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Seminars in Reproductive Medicine

Rebecca S Usadi, Kathryn S Merriam
The incidence of subclinical hypothyroidism (SCH) in pregnancy was classically thought to be low; however, with new definition of normal TSH range in pregnancy, there has been an increase in the percentage of women who meet classification for SCH. The diagnosis of SCH is important not only for monitoring for maternal conversion to overt hypothyroidism, but also for identifying obstetric and neonatal outcomes related to SCH. Although there have been proven associations between maternal overt hypothyroidism and adverse obstetric and neonatal outcomes, there has been conflicting data on the correlation between SCH and these outcomes...
October 17, 2016: Seminars in Reproductive Medicine
Natalie M Crawford, Anne Z Steiner
Thyroid hormones are important for normal reproductive function, and maternal thyroid dysfunction has been associated with infertility, miscarriage, preterm birth, and poor neurodevelopment in the offspring. Thyroid autoimmunity is the leading cause of thyroid dysfunction in women of reproductive age. Women with thyroid autoimmunity, even with normal thyroid function, appear to be at a higher risk for poor reproductive outcomes, including miscarriage and preterm birth. Thyroxine replacement in women with thyroid autoimmunity with or without appreciable thyroid dysfunction may improve pregnancy outcomes...
October 17, 2016: Seminars in Reproductive Medicine
Sophia S Yu, Lindsay A Bischoff
Owing to the young median age of diagnosis, thyroid cancer in women can coincide with pregnancy and affect its management. The evaluation of a thyroid nodule in pregnant women is similar to that in nonpregnant women, but special consideration must be taken for the impact of a cancer diagnosis and its sequelae in pregnancy. The initial comprehensive exam for pregnant and nonpregnant women includes evaluation of the biochemical function and structure of the thyroid gland, and then fine-needle aspiration biopsy of any suspicious nodule...
October 14, 2016: Seminars in Reproductive Medicine
Aimee Seungdamrong
Subclinical hypothyroidism has been found to be associated with adverse reproductive outcomes, such as infertility, miscarriage, preterm birth, and complications of pregnancy. Multiple studies have investigated the relationships between thyroid function, thyroid antibodies, fertility, and pregnancy. Thyroid autoimmunity is the most common cause of hypothyroidism in iodine-sufficient locations. Thyroid antibodies have been associated with adverse reproductive outcomes such as miscarriage and infertility. Debate exists regarding the method of identification of thyroid dysfunction in pregnancy, which can be conducted by targeted screening or by universal screening...
October 14, 2016: Seminars in Reproductive Medicine
Sudipa Sarkar, Lindsay A Bischoff
Hyperthyroidism can occur during pregnancy and the postpartum period, and the treatment of hyperthyroidism should be considered in the preconception phase. Pregnancy has multiple normal physiologic effects on thyroid hormone, which is a separate process distinct from syndromes such as transient hyperthyroidism of hyperemesis gravidarum. The rationale regarding antithyroid drug use during different stages of pregnancy is reviewed, including the literature regarding adverse neonatal outcomes such as aplasia cutis and methimazole embryopathy in the setting of first trimester maternal methimazole use...
October 14, 2016: Seminars in Reproductive Medicine
Neal Patel, James A Kashanian
Normal thyroid physiology is paramount for the proper development and important for the maintenance of male reproduction. Both short- and long-term deviations in thyroid hormone levels have been shown to alter male reproductive function on a micro- and macroscopic level. Thyrotoxicosis and hypothyroidism are associated with changes in spermatogenesis, semen quality, levels of sexual hormones, and erectile function. However, the degree to which thyroid dysfunction is clinically responsible for male infertility has not been clearly elucidated...
October 14, 2016: Seminars in Reproductive Medicine
Jeffrey M Kroopnick, Caroline S Kim
Overt hypothyroidism in pregnancy, defined as an elevated serum thyroid-stimulating hormone (TSH) and reduced serum free thyroxine or a TSH >10 mIU/L, is known to have adverse effects on pregnancy. Subclinical hypothyroidism is typically defined as an elevated TSH and normal FT4 levels. There remains much controversy on the benefit of starting levothyroxine for mothers diagnosed with subclinical hypothyroidism. Recent studies are redefining the normal range for TSH in pregnancy, and the data on whether treatment of subclinical hypothyroidism improves outcomes for the mother and fetus are unclear...
October 14, 2016: Seminars in Reproductive Medicine
Clarisa R Gracia
No abstract text is available yet for this article.
October 12, 2016: Seminars in Reproductive Medicine
Megan E Gornet, Nabal J Bracero, James H Segars
The emergence of the Zika virus (ZIKV) epidemic in South and Central America has ascended to the forefront of international attention. While research regarding the effects and details surrounding ZIKV in pregnancy is well underway, especially related to blood-borne transmission, less attention has been devoted to ZIKV infection in semen and questions concerning implications of ZIKV infection in men. In this review, we present what is known and unknown, and the implications for localization of ZIKV to the male urogenital system...
September 2016: Seminars in Reproductive Medicine
Serdar E Bulun
No abstract text is available yet for this article.
