Endocrine Abstracts

JOINT2048

Introduction: Hypothyroidism affects the reproductive function of the female body, leading to infertility. Prolonged disturbance of hormonal status with infertility requires the use of in vitro fertilization (IVF) programmes.

Purpose: To evaluate the thyroid gland status of women for preparation for the IVF programme.

Material and Methods: The patients are divided into the following groups: 32 patients with history of female infertility with hypothyroidism conceived by IVF- first group, 22 patients with history of female infertility with hypothyroidism conceived naturally -second group. Out of 54 patients, 37 (68.5%) had primary and 17 (31.5%) had secondary infertility.

Results: Common complaints in women of both groups were ectodermal disorders like dry skin, hair loss, brittle nails which occurred in half of all patients. Hyperprolactinaemia was significantly more frequent in women of the first group (31.3%), increased blood pressure was observed in 5 (16.1%) patients of the first group and in 1 (4.5%) of the second group. On palpation of the thyroid gland and examination of imaging techniques, particularly ultrasound, the following thyroid changes were found. Nodular goitre was found in 9 (16.7%) patients. One patient underwent fine-needle aspiration biopsy (FNAB) of the nodule due to its exceeding its size by more than 10 mm and to confirm its benignity. Hypoplasia of the thyroid was observed in 7 patients, diffuse goitre of the first degree in 21 (38.9%) women. Autoimmune thyroiditis (AIT) with confirmation of hormonal studies was found in 25 (46.3%) patients. To make a final diagnosis, the hormonal profile of the women was investigated, which showed the following results. In women of the first group thyroid hormone (TSH) was higher than normal and hypothyroid state lasted longer, due to this there was an increase in prolactin levels in the blood. The increase of luteinizing and follicle stimulating hormones in the same group indicated pronounced menstrual cycle disorders in the form of menorrhagia in 48%, oligomenorrhoea in 14.8% and increase of anovulatory cycles in 54.8% of cases. Decrease in the number of antral follicles was observed in 40.7% of cases, which is one of the indicators of reduced ovarian reserve.

Conclusion: In conditions of thyroid hormone imbalance, also higher levels of luteinising and follicle stimulating hormones and low levels of progesterone in relation to the second group, manifested more often by menorrhagia and oligomenorrhoea, decreased ovarian reserve necessitates correction of hormonal status for IVF efficiency.