The Role of Thyroid Dysfunction in the Development of Endocrine Infertility in Women and Modern Treatment Methods

Abstract

Aim. To assess the role of thyroid dysfunction in the development of endocrine infertility in women and to develop modern treatment methods aimed at restoring reproductive function. Materials and methods. The study included 90 women with endocrine infertility caused by thyroid dysfunction. The patients were divided into two main groups based on the form of thyroid dysfunction: Group I (hypothyroidism) included 30 women with infertility due to hypothyroidism; Group II (hyperthyroidism) included 30 women with infertility due to hyperthyroidism. The control group consisted of 30 healthy women of reproductive age. All patients underwent clinical examination, which included medical history and general physical examination with a focus on symptoms of thyroid dysfunction, laboratory tests including serum levels of thyroid-stimulating hormone (TSH), free thyroxine (T4), free triiodothyronine (T3) by enzyme-linked immunosorbent assay (ELISA), antibodies to thyroid peroxidase (TPO-Ab) and thyroglobulin. Results. Hormonal study results before treatment showed that in Group I, the average TSH level was 7.8±2.1 mIU/L, significantly higher than in the control group (1.6±0.5 mIU/L, p<0.01). The average free T4 level was reduced to 0.9±0.2 ng/dL compared to the control group (1.2±0.3 ng/dL, p<0.05). TPO-Ab levels were elevated in 60% of patients in Group I. In Group II, the average free T4 level was increased to 2.3±0.4 ng/dL, significantly higher than in the control group (p<0.01). The TSH level was reduced to 0.2±0.1 mIU/L (p<0.01). TPO-Ab levels were elevated in 50% of patients in Group II. Hormonal study results after 6 months of therapy with Tyromine in patients with hypothyroidism (Group I) showed a significant decrease in TSH levels to 2.3±0.6 mIU/L (p<0.01) and an increase in free T4 levels to 1.1±0.2 ng/dL (p<0.05). Regular menstrual function was restored in 84% of patients, and 83.4% achieved pregnancy. In the group of patients with hyperthyroidism (Group II), Tyromine therapy led to a decrease in free T4 levels to 1.4±0.3 ng/dL (p<0.01) and an increase in TSH levels to 1.8±0.4 mIU/L (p<0.01). Menstrual cycles normalized in 85% of patients, and 84.5% achieved pregnancy. Conclusion. Our study demonstrated that thyroid dysfunction plays a significant role in the development of endocrine infertility in women, significantly impacting their reproductive function. Hypothyroidism and hyperthyroidism lead to severe hormonal imbalances, adversely affecting the menstrual cycle, ovulation, and overall fertility. The use of Tyromine showed high effectiveness in normalizing thyroid hormone levels, improving clinical outcomes, and restoring reproductive function in 84.5% of patients with thyroid dysfunction.