Table 3.

Recommendations for women with infertility and/or undergoing assisted reproductive technology (ART) according to the ETA 2021 guidelines (14).

Test/Treatment	ETA 2021
TSH screening	Women seeking care for infertility
Recommended TSH upper limits	4.0 mIU/L or ULRR*
TPOAb measurement	Women seeking care for infertility
TgAb measurement	If TSH>2.5 mIU/L and TPOAb negative
Thyroid ultrasound	If TSH>2.5 mIU/L and TPOAb negative
L-T4 treatment in women undergoing ART	Recommended in overt hypothyroidism Recommended if TSH is >4 mIU/L with/without TAI Suggested in TAI if TSH is >2.5< 4 mIU/L on a case-by-case basis
Fertilization preferred method in TAI	ICSI suggested

TSH, thyroid stimulating hormone; ART, assisted reproductive technology; ULRR, Upper limit reference range. TAI, thyroid autoimmunity. TPOAb, thyroperoxidase antibody; TgAb, thyroglobulin antibody; L-T4, levothyroxine; OS, ovarian stimulation ICSI, intracytoplasmic sperm injection. ART, assisted reproductive technology.

*If ULRR is >4.0 mUI/L.