ASSOCIATION OF THYROID HORMONE LEVELS WITH LUTEAL PHASE DEFICIENCY IN INFERTILE WOMEN
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Abstract
Objectives: To find out the association of thyroid hormone levels with Luteal Phase Deficiency (LPD)
Methodology: This prospective study was conducted at Peshawar Medical College, from April to August 2013. The sample size was 125 infertile women of the reproductive age group (18-42 years) selected through consecutive sampling technique. On the 22nd and 23rd of the menstrual cycle, endometrial biopsies were performed. Chemiluminescence Immunoassay was used to estimate the serum levels of the thyroid hormones. SPSS version 19 was used to conduct the statistical analysis. The Chi-square test was used to see whether there was any statistically significant difference between the endometrial findings of patients with normal thyroid profiles and those who had elevated thyroid hormone levels. It was deemed statistically significant when the probability value was p<0.05.
Results: The majority of infertile patients (n=99) had normal thyroid profiles, followed by hyperthyroid cases (n=23). Only three turned out to be hypothyroid. There was no significant difference in endometrium between the patients with normal and increased thyroid hormone levels.
Conclusion: Although no statistically significant association between the thyroid hormones levels and the endometrium in cases of Luteal Phase Deficiency could be found in this study, their role cannot be ignored and needs further evaluation
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References
Pfeifer FM, Goldberg J, McClure R, Lobo R, Thoma M, Widra E, Schattman G, Licht M, Collins J, Cedars M, Racows¬ky C, Vernon M, Davis O, Barnhart K, Graci C, Catherino W, Rebar R, La Bar¬bera A. The clinical relevance of luteal phase deficiency: a committee opin¬ion. Fertil Steril. 2012;98(5):1112-7. DOI:10.1016/j.fertnstert.2012.06.050.
Engman L, Luciano AA. Luteal phase deficiency: What we now know Man¬ agement of this elusive condition can be a challenge due to disagreement about its cause, true incidence, and diagnosis. OBG Manage. 2003;15(8):41-58.
Darland NW. Infertility Associated with Luteal Phase Defect. J Obstet Gyne¬col Neonatal Nurs. 1985;14(3):212- 7. DOI:10.1111/j.1552-6909.1985. tb02229.x.
Miller PB, Soules MR. Luteal Phase Deficiency: pathophysiology, diagno¬sis, and treatment. Glob Libr Women’s Med. 2009:1756-2228. DOI:10.3843/ GLOWM.10327.
Sharma V, Saxena V, Khatri SL. Histo¬pathological study of endometrium in cases of infertility. J Clin Exp Pathol. 2016;6:272-5.
Schliep KC, Mumford SL, Hammoud AO, Stanford JB, Kissell KA, Sjaarda LA, et al. Luteal phase deficiency in regu¬larly menstruating women: prevalence and overlap in identification based on clinical and biochemical diagnos¬tic criteria. J Clin Endocrinol Metab. 2014;99(6):1007-14. DOI:10.1210/ jc.2013-3534.
Valvekar U, Lakshmi S, Kumar AN. Hy¬pothyroidism and hyperprolactinemia showed positive correlation in women with primary and secondary infertility. Int J Reprod Contracept Obstet Gynecol. 2016;5(7):2079-84.
Rodriguez-Castelan J, Mendez-Tepepa M, Carrillo-Portillo Y, Anaya-Hernandez A, Rodriguez-Antolin J, Zambrano E, et al. Hypothyroidism Reduces the Size of Ovarian Follicles and Promotes Hyper-trophy of Periovarian Fat with Infiltra¬tion of Macrophages in Adult Rabbits. Biomed Res Int. 2017;2017:3795950. DOI:10.1155/2017/3795950.
Cho MK. Thyroid dysfunction and subfertility. Clin Exp Reprod Med. 2015;42(4):131-5. DOI:10.5653/ cerm.2015.42.4.131.
Strowitzki T, Germeyer A, Popovici R, von Wolff M. The human endometrium as a fertility-determining factor. Hum Reprod Update. 2006;12(5):617-30. DOI:10.1093/humupd/dml033.
Mesen TB, Young SL. Progesterone and the luteal phase: a requisite to repro¬duction. Obstet Gynecol Clin North Am. 2015;42(1):135-51. DOI: 10.1016/j. ogc.2014.10.003.
