Subclinical hypothyroidism and thyroid autoimmunity in women with infertility.
OBJECTIVE
To determine the prevalence of different subclinical hypothyroidism (SH) grades and thyroid autoimmunity (TAI) in infertile women.


METHODS
Retrospective study. Setting. Endocrinology division of a public hospital in Argentina.


METHODS
Group I comprised 244 women consulting on infertility (>1 year without pregnancy); Group C (controls) comprised 155 healthy women with confirmed fertility.


METHODS
Thyroid-stimulating hormone and thyroid peroxidase antibodies were measured in all patients, and a thyrotropin-releasing hormone (TRH) stimulation test was performed in 71 patients to diagnose SH grade 1. The pregnancy rate in hypothyroid women on levothyroxine treatment was also evaluated.


RESULTS
SH was diagnosed in 13.9% of the patients in Group I and in 3.9% of Group C (p < 0.002). The TRH stimulation test was useful to detect SH grade 1 in 12.7% of the infertile patients. Patients with precocious ovarian failure, tubal disturbances and ovulatory dysfunction presented higher SH rates (40.0, 18.2 and 15.4%, respectively) than control patients (p < 0.0001, p < 0.002 and p < 0.003). No significant difference in TAI prevalence was shown in Group I relative to Group C. Pregnancy rate of 44.1% was achieved under levothyroxine treatment.


CONCLUSIONS
We observed a higher prevalence of SH, but not of TAI, in patients with infertility. Our results support thyroid screening in women with reproductive failure.
Abalovich
Marcos
M
Human Reproduction and Thyroid Sections, Endocrinology Division, Hospital Carlos Durand, Buenos Aires, Argentina. mabalovich@intramed.net
Mitelberg
Laura
L
Allami
Carlos
C
Gutierrez
Silvia
S
Alcaraz
Graciela
G
Otero
Patricia
P
Levalle
Oscar
O
D000328:Adult; D015551:Autoimmunity; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D007247:Infertility, Female / Q000150:complications* / Q000276:immunology; D011247:Pregnancy; D018873:Pregnancy Rate; D015995:Prevalence; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000276:immunology*; D013974:Thyroxine / Q000627:therapeutic use
D013974:Thyroxine