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Levothyroxine supplementation improves serum anti‐Müllerian hormone levels in infertile patients with Hashimoto’s thyroiditis
Author(s) -
Kuroda Masako,
Kuroda Keiji,
Segawa Tomoya,
Noh Jaeduk Y.,
Yoshihara Ai,
Ito Koichi,
Osada Hisao,
Takeda Satoru,
Teramoto Shokichi
Publication year - 2018
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13554
Subject(s) - medicine , levothyroxine , anti müllerian hormone , infertility , hormone , subclinical infection , thyroid peroxidase , ovarian reserve , thyroid , thyroiditis , thyroid function , endocrinology , gastroenterology , pregnancy , biology , genetics
Aim Thyroid dysfunction and autoimmunity are associated with an adverse effect on fertility. An aberrant high thyroid stimulating hormone level is associated with diminished ovarian reserve in women of reproductive age; however, the utility of levothyroxine (LT4) replacement for infertile patients with subclinical hypothyroidism is still under discussion. The aim of this study was to investigate whether LT4 supplementation for infertile patients with subclinical hypothyroidism improves impaired ovarian function. Methods We measured levels of serum thyroid‐related hormones and a biomarker of ovarian function, anti‐Müllerian hormone (AMH) in infertile women from 2014 to 2015. Out of a consecutive 1431 infertile patients, 311 patients with an elevated thyroid stimulating hormone level (≥ 2.5 μIU/mL) underwent detailed thyroid examinations, including blood tests of thyroid antibodies. We recruited 174 infertile patients, excluding patients with factors impacting ovarian and thyroid function. We evaluated alterations in AMH and thyroid related hormone levels during LT4 supplementation and infertility treatment with assisted reproductive technology. Results After LT4 supplementation, no significant change in the average AMH level was detected overall. However, the AMH level in 35 patients with Hashimoto’s disease increased significantly after treatment (1 month 1.3 ± 0.5 fold, P = 0.007; 3 months 1.3 ± 0.4 fold, P = 0.040). The AMH level in patients with thyroglobulin antibody‐positive and thyroid peroxidase antibody‐negative also significantly increased after LT4 treatment (1 and 3 months 1.5 fold; P = 0.023). Conclusion In the patients with Hashimoto’s disease, preconception LT4 treatment may relieve adverse effects, including autoimmune antibodies, and support follicular development.