, infertility is not only a serious health but also a psycho-social problem, one that is on the rise in the world. Thyroid autoimmunity (TAI) is the most common disease of the thyroid gland in the reproductive period, which can affect spontaneous conception as well as conception through assisted reproduction technology (ART), but also the maintenance of healthy pregnancy. It can also cause numerous maternal and fetal complications. There is a wide array of publications on the topic of the mechanisms of association between TAI and reproduction, with the question of whether thyroid autoantibodies are solely tissue-specific antibodies, whether and when to start levothyroxine treatment, and that we require more fundamental research on the direct effect of thyroid autoantibodies starting from folliculogenesis to embryogenesis and implantation as well as the post-implantation embryo development, but also the composition of the follicular fluid as a microenvironment of enormous importance for the maturation of the oocytes which thyroid autoantibodies reach via the blood-follicle barrier. [ABSTRACT FROM AUTHOR]