The choice of therapy depends on th

The choice of therapy depends on the patient’s preference, disease history, the presence of high TSH-R-Ab levels, and the timescale for conception [134-138]. Pregnancy should be postponed if hyperthyroidism is inadequately controlled until euthyroidism is reached and confirmed on two occasions over 2 months on a stable therapeutic regimen. Patients should be informed about: (1) the increased risk of ATD-associated birth defects; (2) the possibility of stopping ATD during gestational weeks 6–10; (3) the preference for PTU, when ATD are necessary before/during the first trimester of pregnancy; (4) the advice to switch from PTU to MMI after 16 weeks of pregnancy; and (5) not to use block-replacement therapy. Pregnancy should be delayed for 6 months post-RAI, and contraception is advised during that period. Thyroidectomy is indicated in the case of contraindications/rejection of ATD/RAI. After surgery, euthyroidism should be confirmed prior to conception.