机构:[1]Kunming Med Univ, Affiliated Hosp 1, Dept Reprod & Genet, Kunming 650032, Yunnan, Peoples R China昆明医科大学附属第一医院生殖遗传科外科科室[2]Kunming Med Univ, Affiliated Hosp 1, MOH Key Lab Drug Addict Med, Kunming, Yunnan, Peoples R China医技科室医学影像中心CT室昆明医科大学附属第一医院国家卫生健康委毒品依赖和戒治重点实验室[3]Department of Reproduction and Genetics,The First Affiliated Hospital of Kunming Medical University,Kunming 650032 China
Background: Overt thyroid diseases have been identified as risk factors for female infertility. However, it remains largely unclear whether subclinical hypothyroidism (SCH), a very common thyroid disorder, is associated with female infertility. This study aimed to investigate the potential association between SCH and the ovarian reserve in women seeking infertility treatment. Methods: This retrospective study included 2568 women with normal thyroid function (n = 2279) or SCH (n = 289) who visited our clinic for infertility treatment. Ovarian reserve markers, including follicle-stimulating hormone (FSH) concentrations on days 2-4, the antral follicle count (AFC), and anti-Mullerian hormone (AMH) concentration, were compared between euthyroid women and those with SCH. Multiple linear and Poisson regression analyses were used to estimate the associations of SCH with ovarian reserve markers. These analyses were repeated separately in women aged <35 (n = 1349) and >= 35 years (n = 1219). Results: In the total study population, women with SCH had significantly lower AMH concentrations (median: 2.05 vs. 2.51 ng/mL, p = 0.015) and AFCs (median: 10.0 vs. 11.0, p = 0.013), compared with euthyroid women. In linear and Poisson regression analyses, SCH was significantly associated with a higher basal FSH concentration (mean difference = 1.13 mIU/mL [95% confidence interval (CI) 0.97 to 1.29 mIU/mL], p < 0.001), lower AMH concentration (mean difference = -0.27 ng/mL [CI -0.43 to -0.12 ng/mL], p = 0.001), and lower AFC (mean difference = -0.7 [CI -1.3 to -0.2], p = 0.005). In women aged >= 35 years, SCH was significantly associated with FSH (mean difference = 1.74 mIU/mL, p < 0.001) and AMH concentrations (mean difference = -0.40 mg/mL, p < 0.001) and AFC (mean difference = -0.8, p < 0.001). In women <35 years old, SCH was significantly associated with a higher FSH concentration (mean difference = 0.30 mIU/mL, p < 0.001), but not with AMH or AFC concentrations (p = 0.84 and 0.06, respectively). Thyroperoxidase antibody (TPOAb) positivity was not associated with measures of ovarian reserve. Conclusions: The data suggest that SCH is associated with decreased ovarian reserve during later reproductive age. TPOAb positivity was not associated with ovarian reserve. Future research is necessary to investigate the underlying molecular mechanisms regulating the diminished ovarian reserve in women with SCH and to evaluate whether levothyroxine supplementation may improve the ovarian function of women with SCH.
基金:
National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81801416]; Technology and Innovation Team of Reproduction and Genetics at Kunming Medical University [CXTD201708]; First Affiliated Hospital of Kunming Medical University [2017BS008]
第一作者机构:[1]Kunming Med Univ, Affiliated Hosp 1, Dept Reprod & Genet, Kunming 650032, Yunnan, Peoples R China
通讯作者:
通讯机构:[3]Department of Reproduction and Genetics,The First Affiliated Hospital of Kunming Medical University,Kunming 650032 China
推荐引用方式(GB/T 7714):
Rao Meng,Wang Huawei,Zhao Shuhua,et al.Subclinical Hypothyroidism Is Associated with Lower Ovarian Reserve in Women Aged 35 Years or Older[J].THYROID.2020,30(1):95-105.doi:10.1089/thy.2019.0031.
APA:
Rao, Meng,Wang, Huawei,Zhao, Shuhua,Liu, Jiang,Wen, Ya...&Tang, Li.(2020).Subclinical Hypothyroidism Is Associated with Lower Ovarian Reserve in Women Aged 35 Years or Older.THYROID,30,(1)
MLA:
Rao, Meng,et al."Subclinical Hypothyroidism Is Associated with Lower Ovarian Reserve in Women Aged 35 Years or Older".THYROID 30..1(2020):95-105