Thyroid autoimmunity, hypothyroidism and ovarian reserve: a cross-sectional study of 5000 women based on age-specific AMH values

Polyzos, Nikolaos N.P.; Sakkas, Evangelos; Vaiarelli, Alberto; Poppe, Kris; Camus, Marguerite; Tournaye, Herman

doi:10.1093/humrep/dev089

Cited by 76 publications

(79 citation statements)

References 25 publications

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“…The results of these studies are variable. Polyzos et al for example did not observe an association between thyroid disorders and TAD, and low ovarian reserve as estimated by AMH levels [39]. Magri et al on the other hand found a negative influence of TAD on ART outcome in women with a normal ovarian reserve as depicted by high serum AMH levels [40].…”

Section: Discussionmentioning

confidence: 99%

“…Magri et al on the other hand found a negative influence of TAD on ART outcome in women with a normal ovarian reserve as depicted by high serum AMH levels [40]. Taking into consideration that one needs to be careful in extrapolating results from animal studies directly to the human condition, an explanation for the discrepancy among these studies may be that in the studies by Polyzos et al [39] and Magri et al [40] subclinical hypothyroidism prevailed while is the present study TSH concentrations were increased approximately 24-fold, indicative for a more severe disturbed thyroid function.…”

Section: Discussionmentioning

confidence: 99%

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Prolonged hypothyroidism severely reduces ovarian follicular reserve in adult rats

Rijntjes

Swarts

et al. 2017

J Ovarian Res

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BackgroundThere is substantial evidence both in humans and in animals that a prolonged reduction in plasma thyroid hormone concentration leads to reproductive problems, including disturbed folliculogenesis, impaired ovulation and fertilization rates, miscarriage and pregnancy complications. The objective of the present study is to examine the consequences of chronic hypothyroidism, induced in adulthood, for the size of the ovarian follicle pool. In order to investigate this, adult female rats were provided either a control or an iodide deficient diet in combination with perchlorate supplementation to inhibit iodide uptake by the thyroid. Sixteen weeks later animals were sacrificed. Blood was collected for hormone analyses and ovaries were evaluated histologically.ResultsAt the time of sacrifice, plasma thyroid-stimulating hormone concentrations were 20- to 40-fold increased, thyroxine concentrations were negligible while tri-iothyronin concentrations were decreased by 40% in the hypothyroid group, confirming that the animals were hypothyroid. Primordial, primary and preantral follicle numbers were significantly lower in the hypothyroid ovaries compared to the euthyroid controls, while a downward trend in antral follicle and corpora lutea numbers was observed. Surprisingly the percentage of atretic follicles was not significantly different between the two groups, suggesting that the reduced preantral and antral follicle numbers were presumably not the consequence of increased degeneration of these follicle types in the hypothyroid group. Plasma anti-Müllerian hormone (AMH) levels showed a significant correlation with the growing follicle population represented by the total ovarian number of primary, preantral and antral follicles, suggesting that also under hypothyroid conditions AMH can serve as a surrogate marker to assess the growing ovarian follicle population.ConclusionsThe induction of a chronic hypothyroid condition in adult female rats negatively affects the ovarian follicular reserve and the size of the growing follicle population, which may impact fertility.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prolonged hypothyroidism severely reduces ovarian follicular reserve in adult rats

Rijntjes

Swarts

et al. 2017

J Ovarian Res

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“…Since the pathophysiology of type 1 diabetes stems from autoimmune destruction of pancreatic β-cells, possible mechanisms include autoimmune disease. Previous studies that examined autoimmune oophoritis are few, although the presence of anti-ovarian antibodies is < 5% among women with type 1 diabetes (26), and AMH concentrations have not been associated with thyroid antibodies among women undergoing assisted reproduction procedures (27). To our knowledge, there are no studies that examine the possibility of autoimmune dysregulation at the hypothalamic-pituitary level.…”

Section: Discussionmentioning

confidence: 99%

Antimüllerian hormone among women with and without type 1 diabetes: the Epidemiology of Diabetes Interventions and Complications Study and the Michigan Bone Health and Metabolism Study