September 2016: Seminars in Reproductive Medicine
Serdar E Bulun
No abstract text is available yet for this article.
September 2016: Seminars in Reproductive Medicine
Chantel I Washington, Sara Haque, James H Segars, Nabal Bracero, Fernando Rodriguez, G David Ball, Owen K Davis
The Zika virus (ZIKV) epidemic spreading through South and Central America, as well as several U.S. territories has created worldwide concern as the linkage between ZIKV infection and microcephaly has been established. Both travel associated and sexually transmitted cases have put couples who live in nonendemic areas at risk of falling victim to effects of Zika. The presence of ZIKV within reproductive tissues may pose a significant threat to patients seeking fertility services and to safety of the tissues currently housed in assisted reproductive technology (ART) laboratories...
September 2016: Seminars in Reproductive Medicine
David A Schirmer, Jennifer Fay Kawwass
Over the past year, the Zika virus, an arthropod-borne Flavivirus, has transitioned from a relatively unknown tropical disease to the cause of a public health emergency. The Zika virus is transmitted by the Aedes species of mosquito as well as by sexual intercourse. Although the symptoms of acute Zika virus infection are usually mild and self-limited, it causes fetal microcephaly in pregnant women, and is associated with an increased risk of Guillain-Barré syndrome. The risk of microcephaly from Zika virus infection is estimated to be highest in women who are infected during the first trimester of pregnancy...
September 2016: Seminars in Reproductive Medicine
Laura S Muñoz, Paula Barreras, Carlos A Pardo
Zika virus (ZIKV) has caused a major infection outbreak in the Americas since 2015. In parallel with the ZIKV epidemic, an increase in cases of neurological disorders which include Guillain-Barré syndrome (GBS), encephalitis, and myelitis have been linked to the infection. We reviewed the evidence suggesting a relationship between ZIKV and neurological disorders in adults. A search of the literature supporting such link included databases such as PubMed and the World Health Organization (WHO) surveillance system...
September 2016: Seminars in Reproductive Medicine
Anne Burke, Caroline Moreau
The connection between infection with the Zika virus (ZKV) and congenital anomalies such as microcephaly has been generally accepted. Although efforts are underway to develop preventive interventions such as vaccines, these are not yet available. Family planning is an effective preventive approach that has been underemphasized in many lists of research priorities. In addition to acquisition of ZKV from mosquitoes, sexual transmission from males to females has been documented. Women at risk of ZKV need access to effective contraception if they want to avoid or postpone pregnancy, as well as access to safe abortion...
September 2016: Seminars in Reproductive Medicine
Shriddha Nayak, Jun Lei, Andrew Pekosz, Sabra Klein, Irina Burd
Zika virus (ZIKV) is one of the most important emerging viruses of 2016. A developing outbreak in the Americas has demonstrated an association between the virus and serious clinical manifestations, such as Guillain-Barré syndrome in adults and congenital malformations in infants born to infected mothers. Pathogenesis and mechanisms of neurologic or immune disease by ZIKV have not been clearly delineated. However, several pathways have been described to explain viral involvement in brain and immune system as well as other organ systems such as eye, skin, and male and female reproductive tracts...
September 2016: Seminars in Reproductive Medicine
Solange N Eloundou, Jeanne S Sheffield
The identification of Zika virus as a significant teratogen has raised international concern, causing the World Health Organization to declare a Public Health Emergency of International Concern. This has allowed a global mobilization of experts in tropical infectious diseases, obstetrics, pediatrics, virology, public health policy, reproductive health, bioethics, and germ cell research to name just a few. This worldwide crisis has also raised awareness of health care disparities and concerns regarding the ability of families and societies to shoulder the long-term financial burden that the follow-up of affected children will require...
September 2016: Seminars in Reproductive Medicine
Anna P Durbin
Zika virus is a mosquito-borne Flavivirus that spread rapidly through South and Central America in 2015 to 2016. Microcephaly has been causally associated with Zika virus infection during pregnancy and the World Health Organization declared Zika virus as a Public Health Emergency of International Concern. To address this crisis, many groups have expressed their commitment to developing a Zika virus vaccine. Different strategies for Zika virus vaccine development are being considered including recombinant live attenuated vaccines, purified inactivated vaccines (PIVs), DNA vaccines, and viral vectored vaccines...
September 2016: Seminars in Reproductive Medicine
Jeanne Sheffield, James Segars
No abstract text is available yet for this article.
September 2016: Seminars in Reproductive Medicine
Krina T Zondervan, Nilufer Rahmioglu, Andrew P Morris, Dale R Nyholt, Grant W Montgomery, Christian M Becker, Stacey A Missmer
Endometriosis is a heritable, complex chronic inflammatory disease, for which much of the causal pathogenic mechanism remains unknown. Genome-wide association studies (GWAS) to date have identified 12 single nucleotide polymorphisms at 10 independent genetic loci associated with endometriosis. Most of these were more strongly associated with revised American Fertility Society stage III/IV, rather than stage I/II. The loci are almost all located in intergenic regions that are known to play a role in the regulation of expression of target genes yet to be identified...
July 2016: Seminars in Reproductive Medicine
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