scholarly journals Body Mass Index (BMI) dependent effect of thyroid stimulating hormone (TSH) and gonadotropins on ovarian reserve markers in the secondary infertile women at fertile age.

2021 ◽  
Author(s):  
Haroon Latif Khan ◽  
Komal Fatima ◽  
Shahzad Bhatti ◽  
Sammar Nathanial ◽  
Hooria Younus
Keyword(s):  
Ovarian Reserve ◽  
Medical Condition ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Reproductive Age ◽  
P Value ◽  
Cross Sectional ◽  
Infertile Women ◽  
Ovarian Reserve Markers ◽  
Tsh Levels

Abstract Background: Infertility is a medical condition when a couple fails to conceive after having regular unprotected intercourse without the use of any contraceptive, it a complex global health issue that can be primary with no previous conception or secondary with one or more previous conceptions. A number of anomalies in the reproductive track govern the state of infertility in female of reproductive age.Materials and Methods: The study was conducted on 100 secondary infertile women based on BMI groups {Normal 18-23.9 kg/m2 (N=35) and Overweight 24-27 kg/m2 (N=65)}, attending tertiary care infertility center: Lahore Institute of Fertility and Endocrinology, Hameed Latif Hospital. The present analytical cross sectional study was conducted to assess the BMI based combinatorial effect of gonadotropins with thyrotropin and ovarian reserve markers in secondary infertile women. Serum hormonal levels of TSH, LH, FSH and AMH were measured by using Roche electrochemiluminescence immunoassay (ECLIA) and AFC was recorded by transvaginal ultrasonography. The results were statistically analyzed by Spearman correlation test using XLSTAT, considered significant at p-value <0.05. Results: A total of 18% of secondary infertile women with normal BMI were found to have a lower serum TSH levels (<0.27µIU/ml) which can be characterized as hyperthyroidism as compared to overweight population. A strong significant positive correlation was found in the TSH, age and BMI, however, these factors were found to be negatively correlated with AMH and AFC. Gonadotropins level was increased with increase in TSH levels among participants with normal BMI but decreased with TSH escalation values among overweight population. Conclusion: TSH was found to be one of the most important diagnostic factors of infertility must be monitored in relation with other parameters (AMH, AFC, FSH, and LH) in order to spot instigation point, as it directly acts upon ovulation surge by controlling gonadotropins related actions on ovarian reserve. Weight should also be assessed regularly with age to minimize the infertility issues.

Thyroid Autoantibodies do not Impair the Ovarian Reserve in Euthyroid Infertile Women: A Cross-Sectional Study

2018 ◽  
Vol 50 (07) ◽  
pp. 537-542 ◽  
Author(s):  
Satoko Osuka ◽  
Akira Iwase ◽  
Maki Goto ◽  
Sachiko Takikawa ◽  
Tomoko Nakamura ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Serum Levels ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Autoantibodies ◽  
Double Negative ◽  
Double Positive ◽  
Cross Sectional ◽  
Thyroid Autoantibody ◽  
Infertile Women ◽  
Tsh Levels

AbstractPatients with primary ovarian insufficiency (POI) have a high prevalence of thyroid autoimmune disorders. However, the extent of the contribution of thyroid autoantibodies or elevated thyroid-stimulating hormone (TSH) levels to decreased ovarian reserve is unclear. Therefore, we evaluated the serum levels of anti-Müllerian hormone (AMH) and thyroid autoantibodies [antithyroperoxidase antibody (TPOAb), and antithyroglobulin antibody (TgAb)] in euthyroid infertile women. One hundred and fifty-three women with normal menstrual cycles were recruited for this retrospective study. Serum levels of AMH were compared between patients with positive and negative thyroid autoantibodies. The correlation between serum levels of AMH and each thyroid autoantibody was also evaluated. Participants were observed to be either TPOAb or TgAb positive (n=27), only TPOAb positive (n=8), only TgAb positive (n=7), TPOAb and TgAb positive (double positive; n=12), and TPOAb and TgAb negative (double negative; n=126). No significant differences were found in serum AMH levels between the TPOAb- or TgAb-positive women and the antibody-double negative women. Serum AMH levels did not show a significant correlation with the concentration of TgAb or TPOAb. On the other hand, serum AMH levels negatively correlated with TSH levels in patients who were either positive for TPOAb or TgAb. Thyroid autoantibodies are not likely to influence ovarian reserve in euthyroid women whose TSH levels fall within the normal range although elevated TSH levels may be involved in the decline of serum AMH levels.

