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Low frequency of thyroid dysfunction in infertile women

(March 2003)

The background of the study. Women with thyroid disorders may have menstrual abnormalities and infertility, but the frequency of thyroid disorders in women with infertility has rarely been studied.

How the study was done. The study group consisted of 438 consecutive women with regular menstrual cycles who had been infertile for at least one year. The women were evaluated by history, physical examination, ultrasonography of the pelvis, hysterosalpingography or laparoscopy (if indicated), and measurements of serum thyrotropin (TSH), free thyroxine (T4), and antithyroid peroxidase antibodies. Semen analyses were done on the male partners. The infertility was categorized as being caused by endometriosis, tubal disease, ovulatory dysfunction, or male infertility or as idiopathic (cause not known). Serum TSH, free T4, and antithyroid peroxidase antibodies were also measured in 100 aged-matched women who had had at least one spontaneous pregnancy.

The results of the study. The infertility was attributed to the woman in 197 couples (45 percent) and the man in 168 couples (38 percent); it was idiopathic in 73 couples (17 percent). Among the infertile women, 59 percent had ovulatory dysfunction, 30 percent had tubal disease, and 11 percent had endometriosis. The average serum TSH and free T4 concentrations were very similar in all groups of women. Among the infertile women, 4 (1 percent) had hypothyroidism, and 9 (2 percent) had hyperthyroidism; they were distributed among all the infertility groups. Among the control women, 1 (1 percent) had hypothyroidism and 3 (3 percent) had hypothyroidism. The frequency of high serum antithyroid peroxidase antibody concentrations was slightly higher in women with some causes of infertility, as compared with the control women (endometriosis, 29 percent; tubal disease, 18 percent; ovulatory dysfunction, 16 percent; male infertility, 11 percent; idiopathic, 7 percent; control, 8 percent).

The conclusions of the study. Women with infertility have evidence of autoimmune thyroid disease more often than do fertile women, but the frequency of thyroid dysfunction is not increased.

The original article. Poppe K, Glinoer D, Van Steirteghem A, Tournaye H, Devroey P, Schiettecatte J, Velkeniers B. Thyroid dysfunction and autoimmunity in infertile women. Thyroid 2002;12:997-1001.

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