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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