Levothyroxine with Clomiphene Citrate for Ovulation Induction in Patients with Polycystic Ovary Syndrome and Subclinical Hypothyroidism

Ahmed Nofal

doi:10.19080/jgwh.2020.17.555972

Abstract

Levothyroxine with Clomiphene Citrate for Ovulation Induction in Patients with Polycystic Ovary Syndrome and Subclinical Hypothyroidism

Highlights

Polycystic ovary syndrome (PCOS), affecting about 5 to 10% of women [1] Hypothyroid disturbances and elevated thyroid stimulating hormone (TSH) levels are common findings in PCOS [2]
There was no significant difference between both groups regarding ovarian function represented in luteinizing hormone (LH), follicle stimulating hormone (FSH), TSH, progesterone before treatment
This was a prospective observational study that was conducted at infertility unit in menoufia university hospitals upon patients suffering from infertility, PCOS and subclinical hypothyroidism from June 2018 till may 2019. 220 patients enrolled into this study,18 cases dropped out of the study due to failure of follow up of the patients, the 204 patients who completed the study were randomized by random randomization into 2 groups Group (I) in this group102 patients received 50u Eltroxin till TSH was normalized they received combined Eltroxin and 100mg Clomid for 3 successive cycles Group (II) 102 patients received sugary tablet and 100m Clomid for 3 successive cycles

Summary

Introduction

Polycystic ovary syndrome (PCOS), affecting about 5 to 10% of women [1] Hypothyroid disturbances and elevated TSH levels are common findings in PCOS [2]. Polycystic ovary syndrome (PCOS), affecting about 5 to 10% of women, is characterized by hyperandrogenism, menstrual disturbance, obesity, anovulation, infertility, Insulin Resistance, hyperglycemia, weight gain, and metabolic syndrome (MBS) as hypothyroidism [1]. Hypothyroid disturbances and elevated TSH levels are common findings in PCOS. Out of that 57.69% had subclinical hypothyroidism and 42.30 % had overt hypothyroidism women with diagnosed PCOS should be screened for thyroid dysfunction. Hypothyroidism causes altered follicle stimulating hormone (FSH)/luteinizing hormone (LH) ratio and raised dehydroepiandrosterone (DHEA-S) levels. As excess thyroid stimulating hormone (TSH) causes stimulation of FSH receptor [3]. The National Academy of Clinical Biochemistry suggested serum TSH (0.4– 2.5) mIU/L as the normal range, according to United States Preventive Services Task Force (USPSTF) Guidelines defined subclinical hypothyroidism SCH as high serum TSH (2.5-10 mIU/L) with a normal FT4 concentration [4]

Objectives

Methods

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Discussion

Conclusion