Correlation of Serum TSH with Ovarian Reserve in Patient of Infertility. A Retrospective Study

Abstract

Background: Various hormones have different impact in fertility either to predict, to investigate or to treat infertility. Due to hindrance in follicular growth, embryo development, implantation and placental formation thyroid dysfunction affects fertility. Studies suggest that thyroid disorder affecting follicular process is associated with ovarian reserve. Similarly serum FSH is directly related to AMH depicting strong correlation of age with each other. This study was conducted to see the association between thyroid dysfunction and serum Anti Mullerian Hormone (AMH) level. Methods: All the female having infertility between age of 20 to 45 were included in the study. Those who did not undergo hormonal assay were excluded from study. All the data were taken from Opd record and their serum Thyroid Stimulating Hormone, AMH and Day2 Follicle Stimulating Hormone Luteinizing Hormone, Prolactin, Estradiol and Progesterone were evaluated. Result: A total of 292 patients visited infertility clinic at our institution over a period of 1.5 yrs and of them only 80 had undergone all hormonal assay. Majority of women enrolled for the study were in the age group 21-30 and the mean age was 29.98±5.4 yrs. Hypothyroidism was seen in 27.5% (n=22) females while we found no cases of hyperthyroidism in our study. Though 35% of females had TSH <2.5. Low serum AMH levels (<1.6 ng/ml) were noted in 25% (n=20). Among women of age less than 35 yrs and low AMH (<1.6) mean TSH was 7.27±6.93 and with normal AMH (>1.6) mean TSH was 3.61±1.73 which was statistically significant (p-value <0.001). Similarly mean FSH in women with low AMH (<1.6) was 8.66±2.89 and with normal AMH (>1.6) was 5.81±1.36 which was statistically significant (p-value <0.001). Conclusion: TSH and FSH level is inversely related to ovarian reserve infertile women.