The impact of elevated thyroid stimulating hormone on female subfertility

Hiraoka, Takehiro; Wada‐Hiraike, Osamu; Hirota, Yasushi; Hirata, Tetsuya; Koga, Kaori; Osuga, Yutaka; Fujii, Tomoyuki

doi:10.1007/s12522-015-0221-9

Cited by 14 publications

(7 citation statements)

References 30 publications

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“…In a cross sectional study of 5000 Belgian women (mean age: 32.0, SD: 5.5 years), there were no significant association, between ovarian reserve, thyroid hormones and thyroid autoimmunity [9]. Several studies also show an inverse association between ovarian reserves, hypothyroidism and thyroid autoimmunity in humans and animals [10, 11]; however to the best of our knowledge, the interaction between changes in thyroid functions and ovarian reserves status has not yet been reported and it is unclear whether or not women with poor ovarian reserves are at increased risk of occurrence of hypothyroidism.…”

Section: Introductionmentioning

confidence: 99%

Overtime trend of thyroid hormones and thyroid autoimmunity and ovarian reserve: a longitudinal population study with a 12-year follow up

et al. 2019

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Background Ovarian reserve, vital for reproductive function, can be adversely affected by thyroid diseases. Despite alternations of thyroid hormones with ageing, data on interactions between the overtime trend of thyroid functions and ovarian reserve status has rarely been reported. We aimed to examine the overtime trend of thyroid hormones, thyroid peroxidase antibody (TPO Ab) and their associations with ovarian reserve status, identified by levels of age specific anti-mullerian hormone (AMH) in reproductive aged women, who participated in 12-year cohort of Tehran Thyroid Study (TTS). Methods Reproductive age women( n = 775) without any thyroid disease or ovarian dysfunction were selected from the Tehran Thyroid Study cohort. Participants were divided into four age specific AMH quartiles (Q1-Q4), Q1, the lowest and Q4, the highest. AMH was measured at the initiation of study and thyroid stimulating hormone (TSH), free T4 (FT4), and TPO Ab were measured at baseline and at three follow up visits. Results At baseline, there was no statistically significant difference in thyroid hormones between women of the four quartiles, although TPO Ab levels were higher in women of Q1. During the follow ups, FT4 was decreased in all quartiles ( p < 0.05), whereas TPO Ab increased in Q1 ( p = 0.02). Odds ratio of overall TPO Ab positivity in women of Q1 was 2.08 fold higher than those in Q4. (OR: 2.08, 95%CI: 1.16, 3.72; p = 0.01). Conclusion Women with the lowest ovarian reserves had higher levels of TPO Ab, with a positive trend of this antibody overtime in comparison to other quartiles, indicating that this group may be at a higher risk of hypothyroidism over time.

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Section: Introductionmentioning

confidence: 99%

Overtime trend of thyroid hormones and thyroid autoimmunity and ovarian reserve: a longitudinal population study with a 12-year follow up

et al. 2019

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“…Previous studies have shown that there is an association between thyroid autoimmunity and infertility [ 29 , 30 ]. Human and animal studies have shown that there is a negative correlation between ovarian reserve and thyroid autoimmunity [ 31 , 32 ]. A case-control study found that AITD is independently associated with AMH and that women with AITD have lower AMH than in the control group [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Elevated Thyroglobulin Antibody Level is Associated with Decreased Anti-Müllerian Hormone in Women of Reproductive Age

Zynat,

Wang,

Han

et al. 2023

International Journal of Endocrinology

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Purpose. Women with Hashimoto’s thyroiditis (HT) have an increased risk of ovarian insufficiency. However, whether thyroid antibodies affect the ovarian reserve remains controversial. The aim of this study was to explore the possible relationship between anti-Müllerian hormone (AMH) and thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) levels in women of reproductive age. Methods. A total of 483 women between 18 and 45 years old who had their TPOAb, TgAb, thyroid-stimulating hormone (TSH), free thyroxine (FT4), and AMH levels measured on the same day were enrolled in this study. The levels of TSH, FT4, TPOAb, and TgAb, the prevalence of overt and subclinical hypothyroidism, and the positive rate of TPOAb and TgAb were compared between patients with low (below the 10th percentile), normal (10th to 90th percentile), and high (higher than the 90th percentile) AMH levels. Results. The median AMH level was 1.72 (0.33–4.27) ng/mL. A total of 9.9% of patients had low AMH levels. The TgAb levels and the prevalence of TgAb positivity were higher in the low AMH group (37.62 (13.10–232.68) IU/mL, 35.42%) than in the normal (12.46 (10.0–67.04) IU/mL, 19.59%) and high (13.61 (10.0–95.74) IU/mL, 23.4%) AMH groups ( p = 0.001 , p = 0.040 , respectively). Serum AMH levels were inversely correlated with TgAb levels (r = −0.114, p = 0.013 ). Conclusion. The AMH of women of reproductive age is affected by HT. Furthermore, women with the lowest AMH level had higher levels of TgAb and a positive rate of TgAb, and high TgAb levels may cause autoimmune damage to the ovaries.

