INVESTIGATION OF THYROIDS DYSFUNCTION AMONG INFERTILE WOMEN IN NASIRIYAH CITY
Keywords:Thyroid dysfunction, Hyperthyroidism, Hypothyroidism, Infertile, Women
Objective: Epidemiological studies revealed that 10-15 % of couples in the world experience infertility. Thyroid dysfunction (hyperthyroidism and hypothyroidism) possessed adverse effect on reproductive health and resulted in, interference with ovulation, reduced rates of conception, increased early pregnancy loss, and adverse effects on pregnancy and neonatal outcomes. The current study aims to explore the thyroid dysfunction among infertile women in Nasiriyah city-Iraq.
Methods: The study was conducted on 60 infertile women (age group 17–45 y) who visited infertility departments in Al-Hussein hospital, Al-Haboubi hospital and Bent AL Huda hospital, in Nasiriyah city, from October 2019 to March 2020. Thirty normal females (age matched) were taken as controls. TSH, T3, T4, LH, FSH, prolactin, progesterone and estradiol levels were determine by using VIDAS® Assay.
Results: The prevalence of hyperthyroidism among infertile women was 13.33% and hypothyroidism was 10.00%. Both hyper and hypothyroidism induced adverse changes in the serum levels of LH, FSH, prolactin and gonadal hormones.
Conclusion: Thyroid dysfunction was associated with a risk of not getting pregnancy. Women were advised to achieve euthyroidism before planning a pregnancy.
2. Evers JLH, Collins JA. Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Lancet 2003;361:1849-52.
3. Khar A, Taverny Bennardo T, Jutisz M. Effect of thyroid hormones on gonadotrophin release and biosynthesis using rat pituitary cell culture. J Endocrinol 1980;85:229-35.
4. Poppe K, Glinoer D, Van Steirteghem A, Tournaye H, Devroey P, Schiettecatte J, et al. Thyroid dysfunction and autoimmunity in infertile women. Thyroid 2002;12:997–1001.
5. Bjoro T, Holmen J, Kruger O, Midthjell K, Hunstad K, Schreiner T, et al. Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The health study of nord-trondelag (HUNT). Eur J Endocrinol 2000;143:639–47.
6. Aghini Lombardi F, Antonangeli L, Martino E, Vitti P, Maccherini D, Leoli F, et al. The spectrum of thyroid disorders in an iodine-deficient community: the pescopagano survey. J Clin Endocrinol Metab 1999;84:561–6.
7. Furszyfer J, Kurland LT, McConahey WM, Woolner LB, Elveback LR. Epidemiologic aspects of Hashimoto’s thyroiditis and graves’ disease in rochester, minnesota (1935–1967), with special reference to temporal trends. Metabolism 1972;21:197–204.
8. Krassas GE, Poppe K, Glinoer D. Thyroid function and human reproductive health. Endocr Rev 2010;31:702-55.
9. Liu J, Guo M, Hu X, Weng X, Tian Y, Xu K, et al. Effects of thyroid dysfunction on reproductive hormones in female rats. Chinese J Physiol 2018;61:152-62.
10. Veeresh T, Moulali D, Sarma DHS. A study on serum FSH, LH and prolactin levels in women with thyroid disorders. Int J Sci Res Publications 2015;5:1-4.
11. Jefferys A, Vanderpump M, Yasmin E. Thyroid dysfunction and reproductive health. Fertility Assisted Reproduction Primary Care 2015;17:39-45.
12. Hatsuta M, Tamura K, Shimizu Y, Toda K, Kogo H. Effect of thyroid hormone on CYP19 expression in ovarian granulosa cells from gonadotropin-treated immature rats. J Pharmacol Sci 2004;94:420-5.
13. Akinci B, Comlekci A, Ozcan MA. The alteration of coagulation in patients with thyroid dysfunction. Recent Pat Endocr Metab Immune Drug Discovery 2011;5:50-7.
14. Poppe K, Velkeniers B, Glinoer D. Thyroid disease and female reproduction. Clin Endocrinol (Oxf) 2007;66:309–21.
15. Poppe K, Velkeniers B, Glinoer D. The role of thyroid autoimmunity in fertility and pregnancy. Nat Clin Pract Endocrinol Metab 2008;4:394-405.
