Prevalence of Thyroid Disorders in Patients with Infertility

Authors

  • Hafiza Sidra Fatima Combined Military Hospital, Multan, Pakistan
  • Lubna Noor Baloch Combined Military Hospital, Multan, Pakistan
  • Nida Yaseen Combined Military Hospital, Multan, Pakistan
  • Maryam Arif Combined Military Hospital, Multan, Pakistan
  • Sadia Majeed Combined Military Hospital, Multan, Pakistan
  • Abdul Rehman Asudais Mukhtar A Shaikh, Hospital, Multan

DOI:

https://doi.org/10.61581/mjsp.v6i01.386

Keywords:

Primary Infertility, Thyroid dysfunction, Thyroid stimulating harmone, Thyroixin, Hypothyroidism

Abstract

Objective: To compare thyroid hormone concentrations and the frequency of thyroid dysfunction between women with primary infertility and fertile controls.

Methodology: In this case-control study, conducted at the Outpatient Department of Gynaecology & Obstetrics, Combined Military Hospital Multan from 28 April 2024 to 27 October 2024, 91 women aged 20–35 years were enrolled and 79 with complete, verifiable records were analysed: 39 women with primary infertility (Group I) and 40 fertile controls (Group II). Serum free triiodothyronine (fT3), free thyroxine (fT4) and thyroid-stimulating hormone (TSH) were measured by chemiluminescent microparticle immunoassay. The Shapiro-Wilk test checked data distribution, the Mann-Whitney U test compared groups, Spearman correlation examined associations and the chi-square test compared categorical frequencies, using SPSS 20.0 with p<0.05 as significant.

Results: Mean age, fT3, fT4 and TSH did not differ significantly between groups (p=0.080, 0.294, 0.383 and 0.287). Euthyroid status was present in 53.8% of Group I versus 77.5% of Group II (p=0.064). Hyperthyroidism was the most frequent disorder in Group I (28.2%). Within Group I, fT3 correlated strongly with fT4 (rho=0.989, p<0.001), and TSH correlated inversely with fT3 (rho=?0.689) and fT4 (rho=?0.690, both p<0.001); age showed no significant relationship with any hormone.

Conclusion: Thyroid hormone concentrations were broadly similar between infertile and fertile women, although thyroid dysfunction, mainly hyperthyroidism, was numerically more common in the infertile group. Thyroid function testing remains a reasonable and inexpensive part of the infertility work-up, though it should not replace evaluation of other contributing causes.

Downloads

Download data is not yet available.

References

1. World Health Organization. Infertility prevalence estimates, 1990–2021. Geneva: World Health Organization; 2023.

2. Sun H, Gong TT, Jiang YT, Zhang S, Zhao YH, Wu QJ. Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990-2017: results from a global burden of disease study, 2017. Aging (Albany NY). 2019;11(23):10952-91.

3. Jabeen F, Khadija S, Daud S. Prevalence of primary and secondary infertility. Saudi J Med. 2022;7(1):22-8.

4. Khan S, Akram U, Parveen S, Urooj U, Khattak SN, Zohra S. Knowledge and perception regarding infertility among infertile couples reporting to Combined Military Hospital Mardan. Pak Armed Forces Med J. 2023;73(3):707-11.

5. Romualdi D, Ata B, Bhattacharya S, Bosch E, Costello M, Gersak K, et al. Evidence-based guideline: unexplained infertility. Hum Reprod. 2023;38(10):1881-90.

6. Brown EDL, Obeng-Gyasi B, Hall JE, Shekhar S. The thyroid hormone axis and female reproduction. Int J Mol Sci. 2023;24(12):9815.

7. Unuane D, Velkeniers B, Poppe KG. Thyroid disorders and female infertility. J Clin Endocrinol Metab. 2026;111(5):e1239-51.

8. Maraka S, Dosiou C. Subclinical hypothyroidism and thyroid autoimmunity in pregnancy: to treat or not to treat. Endocrinol Metab Clin North Am. 2024;53(3):363-76.

9. Hasegawa Y, Kitahara Y, Osuka S, Tsukui Y, Kobayashi M, Iwase A. Effect of hypothyroidism and thyroid autoimmunity on the ovarian reserve: a systematic review and meta-analysis. Reprod Med Biol. 2021;21(1):e12427.

10. Liu Q, Qiu Y, Jiang J, Long S, Zhu C, Chen G, et al. Causal association between thyroid function and the risk of infertility: a Mendelian randomization study. Front Endocrinol (Lausanne). 2024;15:1425639.

11. Practice Committee of the American Society for Reproductive Medicine. Subclinical hypothyroidism in the infertile female population: a guideline. Fertil Steril. 2024;121(5):765-82.

12. Kirkegaard S, Uldall Torp NM, Andersen S, Andersen SL. Endometriosis, polycystic ovary syndrome, and the thyroid: a review. Endocr Connect. 2024;13(2):e230431.

13. Jagun OE, Andu BA, Olawale OO. Subclinical hypothyroidism among infertile women at a tertiary hospital in South-West Nigeria. Afr Health Sci. 2022;22(2):444-50.

14. Şahin A, Önder F. Investigation of thyroid hormones and prolactin levels in fertile and infertile women. Middle Black Sea J Health Sci. 2016;2(1):1-6.

15. Valvekar U, Lakshmi S, Kumar AN. Hypothyroidism and hyperprolactinemia showed positive correlation in women with primary and secondary infertility. Int J Reprod Contracept Obstet Gynecol. 2016;5:2079-83.

16. Wu J, Zhao YJ, Wang M, Tang MQ, Liu YF. Correlation analysis between ovarian reserve and thyroid hormone levels in infertile women of reproductive age. Front Endocrinol (Lausanne). 2021;12:745199.

17. Plowden TC, Schisterman EF, Sjaarda LA, Zarek SM, Perkins NJ, Silver R, et al. Subclinical hypothyroidism and thyroid autoimmunity are not associated with fecundity, pregnancy loss, or live birth. J Clin Endocrinol Metab. 2016;101(6):2358-65.

18. Dhillon-Smith RK, Middleton LJ, Sunner KK, Cheed V, Baker K, Farrell-Carver S, et al. Levothyroxine in women with thyroid peroxidase antibodies before conception. N Engl J Med. 2019;380(14):1316-25.

19. Khatiwada S, Gautam S, KC R, Singh S, Shrestha S, Jha P, et al. Pattern of thyroid dysfunction in women with menstrual disorders. Ann Clin Chem Lab Med. 2016;2(1):3-6.

20. Chaudhry I. Frequency of hyperprolactinemia in female infertility. Pak J Med Health Sci. 2016;10(2):652-3.

21. Darwish A, Mohamed EE. Introductory chapter: one-stop infertility evaluation unit. In: Testes and ovaries – functional and clinical differences and similarities. Rijeka: InTech; 2017.

Downloads

Published

30-03-2025

How to Cite

1.
Fatima HS, Baloch LN, Yaseen N, Arif M, Majeed S, Asudais AR. Prevalence of Thyroid Disorders in Patients with Infertility. Med J South Punjab [Internet]. 2025 Mar. 30 [cited 2026 Oct. 10];6(01):47-54. Available from: https://www.medteach.org/index.php/mjsp/article/view/386