Background: Hypothyroidism has a significant effect on fertility causing anovulatory cycles, luteal phase defect, hyperprolactinemia and sex hormone imbalances. To identify potential and overt hypothyroidism, thyroid screening should be done for all infertile women. The objective of the study was to find the prevalence of subclinical and overt hypothyroidism among infertile women, to find the correlation of hypothyroidism with hormonal and metabolic parameters associated with infertility. Methods: Hospital based analytical cross sectional study was conducted for one and half years among 300 infertile women with primary and secondary infertility. Women with primary and secondary infertility. All hypothyroid women on thyroxine supplementation, male factor infertility, female factor infertility like tubal factor, anomalies of the urogenital tract, obvious organic lesions in the pelvis and women unwilling to participate or sign the informed consent. Results: The prevalence of hypothyroidism in infertile women was 27%. Among them, 25% were subclinical hypothyroid and 2.33% overt hypothyroid. Menstrual dysfunction was observed in 52% of subclinical and 51.15% of overt hypothyroid women, predominant type being oligomenorrhea. We found a negative correlation of hypothyroidism with the family history of thyroid disease. 91.4% of hypothyroid infertile women were obese and the association was strongly significant. Prevalence of hyperprolactinemia in infertile women was 24.67%. The association of hyperprolactinemia with hypothyroidism was 23%. Raised LDL levels were observed in 80% of subclinical and 100% overt hypothyroidism infertile women. Conclusions: Hypothyroidism alters the Hypothalamo-Pituitary ovarian axis and is one of the important etiological factors of female infertility. Most of the women were asymptomatic. Hence every infertile woman should be screened for thyroid profile to open better prospects of conception.

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Background: Hyperprolactinemia is one of the common endocrinological disorders affecting fertility by causing anovulatory cycles, luteal phase defect and sex hormone imbalances. There is higher incidence of hyperprolactinemia among infertile females. So estimation of serum prolactin should be done at an early stage of infertility workup which is cost effective and causes better outcome. The objective of this study was to find out the prevalence of hyperprolactinemia in female infertility after excluding tubal factor and male factor and to find its correlation with hypothyroidism. Methods: Hospital based analytical cross sectional study was conducted for 1½ years, among 300 infertile females. Females with primary and secondary infertility. Male factor infertility, females with tubal factor, history of thyroid disease/thyroid surgery/thyroid medication. Results: Prevalence of hyperprolactinemia that is serum prolactin > 25µg/L was 24.67%.The mean serum prolactin level in hyperprolactinemic females was 84.83µg/L. Incidence of hypothyroidism in hyperprolactinemia was 25.68%.Obesity (BMI >25) was present in 26% Galactorrhea was present in 20.27% females. Obesity and galactorrhea had strong positive correlation with hyperprolactinemia. Among the 300 females, 239 (79.6 %) had primary infertility and 61(20.4%) had secondary infertility. Conclusions: Hyperprolactinemia alters the hypothalamopituitary ovarian axis and causes reproductive dysfunction. In our study, the prevalence of hyperprolactinemia was found to be high among infertile females. The relatively high occurrence of hypothyroidism among infertile females emphasizes the importance of estimating both serum prolactin and TSH in infertility.

INTRODUCTIONPolycystic ovarian syndrome (PCOS) is a common endocrinopathy, affecting approximately 5-10% of women of reproductive age characterized by oligo-or anovulation, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology on ultrasonography. [1][2][3][4] Burghen et al in 1980 reported that women with PCOS, had basal and glucose-stimulated hyperinsulinemia compared with weight-matched control women, suggesting the presence of insulin resistance (IR) and noted significant positive linear correlations between insulin and androgen levels. 5 Since then so many studies were done on PCOS and insulin resistance and found that IR affects 50% -70% of women with PCOS leading to co-morbid conditions like impaired glucose tolerance, diabetes, hypertension, dyslipidaemia and metabolic syndrome. Most of the women present at young age and IGT being asymptomatic, it is important to screen them for the prevalence of pre-diabetes and diabetes so that direct counselling regarding life style modifications which helps in decreasing the severity or delaying the onset of diabetes mellitus. ABSTRACTBackground: PCOS is the most frequent endocrine disorder, often complicated by chronic anovulatory infertility and hyperandrogenism. High prevalence of impaired glucose tolerance and type 2 diabetes is observed due to peripheral insulin resistance. Holistic approach to the disorder to prevent long-term complications is required. The objective of the study was to study the prevalence of oral glucose tolerance test abnormalities (OGTT) in PCOS women and to study the significance of risk factors contributing to glucose intolerance in women with PCOS. Methods: Hospital based analytical cross sectional study was conducted for 1 and ½ years among 200 women with PCOS. Women diagnosed as PCOS according to Rotterdam's criteria. Women with other causes of anovulation, premature ovarian failure and women already diagnosed to be diabetic. Results: Abnormal glucose tolerance was observed in 32 (16 %) of the 200 PCOS women. Among them 14.5% had impaired glucose tolerance (IGT) and 1.5% had diabetes. There was a significant trend towards increasing prevalence of IGT and diabetes in females with higher BMI, waist circumference, clinical and biochemical hyperandrogenism and patients with metabolic syndrome. Conclusions: High prevalence of IGT and Non-Insulin Dependent Diabetes Mellitus (NIDDM) in women with PCOS was observed than expected. They have accelerated conversion from IGT to NIDDM. IGT is often asymptomatic and is a known risk factor for type 2 DM and cardiovascular disease. OGTT with 75 gms of glucose is the best screening method for glucose intolerance and a good measure to diagnose type 2 DM in PCOS women.