scholarly journals Thyroid dysfunction in patients of metabolic syndrome: A study from a tertiary care center in India

2021 ◽  
Vol 12 (10) ◽  
pp. 47-50
Author(s):  
Ritu Gupta ◽  
Akhil K Vijayan ◽  
Sushma Choudhary
Keyword(s):  
Metabolic Syndrome ◽  
Thyroid Dysfunction ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Overt Hypothyroidism ◽  
Free T4 ◽  
Cross Sectional

Background: Metabolic syndrome is characterized by hypertension, dyslipidemia, central obesity, glucose intolerance, insulin resistance. Thyroid hormone acts as general pacemaker, accelerating metabolic process and may be associated with metabolic syndrome. There is no information available in literature regarding the prevalence and association of thyroid dysfunction in metabolic syndrome in this central region of the country. Aims and Objective: To estimate the prevalence of thyroid dysfunction in patients of metabolic syndrome. Materials and Methods: It is a duration based prospective cross sectional study including 200 patients of metabolic syndrome. A detailed history, clinical examination and relevant investigations including serum Free T4 (FT4), Free T3 (FT3), Thyroid Stimulating Hormone (TSH) were done. Range, frequencies, percentage, mean, standard deviation and P value were calculated. P value of < 0.05 was taken as significant. Results: Prevalence of thyroid dysfunction in metabolic syndrome patients was 28.5%. Prevalence of subclinical and overt hypothyroidism was 18.5% and 8.5% respectively. In patients with both metabolic syndrome and thyroid dysfunction, most common components associated are diabetes mellitus and hypertriglyceridemia. Conclusion: Thyroid dysfunction is significantly common in metabolic syndrome patients. It should be aggressively detected and treated in these patients for better outcome.

scholarly journals A study of thyroid profile in cases of primary infertility attending a tertiary care hospital of south India

2018 ◽  
Vol 7 (6) ◽  
pp. 2180
Author(s):  
Anitha Nirakari B.
Keyword(s):  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Early Stage ◽  
Tertiary Care ◽  
P Value ◽  
Large Sample Size ◽  
Care Hospital ◽  
Cross Sectional ◽  
Infertile Women ◽  
Primary Infertility

Background: Infertility is a rising major problem affecting more than 50 million couples globally every year. Endocrine as well as immune system abnormalities can impair the fertility. Most of the studies globally indicated association of infertility with multiple factors like stress, luteal phase defects, structural and functional reproductive disturbances. Many infertile women with thyroid dysfunction had associated hyperprolactinemia with increases TSH in ovulatory dysfunction. The aim of the present study was to determine the association of hypo and hyperthyroidism with infertility among cases of primary infertility in women.Methods: A cross sectional study was conducted among the patients attending the infertility clinic for the first time. The study was approved by the institutional ethical committee and the study was carried as per the guidelines of the ethical committee. The serum levels of T3, T4 and TSH were estimated and Prolactin in cases where necessary by Chemiluminiscence immunoassay. The data was analyzed by using the unpaired “t” test. A ‘p’ value <0.05 was considered significant.Results: 285 cases were enrolled and majority (38.6%) was in 31-34 age groups with mean age of 24.2± 1.6 years. 30.53% were found with thyroid dysfunction. Majority (16.49%) were found with subclinical hypothyroid, followed in order by primary hypothyroid (9.82%), subclinical hyperthyroid (2.11%), primary hyperthyroid (1.05%), secondary hypothyroid (0.70%) and secondary hyperthyroid (0.35%).Conclusions: To conclude, thyroid dysfunction is a common cause of infertility and can be easily managed by correcting the levels of thyroid hormones. Present study suggests that thyroid replacement therapy in subclinical hypothyroidism at an early stage is justified in infertile women. Borderline variations in TSH levels should not be ignored in infertile women who are otherwise asymptomatic for subclinical hypothyroidism. Hence for better management of cases of primary infertility studies with large sample size and long term follow up are required to validate and justify the variation in TSH and prolactin levels.