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“…Some guidelines and review studies suggest that it is preferable for a woman who wishes to become pregnant to maintain serum TSH concentrations <2.5 mIU/L, and this level should be preserved during the first and second trimesters of pregnancy ( 41 , 42 ). The harm of TSH levels above normality (>4.5 mIU/L) is attested by some studies that, by means of multivariate analysis, found a positive correlation between high TSH levels and decreased clinical pregnancy rates, although the same correlation has not been attested for the frequency of miscarriages and live births ( 25 , 43 ). Hyperthyroidism, marked by low serum TSH levels, is also related to decreased rates of live births ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of thyroid function on assisted reproduction outcomes in euthyroid infertile women: A single center retrospective data analysis and a systematic review and meta-analysis

et al. 2022

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BackgroundThe influence of thyroid-stimulating hormone (TSH) on gestational outcomes have been studied and checked whether differing TSH levels are relevant on human reproduction outcomes. International guidelines recommend TSH values <2.5 mIU/L in women trying to conceive, since values above this level are related to a higher frequency of adverse reproductive outcomes. This study aimed to evaluate whether TSH values correlate with different gestational outcomes in euthyroid infertile women without autoimmune thyroid disease.MethodsA retrospective cohort study was conducted involving 256 women who underwent in vitro fertilization (IVF) treatment. The participants were divided into two groups: TSH 0.5-2.49 mIU/L (n=211) and TSH 2.5-4.5 mIU/L (n=45). The clinical data, hormonal profiles and reproductive outcomes were compared between groups. Additionally, a systematic review with meta-analysis following the PRISMA protocol was carried out in PubMed/MEDLINE, EMBASE, and SciELO, with no time or language restrictions, for articles comparing TSH groups named “low TSH” (<2,5 mIU/L) and “high TSH” (≥2.5 mIU/L). A meta-analysis of proportions was performed with pooled estimates expressed as relative risk (RR) of events and a random effects model.ResultsAge, BMI, free thyroxine levels (FT4) hormonal profile and IVF outcomes were not different between groups, neither gestational outcomes (p=0.982). Also, no difference was observed when the TSH and FT4 levels were compared between patients with positive or negative gestational outcomes (p=0.27 and p=0.376). Regarding the systematic review with meta-analysis, 17 studies from 2006 to 2022 were included, and added by this original retrospective research comprising 13.247 women undergoing IVF. When comparing the proportions of clinical pregnancy between the TSH groups, no significant difference was found (RR 0.93, 95% CI 0.80–1.08), with high between studies heterogeneity (I²: 87%; τ2: 0.0544; p<0.01). The number of deliveries was not significantly different between groups, despite a trend towards higher frequency in the high-TSH group (RR 0.96, 95% CI 0.90–1.02).ConclusionVariation in TSH levels within the normal range was not associated with pregnancy and delivery rates in women, without autoimmune thyroid disease, who underwent IVF treatment.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD 42022306967.

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The impact of elevated thyroid stimulating hormone on female subfertility

Abstract: We found an association between elevated TSH and the decreased rate of clinical pregnancy. This might be related to an ovulatory disorder and pathophysiology of unexplained infertility. These results may reinforce the usefulness of TSH screening in infertility population.

Cited by 14 publications

References 30 publications

Overtime trend of thyroid hormones and thyroid autoimmunity and ovarian reserve: a longitudinal population study with a 12-year follow up

Overtime trend of thyroid hormones and thyroid autoimmunity and ovarian reserve: a longitudinal population study with a 12-year follow up

Elevated Thyroglobulin Antibody Level is Associated with Decreased Anti-Müllerian Hormone in Women of Reproductive Age

Effect of thyroid function on assisted reproduction outcomes in euthyroid infertile women: A single center retrospective data analysis and a systematic review and meta-analysis

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