Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 10:15:1477665.
doi: 10.3389/fendo.2024.1477665. eCollection 2024.

Subclinical/overt hypothyroidism may be associated with diminished ovarian reserve in infertile women independent of thyroid autoimmunity

Hongzhan Zhang #  1   2   3 , Han Qiu #  1   2   3 , Zhiqiang Liu  1   3 , Yulian Wu  1   2   3 , Wei Liu  1   2 , Chunyu Huang  1   2   3
Affiliations

Subclinical/overt hypothyroidism may be associated with diminished ovarian reserve in infertile women independent of thyroid autoimmunity

Hongzhan Zhang et al. Front Endocrinol (Lausanne). .

Abstract

Objective: To investigate the association between thyroid dysfunction or thyroid autoimmunity (TAI) and diminished ovarian reserve (DOR).

Methods: A total of 2,867 women undergoing their first in-vitro fertilization (IVF) cycle at Shenzhen Zhongshan Obstetrics & Gynecology Hospital between January 1, 2013 and June 30, 2021, were enrolled in this study. The participants had documented thyroid and ovarian reserve metrics. They were categorized into three groups based on their thyroid function: normal thyroid function (N = 2,540), subclinical/overt hypothyroidism (SCH/OH) (N = 290), and subclinical/overt hyperthyroidism (N = 37). Anti-Mullerian hormone (AMH) and antral follicle count (AFC) were assessed and collected. Women with AMH <1.2 ng/mL and AFC < 5 were diagnosed with DOR. Basic characteristics and ovarian reserve-related parameters were compared among the three groups. The association between thyroid function and ovarian reserve function was further analyzed using logistical regression analyses. In addition, the euthyroid population was stratified using a thyroid-stimulating hormone (TSH) threshold of 2.5 µIU/mL, and the ovarian reserve-related parameters were compared among women with low-normal TSH (TSH < 2.5 µIU/mL), high-normal TSH (2.5 µIU/mL ≤ TSH ≤ 4.2 µIU/mL) and SCH/OH.

Results: Women with SCH/OH had lower AMH levels (2.79 ng/mL vs. 3.41 ng/mL, P < 0.001) and a significantly higher prevalence of AMH level < 1.2ng/mL (17.2% vs. 12.1%, P = 0.015) compared to those with normal thyroid function. The prevalence of DOR was also higher among women with SCH/OH (10.0% vs. 6.5%, P = 0.036). There were no significant differences in ovarian reserve between women with normal thyroid function and those with subclinical/overt hyperthyroidism. Logistic regression analyses showed that the odds ratio (OR) of women with SCH/OH suffering from DOR was 1.666 (95% CI: 1.079-2.572) compared to those with normal thyroid function, after adjusting for TAI status and basic clinical characteristics. When the euthyroid group was stratified according to TSH levels, women with SCH/OH showed significantly lower AMH levels compared to women with low-normal TSH (2.79 ng/mL vs. 3.44 ng/mL, P < 0.001) and a significantly higher prevalence of DOR (10.0% vs. 6.0%, P = 0.010). Logistic regression analyses showed that the women with SCH/OH had an increased prevalence of DOR (OR: 1.819, 95% CI: 1.158-2.858) compared to those with low-normal TSH, after adjusting for TAI status and basic clinical characteristics. However, the OR for DOR among women with high-normal TSH was not significantly elevated compared to those with low-normal TSH (OR: 1.310, 95% CI: 0.936-1.832).

Conclusion: SCH/OH may be associated with DOR, irrespective of TAI status.

Keywords: anti-Müllerian hormone; hypothyroidism; infertility; ovarian reserve; thyroid autoimmunity; thyroid stimulating hormone.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Diagram of the study and distribution of the patients investigated.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Pastore LM, Christianson MS, Stelling J, Kearns WG, Segars JH. Reproductive ovarian testing and the alphabet soup of diagnoses: DOR, POI, POF, POR, and FOR. J Assist Reprod Genet. (2018) 35:17–23. doi: 10.1007/s10815-017-1058-4 - DOI - PMC - PubMed
    1. Chen D, Shen X, Wang L, Kuang Y. Cumulative live birth rates for low-prognosis women over 5 years or 9 frozen-thawed embryo transfer cycles. BMC Pregnancy Childbirth. (2022) 22:233. doi: 10.1186/s12884-022-04511-7 - DOI - PMC - PubMed
    1. Busnelli A, Somigliana E, Cirillo F, Levi-Setti PE. Is diminished ovarian reserve a risk factor for miscarriage? Results of a systematic review and meta-analysis. Hum Reprod Update. (2021) 27:973–88. doi: 10.1093/humupd/dmab018 - DOI - PubMed
    1. Yi Y, Fu J, Xie S, Zhang Q, Xu B, Wang Y, et al. . Association between ovarian reserve and spontaneous miscarriage and their shared genetic architecture. Hum Reprod. (2023) 38:2247–58. doi: 10.1093/humrep/dead180 - DOI - PubMed
    1. Luderer U, Lim J, Ortiz L, Nguyen JD, Shin JH, Allen BD, et al. . Exposure to environmentally relevant concentrations of ambient fine particulate matter (PM(2.5)) depletes the ovarian follicle reserve and causes sex-dependent cardiovascular changes in apolipoprotein E null mice. Part Fiber Toxicol. (2022) 19:5. doi: 10.1186/s12989-021-00445-8 - DOI - PMC - PubMed

LinkOut - more resources