Obstet Gynecol Sci.  2014 Nov;57(6):507-512. 10.5468/ogs.2014.57.6.507.

Subclinical hypothyroidism diagnosed by thyrotropin-releasing hormone stimulation test in infertile women with basal thyroid-stimulating hormone levels of 2.5 to 5.0 mIU/L

• Lee YJ
• Kim CH
• Kwack JY
• Ahn JW
• Kim SH
• Chae HD
• Kang BM

• KMID: 2314018
• DOI: http://doi.org/10.5468/ogs.2014.57.6.507

Abstract

OBJECTIVE
To investigate the prevalence of subclinical hypothyroidism (SH) diagnosed by thyrotropin-releasing hormone (TRH) stimulating test in infertile women with basal thyroid-stimulating hormone (TSH) levels of 2.5 to 5.0 mIU/L.
METHODS
This study was performed in 39 infertile women with ovulatory disorders (group 1) and 27 infertile women with male infertility only (group 2, controls) who had basal serum TSH levels of 2.5 to 5.0 mIU/L and a TRH stimulating test. Serum TSH levels were measured before TRH injection (TSH0) and also measured at 20 minutes (TSH1) and 40 minutes (TSH2) following intravenous injection of 400 microg TRH. Exaggerated TSH response above 30 mIU/L following TRH injection was diagnosed as SH. Group 1 was composed of poor responders (subgroup A), patients with polycystic ovary syndrome (subgroup B) and patients with WHO group II anovulation except poor responder or polycystic ovary syndrome (subgroup C).
RESULTS
The prevalence of SH was significantly higher in group 1 of 46.2% (18/39) compared with 7.4% (2/27) in group 2 (P=0.001). TSH0, TSH1, and TSH2 levels were significantly higher in group 1 than the corresponding values in group 2 (P<0.001, P<0.001, P<0.001). In group 1, TSH1 and TSH2 levels were significantly lower in subgroup C compared with those in subgroup A and B (P=0.008, P=0.006, respectively).
CONCLUSION
TRH stimulation test had better be performed in infertile women with ovulatory disorders who have TSH levels between 2.5 and 5.0 mIU/L for early detection and appropriate treatment of SH.

Keyword

Infertility; Ovulatory disorder; Subclinical hypothyroidism; Thyrotropin-releasing hormone stimulating test

MeSH Terms

Anovulation
Female
Humans
Hypothyroidism*
Infertility
Infertility, Male
Injections, Intravenous
Male
Polycystic Ovary Syndrome
Prevalence
Thyrotropin*
Thyrotropin-Releasing Hormone*
Thyrotropin
Thyrotropin-Releasing Hormone

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