Women have clinical aspects of infertility with thyroid pathology

Abstract

The objective: to study the main clinical aspects of infertility in women with various variants of thyroid pathology.Materials and methods. A clinical screening examination of 496 women with infertility (main group), of which 238 were diagnosed the various thyroid pathologies, and 80 women with thyroid pathology without reproductive function disorders (control group) was carried out.Results. Primary infertility was diagnosed in 49.4 % of examined women, and secondary infertility – in 50.6 % of patients. Female infertility was diagnosed in 327 (65.9 %) patients, male infertility in 126 (25.4 %) women; infertility of unknown genesis was established during the examination of 43 married couples (8.7 %). In the structure of the causes of female infertility, the tubal-peritoneal factor prevailed (37 %), the frequency of external genital endometriosis was 36.4 %, the endocrine factor – 23.2 %, and the uterine factor – 3.4 %. A combination of infertility factors was determined in 23.8 % of women. The results of studying the reproductive history showed that 251 patients with secondary infertility have a history of 279 pregnancies. The positive obstetrical outcomes such as term uncomplicated childbirth was established only in 48 (19.1 %) patients; the first term birth occurred in 28 (11.1 %) women, the second birth – in 16 (6.4 %) patients. Pregnancy ended with premature birth in 27 (10.7 %) women, induced abortions – in 41 (16.3 %), spontaneous abortions – in 58 (23.1 %), 41of them (16.3 %) had one spontaneous abortion; missed abortion – in 57 (22.7 %) patients, ectopic pregnancy – in 19.1 %.A comparative evaluation of thyroid screening results in infertile and fertile women demonstrated that the prevalence of thyroid pathology in infertile patients was 3.8 times higher compared to fertile women (48 % and 12.5 %, respectively). In the structure of the thyroid gland pathology in both groups the presence of antibodies to thyroperoxidase combined with echo signs of autoimmune thyroiditis prevailed, which is 2.8 times more often diagnosed in the group of infertile women compared to fertile women (24 % and 8.7 %, respectively).Conclusions. The prevalence of thyroid pathology in patients with infertility is 3.8 times higher compared to fertile women. In women with secondary infertility pregnancy loss in the I trimester of gestation is dominated in the structure of reproductive outcomes.