DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20204294

A study of association between thyroid dysfunction and serum anti-mullerian hormone levels in women presenting with infertility

Haripriya Vedantham, Prathyusha Tanuku, Nandini Joshi Nee Jahagirdar, Vasundhara Kamineni

Abstract


Background: This study was conducted to study the association between thyroid dysfunction and serum AMH levels in women presenting with infertility.

Methods: An institution based cross-sectional study including, was conducted at Kamineni hospital fertility clinic among 70 women presenting with infertility during a two year period from May 2016 to April 2018 after fulfilling inclusion criteria.

Results: Hypothyroidism was the most common thyroid dysfunction observed in the study participants and subclinical hypothyroidism was seen predominantly. Age of the women did not seem to influence the prevalence of thyroid disease. Low serum AMH indicating poor ovarian reserve was observed in 70% of women over 34yrs suggesting a significant correlation. All the women diagnosed with overt hypothyroidism had low serum AMH levels and half of the women with subclinical hypothyroidism also had low serum AMH levels suggesting a close association between thyroid dysfunction and ovarian reserve. Women with hyperthyroidism had normal AMH levels.

Conclusions: Serum AMH levels in infertile patients, were inversely correlated with TSH levels.


Keywords


Anti-Mullerian hormone, Infertility, Ovarian reserve, Thyroid dysfunction

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References


Sciarra J. Infertility, an international health problem: Int J Gynaecol Obstet. 1994;46:155-63.

Population Council. Infertility: Looking back, looking forward: a profile of sexual and reproductive health in India. New Delhi: Population Council; 2004:67-72.

Infecundity, infertility, and childlessness in developing countries. DHS Comparative Reports No. Calverton, Maryland, USA: ORC Macro and the World Health Organization; 2004. World Health Organization. Available from: https://dhsprogram.com/publications/publication-cr9-comparative-reports.cfm.

Krassas GE, Papadopoulou F, Tziomalos K, Zeginiadou T, Pontikides N. Hypothyroidism has an adverse effect on human spermatogenesis: A prospective, controlled study. Thyroid. 2008;18:1255-9.

Van den Boogaard E, Vissenberg R, Land JA, van Wely M, van der Post JA, Goddijn M, et al. Significance of (sub) clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: A systematic review. Hum Reprod Update. 2011;17:605-19.

Menon UV, Sundaram KR, Unnikrishnan AG, Jayakumar RV, Nair V, Kumar H. High prevalence of undetected thyroid disorders in an iodine sufficient adult south Indian population. J Indian Med Assoc. 2009;107:72.

Fanchin R, Taieb J, Lozano DH, Ducot B, Frydman R, Bouyer J. High reproducibility of serum anti-Mullerian hormone measurements suggests a multi-staged follicular secretion and strengthens its role in the assessment of ovarian follicular status: Hum Reprod. 2005;20:923.

Hehenkamp WJ, Looman CW, Themmen AP, de Jong FH, Te Velde ER, Broekmans FJ. Anti-Mullerian hormone levels in the spontaneous menstrual cycle do not show substantial fluctuation: J Clin Endocrinol Metab. 2006;91:4057.

Hansen KR, Hodnett GM, Knowlton N, Craig LB. Correlation of ovarian reserve tests with histologically determined primordial follicle number. Fertility Steril. 2011;95(1):170-5.

de Vet A, Laven JS, de Jong FH, Themmen AP, Fauser BC. Anti-mullerian hormone serum levels: a putative marker for ovarian aging: Fertil Steril. 2002;77:357.

Weenen C, Laven JS, Von Bergh AR, Cranfield M, Groome NP, et al. Anti-Mullerian hormone expression pattern in the human ovary: potential implications for initial and cyclic follicle recruitment: Mol Hum Reprod. 2004;10:77.

Kevenaar ME, Meerasahib MF, Kramer P, van de Lang-Born BM, de Jong FH, et al. Serum anti-mullerian hormone levels reflect the size of the primordial follicle pool in mice. Endocrinology. 2006;147:3228.

Gerhard I, Becker T, Eggert-Kruse W, Klinga K, Runnebaum B. Thyroid and ovarian function in infertile women. Hum Reprod. 1991;6(3):338-45.

Gerhard I, Eggert-Kruse W, Merzoug K, Klinga K, Runnebaum B. Thyrotropin-releasing hormone (TRH) and metoclopramide testing in infertile women. Gynecol Endocrinol. 1991;5(1):15-32.

Kuroda K, Uchida T, Nagai S, Ozaki R, Yamaguchi T, Sato Y, et al. Elevated serum thyroid-stimulating hormone is associated with decreased anti-Müllerian hormone in infertile women of reproductive age. J Assist Reprod Genetics. 2015;32(2):243-7.

Battikhi MN. Correlation between AMH and TSH in infertile women. EC Gynaecol. 2018:7(1):12-5.

Al-Azzawi OD, Al-Hadithy AH, Amen SS. The effect of thyroid dysfunction on anti-mollurian hormone concentration in the infertile women at the fertile age. Int J Sci Nature. 2015;6(1):45-50.

Broer SL, Broekmans FJ, Laven JS, Fauser BC. Anti-Müllerian hormone: ovarian reserve testing and its potential clinical implications. Hum Reprod Update. 2014;20(5):688-701.

Sammour HM, Abuelghar WM, El-Salam NE, Ahmed HH. TSH and AMH in Infertile Women. Egyptian J Hosp Med. 2017;69(2):1814-22.

Weghofer A, Barad DH, Darmon S, Kushnir VA, Gleicher N. What affects functional ovarian reserve, thyroid function or thyroid autoimmunity? Reprod Biol Endocrinol. 2016;14(1):26.

Polyzos NP, Sakkas E, Vaiarelli A, Poppe K, Camus M, Tournaye H. Thyroid autoimmunity, hypothyroidism and ovarian reserve: a cross-sectional study of 5000 women based on age-specific AMH values. Human Reprod. 2015;30(7):1690-6.