Subclinical/overt hypothyroidism may be associated with diminished ovarian reserve in infertile women independent of thyroid autoimmunity
ObjectiveTo investigate the association between thyroid dysfunction or thyroid autoimmunity (TAI) and diminished ovarian reserve (DOR).MethodsA total of 2,867 women undergoing their first in-vitro fertilization (IVF) cycle at Shenzhen Zhongshan Obstetrics & Gynecology Hospital between Januar...
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Frontiers Media S.A.
2024-12-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2024.1477665/full |
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| author | Hongzhan Zhang Hongzhan Zhang Hongzhan Zhang Han Qiu Han Qiu Han Qiu Zhiqiang Liu Zhiqiang Liu Yulian Wu Yulian Wu Yulian Wu Wei Liu Wei Liu Chunyu Huang Chunyu Huang Chunyu Huang |
| author_facet | Hongzhan Zhang Hongzhan Zhang Hongzhan Zhang Han Qiu Han Qiu Han Qiu Zhiqiang Liu Zhiqiang Liu Yulian Wu Yulian Wu Yulian Wu Wei Liu Wei Liu Chunyu Huang Chunyu Huang Chunyu Huang |
| author_sort | Hongzhan Zhang |
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| description | ObjectiveTo investigate the association between thyroid dysfunction or thyroid autoimmunity (TAI) and diminished ovarian reserve (DOR).MethodsA 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.ResultsWomen 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).ConclusionSCH/OH may be associated with DOR, irrespective of TAI status. |
| format | Article |
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| institution | OA Journals |
| issn | 1664-2392 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj-art-dde7be2e760544328ac24e1dced52ec82025-08-20T02:21:46ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922024-12-011510.3389/fendo.2024.14776651477665Subclinical/overt hypothyroidism may be associated with diminished ovarian reserve in infertile women independent of thyroid autoimmunityHongzhan Zhang0Hongzhan Zhang1Hongzhan Zhang2Han Qiu3Han Qiu4Han Qiu5Zhiqiang Liu6Zhiqiang Liu7Yulian Wu8Yulian Wu9Yulian Wu10Wei Liu11Wei Liu12Chunyu Huang13Chunyu Huang14Chunyu Huang15Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproductive Medicine and Genetics, Shenzhen, ChinaDepartment of Reproductive Immunology, Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation, Shenzhen, ChinaFertility Center, Shenzhen Zhongshan Obstetrics & Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital), Shenzhen, ChinaShenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproductive Medicine and Genetics, Shenzhen, ChinaDepartment of Reproductive Immunology, Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation, Shenzhen, ChinaFertility Center, Shenzhen Zhongshan Obstetrics & Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital), Shenzhen, ChinaShenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproductive Medicine and Genetics, Shenzhen, ChinaFertility Center, Shenzhen Zhongshan Obstetrics & Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital), Shenzhen, ChinaShenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproductive Medicine and Genetics, Shenzhen, ChinaDepartment of Reproductive Immunology, Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation, Shenzhen, ChinaFertility Center, Shenzhen Zhongshan Obstetrics & Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital), Shenzhen, ChinaShenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproductive Medicine and Genetics, Shenzhen, ChinaDepartment of Reproductive Immunology, Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation, Shenzhen, ChinaShenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproductive Medicine and Genetics, Shenzhen, ChinaDepartment of Reproductive Immunology, Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation, Shenzhen, ChinaFertility Center, Shenzhen Zhongshan Obstetrics & Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital), Shenzhen, ChinaObjectiveTo investigate the association between thyroid dysfunction or thyroid autoimmunity (TAI) and diminished ovarian reserve (DOR).MethodsA 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.ResultsWomen 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).ConclusionSCH/OH may be associated with DOR, irrespective of TAI status.https://www.frontiersin.org/articles/10.3389/fendo.2024.1477665/fullinfertilityhypothyroidismthyroid stimulating hormonethyroid autoimmunityovarian reserveanti-Müllerian hormone |
| spellingShingle | Hongzhan Zhang Hongzhan Zhang Hongzhan Zhang Han Qiu Han Qiu Han Qiu Zhiqiang Liu Zhiqiang Liu Yulian Wu Yulian Wu Yulian Wu Wei Liu Wei Liu Chunyu Huang Chunyu Huang Chunyu Huang Subclinical/overt hypothyroidism may be associated with diminished ovarian reserve in infertile women independent of thyroid autoimmunity Frontiers in Endocrinology infertility hypothyroidism thyroid stimulating hormone thyroid autoimmunity ovarian reserve anti-Müllerian hormone |
| title | Subclinical/overt hypothyroidism may be associated with diminished ovarian reserve in infertile women independent of thyroid autoimmunity |
| title_full | Subclinical/overt hypothyroidism may be associated with diminished ovarian reserve in infertile women independent of thyroid autoimmunity |
| title_fullStr | Subclinical/overt hypothyroidism may be associated with diminished ovarian reserve in infertile women independent of thyroid autoimmunity |
| title_full_unstemmed | Subclinical/overt hypothyroidism may be associated with diminished ovarian reserve in infertile women independent of thyroid autoimmunity |
| title_short | Subclinical/overt hypothyroidism may be associated with diminished ovarian reserve in infertile women independent of thyroid autoimmunity |
| title_sort | subclinical overt hypothyroidism may be associated with diminished ovarian reserve in infertile women independent of thyroid autoimmunity |
| topic | infertility hypothyroidism thyroid stimulating hormone thyroid autoimmunity ovarian reserve anti-Müllerian hormone |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2024.1477665/full |
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