16. Poppe K, Velkeniers B. Thyroid disorders in infertile women. Ann Endocrinol (Paris) 2003;64:45–50.
17. Koutras DA. Disturbances of menstruation in thyroid disease. Ann N Y Acad Sci 1997;816:280-4.
18. Mattheij JA, Swarts JJ, Lokerse P, Van Kampen JT, Van der Heide D. Effect of hypothyroidism on the pituitary-gonadal axis in the adult female rat. J Endocrinol 1995;146:87-94.
19. Gude D. Thyroid and its indispensability in fertility. J Hum Reprod Sci 2011;4:59-60.
20. Goswami B, Patel S, Chatterjee M, Koner BC, Saxena A. Correlation of prolactin and thyroid hormone concentration with menstrual patterns in infertile women. J Reprod Infertil 2009;10:207-12.
21. Aghajanova L, Lindeberg M, Carlsson IB, Stavreus Evers A, Zhang P, Scott JE, et al. Receptors for thyroid-stimulating hormone and thyroid hormones in human ovarian tissue. Reprod Biomed Online 2009;18:337-47.
22. Jiang JY, Umezu M, Sato E. Improvement of follicular development rather than gonadotrophin secretion by thyroxine treatment in infertile immature hypothyroid rdw rats. J Reprod Fertil 2000;119:193-9.
23. Feldthusen A, Pedersen PL, Larsen J, Kristensen TT, Ellervik C, Kvetny J. Impaired fertility associated with subclinical hypothyroidism and thyroid autoimmunity: the danish general suburban population study. J Pregnancy 2015. http://dx.doi.org/10.1155/2015/132718.
24. Cignini P, Cafa EV, Giorlandino C, Capriglione S, Spata A, Dugo N. Thyroid physiology and common diseases in pregnancy: review of literature. J Prenat Med 2012;6:64–71.
25. Davis LB, Lathi RB, Dahan MH. The effect of infertility medication on thyroid function in hypothyroid women who conceive. Thyroid 2007;17:773-7.
26. Casey BM, Leveno KJ. Thyroid disease in pregnancy. Obstet Gynecol 2006;108:1283–92.
27. Verma I, Sood R, Juneja S, Kaur S. Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility. Int J Appl Basic Med Res 2012;2:17–9.
28. Udgiri R, Patil VV. Comparative study to determine the prevalence and socio-cultural practices of infertility in rural and urban field practice area of tertiary care hospital, Vijayapura, Karnataka. Indian J Community Med 2019;44:129-33.
29. Doufas AG, Mastorakos G. The hypothalamic-pituitary-thyroid axis and the female reproductive system. Ann N Y Acad Sci 2000;900:65–76.
30. Cramer DW, Sluss PM, Powers RD, McShane P, Ginsburgs ES, Hornstein MD, et al. Serum prolactin and TSH in an in vitro fertilization population: is there a link between fertilization and thyroid function? J Assist Reprod Genet 2003;20:210–15.
31. Blumenthal NJ, Eastman CJ. Beneficial effects on pregnancy outcomes of thyroid hormone replacement for subclinical hypothyroidism. J Thyroid Res 2017:1-7. DOI: org/10.1155/2017/4601365.
32. Al-Seidi FA, Jarullah BA. Diagnosis of hypothyroidism depending upon signs and symptoms design scoring system. J Thi-Qar Sci 2014;4:10-3.
33. Hasin AJ, Ayyed MY, Farawn KD. Histopathological characters of solitary thyroid nodule in patient undergoing surgery at 3 y (2015-2017) in Al-Nasiriyah city. Thi Qar Med J 2019;17:145-57.
34. Frayyeh MJ, Fakhridin MBMR, Al-Lami MQD. The prevalence of autoimmune thyroiditis in a sample of infertile Iraqi women. Iraqi J Sci 2014;55:1183-7.
35. Barbieri RL, Cooper DS, Daniels GH, Nathan D, Klibanski A, Ridgway C. Prolactin response to thyrotropin-releasing hormone (TRH) in patients with hypothalamic-pituitary disease. Fertility Sterility 1985;43:66-73.
36. Evans GA, David DN, Rosenfeld MG. Regulation of prolactin and somatotropin mRNAs by thyroliberin. Proc Nadl Acad Scd USA 1978;75:1294-8.
37. Al-Snafi AE, Al-Baldawi AT, Al-Rubaei AK. The efficacy of bromocriptine with and without ovarian stimulation in the treatment of hyperprolactinemic infertile women. Middle East Fertility Society J 2003;8:1-4.