Introduction: Hashimoto’s thyroiditis (HT), a common
autoimmune thyroid disorder, has been increasingly
recognized as a contributor to female infertility due to its
endocrine and immune dysregulation. While its impact on
ovarian function and implantation has been studied, the
interplay between HT, systemic inflammation, and oral
microbiota remains poorly explored. Objective: This
narrative review aims to investigate the potential
bidirectional connections between Hashimoto’s thyroiditis,
female infertility, and oral microbiota, highlighting the
immune-endocrine-microbial axis as a novel contributor to
reproductive outcomes. Materials and methods: A
comprehensive literature search was conducted in
databases including PubMed, Scopus, and Web of Science,
focusing on studies published after 2018. Articles
addressing the relationship between HT, infertility,
systemic inflammation, and oral microbiota were included.
Results and discussion: Hashimoto’s thyroiditis is
associated with elevated autoantibodies (anti-TPO,
anti-Tg), altered TSH levels, and immune imbalance, all of
which negatively impacting fertility. Concurrently,
dysbiosis of the oral microbiota, particularly an increase in
pathogens like Porphyromonas gingivalis and Fusobacterium
nucleatum, contributes to low-grade systemic inflammation.
This inflammatory state may exacerbate autoimmune
activity and disrupt the hormonal milieu critical for
conception and successful pregnancy. Moreover, HT itself
can impair salivary composition, further promoting oral
dysbiosis. Conclusions: There is emerging evidence
suggesting that oral health and microbial homeostasis may
influence the course of autoimmune thyroiditis and female
fertility. An integrative, multidisciplinary approach
addressing both endocrine and oral health may offer novel
insights and therapeutic avenues in managing infertility
among women with Hashimoto’s thyroiditis.