THE EFFECT OF HYPOTHYROIDISM ON THE OUTCOMES OF IN VITRO FERTILIZATION, DEPENDING ON AUTOIMMUNE STATUS

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.