Clinical presentation: A 25-year-old woman was examined because of infertility and an elevated aTPO level was detected.

Palpation: Both lobes were firm.

Laboratory tests: TSH 1.97 mIU/L, anti-TPO 110 U/mL.

Ultrasonography revealed a moderately hypoechogenic thyroid which contained several more hypoechogenic and echonormal areas. None of them fit to a nodule in pathological sense.

Suggestion: yearly TSH determination, in the event of pregnancy at once.