Kim

Karvonen‐Gutierrez

Kong

et al. 2016

Fertility and Sterility

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Structured Abstract Objective To compare concentrations of anti-Müllerian hormone (AMH) in women with and without type 1 diabetes. Design Cross-sectional analysis of longitudinal studies adjusting for repeated measures Setting Michigan Bone Health and Metabolism Study (MBHMS), a community-based population and the Epidemiology of Interventions and Complications Study (EDIC), an observational cohort of women with type 1 diabetes. Participants Women who were aged 30–45 years and had not undergone oophorectomy, hysterectomy, or natural menopause at the time of AMH measurement were included (n=376 in MBHMS and n=321 in EDIC). Linear mixed regression was used to evaluate whether AMH concentrations differed by diabetes status adjusting for repeated measurements of AMH within individual women, body mass index, smoking status, and oral contraceptive use. Interventions None Main Outcome Measure AMH concentrations Results Prior to 35 years of age, logAMH concentrations were significantly lower among women with type 1 diabetes compared to women without diabetes (β-coefficient −1.27, 95% confidence interval [−2.18, −0.36] in fully-adjusted models). Conclusions Prior to 35 years of age, women with type 1 diabetes have lower AMH levels than women without diabetes. Further investigation is needed to determine the etiologies of this difference and how it may contribute to reproductive disorders among women with type 1 diabetes.

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“…More recently, in a population of approximately 5,000 women attending a reproductive medicine center, Polyzos and colleagues examined the relationship between AMH and TSH as well as anti-thyroperoxidase antibodies. The authors concluded that in this large cohort of Belgian women hypothyroidism and thyroid autoimmunity disorders are not associated with low ovarian reserve (48). As there were differences in participant characteristics, as well as inconsistent findings between studies, additional prospective studies are clearly necessary to further elucidate the relationship between thyroid disorders and markers of ovarian reserve.…”

Section: Discussionmentioning

confidence: 80%

Novel correlates between antimüllerian hormone and menstrual cycle characteristics in African-American women (23–35 years-old)

Marsh

Bernardi

Steinberg

et al. 2016

Fertility and Sterility

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Objective To characterize normative anti-Müllerian hormone (AMH) levels and ascertain which factors are associated with AMH in a large cohort of reproductive-aged women. Design Cross-sectional study. Setting Study of the Environment, Lifestyle and Fibroids (SELF), a longitudinal study performed by the National Institute of Environmental Health Sciences in conjunction with a major health care provider in Detroit, Michigan. Patients 1,654 African-American women (AAW) aged 23-34 at recruitment. Intervention None Main Outcome Measure Serum AMH measured using an ultrasensitive ELISA. Results The median AMH was 3.18 ng/ml, and there was a significant, but nonlinear, relationship between age and AMH, with levels peaking at age 25. As AMH was not normally distributed, log transformation was performed and used for all analyses. In a multivariable age-adjusted model, body mass index, current use of hormonal contraception, and history of a thyroid condition were inversely associated with AMH, while history of abnormal menstrual bleeding and menstrual cycles longer than 35 days were positively associated with AMH. Conclusions While age is correlated with AMH, it accounts for only a portion of the variation seen. This study adds valuable information to the existing literature on normative AMH levels in young reproductive-aged women. While our findings fill a critical data gap for ovarian reserve in AAW, the insights gained will be of benefit for all women.

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Thyroid autoimmunity, hypothyroidism and ovarian reserve: a cross-sectional study of 5000 women based on age-specific AMH values

Abstract: No external funding was used for this study. No conflicts of interest are declared.

Cited by 76 publications

References 25 publications

Prolonged hypothyroidism severely reduces ovarian follicular reserve in adult rats

Prolonged hypothyroidism severely reduces ovarian follicular reserve in adult rats

Antimüllerian hormone among women with and without type 1 diabetes: the Epidemiology of Diabetes Interventions and Complications Study and the Michigan Bone Health and Metabolism Study

Novel correlates between antimüllerian hormone and menstrual cycle characteristics in African-American women (23–35 years-old)

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