R R, SS M. Aetiological factors of Infertility. J Postgrad Med Inst. 2004;18(2):166-71.
Sami N, Ali TS, Wasim S, Saleem S. Risk factors for secondary infertility among women in Karachi, Pakistan. PLoS One. 2012;7(4):35828. DOI:10.1371/jour¬nal.pone.0035828.
Adamson PC, Krupp K, Freeman AH, Klausner JD, Reingold AL, Madhiva¬nan P. Prevalence & correlates of pri¬mary infertility among young women in Mysore, India. Indian J Med Res. 2011;134:440-6.
Kasius JC, Broekmans FJ, Sie-Go DM, Bourgain C, Eijkemans MJ, Fauser BC, et al. The reliability of the histological diagnosis of endometritis in asymptom¬atic IVF cases: a multicenter observer study. Hum Reprod. 2012;27(1):153-8. DOI: 10.1093/humrep/der341.
Sadia S, Waqar F, Akhtar T, Sultana S. Characteristics of infertile patients with ovulatory dysfunction and their relation to body mass index. J Ayub Med Coll Abbottabad. 2009;21(3):12-6.
Jamal T. Tubal Factor in Infertility. J Postgrad Med Inst. 2011;18(2):255-60.
Samarakoon S, Rajapaksa L, Senevi¬ratne HR. Prevalence of primary and secondary infertility in the Colombo Dis¬trict. Ceylon Med J. 2002;45(2):83-91. DOI: 10.4038/cjms.v45i2.4854.
Girish CJ, Manjunath ML. Morphologi¬cal patterns of endometrium in infertile woman-a prospective study. Int J Appl Biol Pharm. 2011;2(3):512-20.
Elahi S, Tasneem A, Nazir I, Nagra SA, Hyder SW. Thyroid dysfunction in infer¬tile women. J Coll Physicians Surg Pak. 2007;17(4):191-4.
Kameswaramma K. Study of correla¬tion of thyroid profile and clinical pa¬rameters in patients with infertility. Int J Reprod Contracept Obstet Gynecol. 2016;5(5):1410-13.
Goswami B, Patel S, Chatterjee M, Koner B, Saxena A. Correlation of Prolactin and Thyroid Hormone Concentration with Menstrual Patterns in Infertile Women. J Reprod Infertil. 2009;10(3):207-12.
Fupare S, Jambhulkar RK, Tale A. Cor¬relation of thyroid hormones with infer¬tility in reproductive age group women. Indian J Medical Res. 2015;4(4):488- 95. DOI:10.5958/2394-6377. 2015. 00005.2
Lalani S, Nizami I, Hashmi AA, Saifud¬din A, Rehman R. Thyroid dysfunction and infertility treatment. Acta Endo¬crinol (Buchar). 2017;13(3):302-7. DOI:10.4183/aeb.2017.302.
Shah SIA, Muhammad S, Sharif N, Shah F. Frequency of Subclinical Hy¬per and Hypothyroidism. Int J Pathol. 2018;16(2):64-8.
Attaullah S, Haq BS, Muska M. Thyroid dysfunction in Khyber Pakhtunkhwa, Pa¬kistan. Pak J Med Sci. 2016;32(1):111- 5. DOI:10.12669/pjms.321.8476
Tayyab M, Yasmin S, Anjum MU. Female Infertility; a study of Socio-Demograph¬ic and Etiological Profile in Abbottabad. Professional Med J. 2018;25(3):414- 18.
Emokpae A, Uadia P, AZ M. Hormonal Evaluations and Endometrial Biopsy in Infertile Women in Kano, Northern Nige¬ria: A Comparative Study. Ann Afr Med. 2005;4(3):99-103.
Aghajanova L, Stavreus-Evers A, Lin¬deberg M, Landgren B-M, Sparre LS, Hovatta O. Thyroid-stimulating hor¬mone receptor and thyroid hormone receptors are involved in human en¬dometrial physiology. Fertil Steril. 2011;95(1):230-7.e2. DOI:10.1016/j. fertnstert.2010.06.079.
Naficy H, Behjatnia Y. The effect of thy¬roid extract on luteal phase deficiency. Acta Med Iran. 1975;18(1-2):55-60.