title: Subclinical hypothyroidism and thyroid autoimmunity in women with infertility.
abstract: 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.
authors.affiliation: Human Reproduction and Thyroid Sections, Endocrinology Division, Hospital Carlos Durand, Buenos Aires, Argentina. mabalovich@intramed.net
authors.forename: Marcos
authors.initials: M
authors.lastname: Abalovich
authors.forename: Laura
authors.initials: L
authors.lastname: Mitelberg
authors.forename: Carlos
authors.initials: C
authors.lastname: Allami
authors.forename: Silvia
authors.initials: S
authors.lastname: Gutierrez
authors.forename: Graciela
authors.initials: G
authors.lastname: Alcaraz
authors.forename: Patricia
authors.initials: P
authors.lastname: Otero
authors.forename: Oscar
authors.initials: O
authors.lastname: Levalle
mesh_terms: 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
chemical_list: D013974:Thyroxine