Abstract:
Introduction. Subclinical hypothyroidism often goes undiagnosed due to the absence of
pronounced clinical symptoms. However, even minimal thyroid hypofunction can have a neg
ative impact on a woman’s reproductive function, including ovarian reserve and the success of
in vitro fertilization (IVF) programs.
Materials and Methods: The study included women with endocrine infertility against
a background of hypothyroidism. The patients were divided into groups: Group 1-women with
hypothyroidism of autoimmune etiology (n=39); Group 2-women with hypothyroidism with
out autoimmune thyroiditis (n=49). The control group consisted of women of reproductive
age without thyroid dysfunction (n=20). To assess ovarian reserve, anti- Müllerian hormone
(AMH) and inhibin B levels were measured on days 3–5 of the menstrual cycle, and antral
follicle count was performed. Additionally, levels of TSH, free T4, antibodies to TPO and TG,
and prolactin were assessed.
Results: Patients with hypothyroidism showed a statistically significant decrease in AMH
and inhibin B levels compared with the control group (p<0.05). TSH levels were higher in the
presence of autoimmune thyroiditis. In patients who became pregnant, inhibin B levels were
statistically significantly higher (p<0.001). Conclusion. Hypothyroidism is associated with a de
crease in ovarian reserve. Inhibin B is an informative prognostic marker of the effectiveness of
IVF programs. The likelihood of pregnancy in patients with hypothyroidism is associated with
higher levels of AMH and inhibin B.
