skip to main content

Subclinical hypothyroidism in fertility treatment — SCE Endocrinology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateThyroidSubclinical hypothyroidism in fertility treatmentSCE Endocrinology

A 50-year-old woman has fatigue and weight gain. TSH is 8.6 mU/L and free T4 is normal on repeat testing; thyroid peroxidase antibodies are positive. She has dyslipidaemia and is trying to conceive through fertility treatment. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Start levothyroxine and monitor TSH response

Start levothyroxine and monitor TSH response is best because positive antibodies with symptoms and fertility planning makes levothyroxine treatment reasonable despite normal free T4. The alternatives are less appropriate because carbimazole and radioiodine are for hyperthyroidism; discharge ignores reproductive context; liothyronine monotherapy is not standard care. The SCE teaching point is to integrate the clinical pattern, biochemistry and context rather than treating an isolated result.

Reference: NICE NG145