Thyroid Disease and Miscarriage: Who's Right?

In studies of women undergoing treatment for infertility, thyroid disease does not seem to be a factor in recurrent miscarriage. Or, does it? There are many new studies being published concerning the effects of thyroid disease. It is now linked with many other health problems such as recurrent miscarriage. However, with every study that "proves" one theory there is another that denies the connection.

In point of fact, Medscape collected several abstracts of studies published in 1999, Autoimmune Thyroid Disease and Miscarriage. Of these, one study concluded flatly that there was no connection between the presence of thyroid antibodies and miscarriage while others concluded that there was a definite link.

Given these conflicting conclusions, how can those of us in the general public know what to believe? When you read about a study, try to find a copy of the full article. Most abstracts list the reference which looks something like this: Antithyroid Antibodies Do Not Affect Pregnancy Outcome in Women Undergoing Assisted Reproduction Kutteh WH, Schoolcraft WB, Scott RT Jr Hum Reprod 1999;14:2886-2890. Hum Reprod is the Journal of Human Reproduction. Many of the professional journals have a presence on the web, but most do not make copies of the articles available to non-subscribers. However, many hospitals have medical libraries that are open to the public with librarians who can help you. If there is not a medical library in your area, your local library can obtain a copy of the journal through interlibrary loan. The librarian may also be able to help you translate the "medicalese" in the study.

The full article will include the parameters of the study:

• How many subjects were included? In the abstracts collected by Medscape, the number of subjects ranged from 28 to over 400.
• How were subjects chosen? Four out five of these studies were conducted within an in vitro fertilization clinic.
• How long were they followed? These studies followed the outcome of one pregnancy.
• Who was chosen for the control group? Not every study has a control, a normal reference point to compare with the study group. When looking at controls, consider what other variables could have affected the outcome.
• Who funded the study? A scientific study could be constructed toward a certain outcome. Does the company or organization that funded the study have a vested interest in the outcome? A study that was funded by a major producer of thyroid replacement medication that finds more reasons for the use of the drug may be suspect.

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