تاثير قصور الغدة الدرقية على خصوبة النساء في محافظة كربلاء

Effect of Hypothyroidism on fertility of women in Karbala Province

Summary
This study aimed to determine the effect of hypothyroidism on female fertility.fertility is the capacity to establish a clinical pregnancy. Few percentages (2–4%) of women are suffering from hypothyroidism in the fertile age.
This study was conducted during the period from November 2020 to April 2021at Karbala city Maternity Hospital, Imam Hussein Teaching Hospital, and some private clinics. The study included 100 women of reproductive age. The range of their age is between (18-45) years. The patients were divided into two groups of hypothyroidism females (60) subdivided into two groups: clinical hypothyroidism (n=41), and subclinical hypothyroidism (n=19) while the control group consisting of 40 healthy females. The biochemical parameters measured were serum level of prolactin hormone, thyroid-stimulating hormone (TSH), Total Thyroxine (T4), T3, Luteinizing Hormone (LH), Follicular Stimulating Hormone (FSH), Progesterone, sex hormone-binding globulin (SHBG), Cholesterol, Triglyceride(TG), High-density lipoprotein HDL, Low-density lipoprotein LDL, and very-low-density lipoprotein VLDL. These parameters were calculated in both the patient and control groups’ sera.
The mean age of the patient was (32.13±10.04) whereas the mean age of the control group was (29.40±7.38) with statistical differences. The majority of studied patients were between 26-33years represented by (32) cases and the last was in the age group between (18-25) years represented by (21) cases. While for women aged between (34-41) years, it was estimated at (29) and the age 42 &more it was estimated at (18). Body Mass Index (BMI) for the patient’s group was (31.48±5.77), the majority (36%) were obese in patients and the control group. The result is shown in clinical hypothyroidism 29% had a BMI of 25–29.9 kg/m2. Obesity was higher (42% versus 5%) in clinical hypothyroidism than in subclinical hypothyroidism. More patients were overweight in the overt hypothyroidism group than in the subclinical hypothyroidism group.
The results of this study showed increase significant (p<0.05) of thyroid-stimulating hormone in patients Hypothyroidism compared with control group and prolactin in patients Hypothyroidism compared with control group. The result showed decrease significant (p<0.05) in Total thyroxin (T4) in patients compared with control group triiodothyronine (T3) decrease in patients while in control. The study recorded a significant decrease (p<0.05) in LH, FSH, and Progesterone in patients compared with control groups. The data of the current study revealed that serum Cholesterol, Triglycerides, High-Density Lipoprotein-Cholesterol, Low-Density Lipoprotein-Cholesterol, Very Low-Density Lipoprotein-Cholesterol (p<0.05) were significant increase in the patient’s group in comparison with a control group. The results of the present study showed that sex hormone-binding globulin was highly significant decrease (P<0.05), its level in the patients was compared with its level with that of control group.
The results of present study increase significant (p<0.05) in the level of TSH and prolactin in clinical hypothyroidism compared with subclinical hypothyroidism, and decrease significant (p<0.05) in the levels of FSH, LH, T3, T4 and progesterone in clinical hypothyroidism compared with subclinical hypothyroidism group. Serum cholesterol, low density Lipoprotein-cholesterol and serum triglyceride were significantly elevated, while high density Lipoprotein cholesterol and serum very low density Lipoprotein no significantly(p>0.05) in clinical hypothyroid patients compared to subclinical hypothyroidism . When comparing some parameters and thyroid function, LH, FSH, Prolactin, Progesterone, and SHBG, There was a significant negative (p<0.05) between TSH and FSH, LH, Progesterone, and SHBG, and significant positive with prolactin, LDL,VLDL and cholesterol , but no significant(p>0.05) with LDL and HDL.
It was found that there is a negative correlation between T4, T3, FSH, LH, progesterone, SHBG and the number of miscarriages (p<0.01).And was fond a positive correlation between TSH , prolactin, cholesterol ,TG and number of miscarriage (p<0.01) , and correlation positive (p<0.05)between LDL, VLDL and number of miscarriage , but no correlation (P>0.05) with HDL .