The fetal thyroid begins to accumulate radioiodine around the 12th week of
pregnancy. Iodide easily crosses the placenta and fetal thyroid uptake can
be effectively blocked by administration of radioiodine to the mother. Ther
apeutic administration of radioiodine to the mother will usually result in
fetal hypothyroidism and may be associated with attention deficit disorders
and impairment of figurative memory in the offspring. The hazard to a fetu
s from exposure to a family member, not the mother, who has been treated wi
th radioiodine is very small and can be minimized by adherence to standard
post treatment guidelines. Lactating mothers who have received standard dia
gnostic doses of I-131 or who have been treated with I-131 should not breas
t-feed their infant from that point forward. Breast-feeding in future pregn
ancies is not contraindicated. Pregnancy testing within 48 hours before I-1
31 administration to potentially fertile women is a wise clinical practice.
Demonstrated effects of radioiodine on spermatogenesis suggest that it is
wise to recommend a 120-day waiting period between radioiodine and fertiliz
ation.