Infertility Clinical Trial
Official title:
TSH and AMH in Infertile Women
Infertility is defined as the inability of a couple to achieve pregnancy over an average
period of one year (in women under 35 years of age) or 6 months (in women above 35 years of
age) of unprotected sexual intercourse. Infertility can be due to female, male reasons or
both. It can be either primary or secondary.
Thyroid dysfunction and autoimmune thyroiditis are known adverse risk factors for pregnancy
as well as fertility, regardless of the presence of disease in women of reproductive age. In
particular, hypothyroid women are at an increased risk of menstrual disorders and
infertility because of altered peripheral estrogen metabolism, hyperprolactinaemia and
abnormal release of gonadotropin-releasing hormone.
The prevalence of subclinical hypothyroidism characterized by aberrant high serum
thyroid-stimulating hormone (TSH) levels with normal free thyroxin (FT4) levels in infertile
women are reported to be approximately 20% and it is a primary cause of subfertility.
Indeed, average TSH levels in infertile women were reportedly higher than those in normal
fertile women. And elevated serum TSH levels were associated with diminished ovarian reserve
in infertile patients. Moreover, although levothyroxine replacement therapy for subclinical
hypothyroidism in infertile patients remains debatable, thyroxin supplementation may improve
fertility to successful pregnancy.
This data suggests that hypothyroidism is strongly correlated with infertility (Velkeniers
et al., 2013).
On the other hand, female fecundity decreases with increasing age, primarily because of
decreased ovarian function. Anti-mullerian hormone (AMH) is a dimeric glycoprotein belonging
to the transforming growth factor-beta (TGF-B) super family, which act on tissue growth and
differentiation. It is produced by the granulosa cells from pre-antral and small antral
follicles. Ovarian research after oophorectomy showed that serum AMH levels were closely
correlated with the number of primordial follicles; therefore, AMH is a suitable biomarker
of ovarian age in women of reproductive age.
Expectedly, ovarian function may be affected by impaired thyroid function, although this
association has not been elucidated. In this study, we will evaluate the relationship
between thyroid function and AMH levels by comparing them in infertile patients and healthy
fertile women.
n/a
Observational Model: Case Control, Time Perspective: Prospective
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