scholarly journals EFFECT OF PREANALYTICAL VARIABLES ON SERUM THYROID STIMULATING HORMONE ANALYSIS BY CHEMILUMINESCENCE METHOD

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S102-05
Author(s):  
Ambreen Rehman ◽  
Naveed Asif ◽  
Saima Shakeel Malik ◽  
Waqas Sheikh ◽  
Quratulain . ◽  
...  
Keyword(s):  
Venous Blood ◽  
Armed Forces ◽  
Epidemiological Studies ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Cross Sectional ◽  
Specimen Handling ◽  
Tsh Levels ◽  
Stimulating Hormone

Objective: To identify effect of pre-analytical variables on serum thyroid stimulating hormone. Study Design: Cross sectional study. Place and Duration of Study: Armed Forces Institute of Pathology (AFIP) Rawalpindi, Department of Chemical Pathology & Endocrinology, from Mar 2018 to Aug 2018. Methodology: Hundred subjects with ages ranging from 18 to 34 years, irrespective of gender, were randomly selected for this study. Five milliliters venous blood sample was collected from each subject in a serum separator and divided into two aliquots. First aliquot was centrifuged and analyzed immediately for TSH, while second aliquot was stored for 24 hours and was then analyzed. TSH was measured by third generation assay usingchemiluminescence technique on ADVIA Centaur® XP. Serum TSH levels were also analyzed twice daily; in the morning (0800 to 0900 hours) and afternoon (1400 to 1600 hours). Data was analyzed using SPSS version 24. Frequency and percentages were calculated for qualitative variables like gender and pre-analytical variables. Test of significance Mann-Whitney U-test was applied and p-value <0.05 was taken as significant. Results: Mean age of subjects was 23 ± 3.4 years. Change in circadian rhythm was observed in 17 (28%) males and 14 (36%) females. Statistically significant association was found between morning and evening TSH levels, while no change was observed in TSH level by early and late centrifugation of samples. Conclusion: TSH levels vary significantly between blood samples collected at different timings of the day from the same person. TSH is resistant to degradation, immunologically stable, and reasonably insensitive to potential problems associated with routine specimen handling, when measured by immunoassay technique. Therefore, it is helpful in large epidemiological studies and small size laboratory, which require long transportation time and storage.

scholarly journals Study of clinical characteristics of women with polycystic ovarian syndrome

2020 ◽  
Vol 9 (6) ◽  
pp. 2424
Author(s):  
Jeevanthy P. Upadhya ◽  
Supriya Rai ◽  
Shrikrishna V. Acharya
Keyword(s):  
Clinical Characteristics ◽  
Acanthosis Nigricans ◽  
Polycystic Ovarian Syndrome ◽  
Tertiary Care ◽  
Vital Role ◽  
Reproductive Age ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Ovarian Syndrome

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinal disorders of the reproductive age group causing anovulation, infertility incidence being 8.7-17.8%. It is associated with obesity, insulin resistance, dyslipidaemia and metabolic syndrome. This study was aimed to study the different clinical characteristics of women diagnosed with PCOS, attending a tertiary care hospital outpatient department.Methods: This was a hospital-based cross-sectional observational study of 200 patients with PCOS meeting the revised Rotterdam criteria from January 2018-June 2019 excluding pregnant and women with other systemic disorders. A detailed history and examination done, data collected regarding menstrual complaints, features of hyperandrogenism, hirsutism, acne, oily skin and Acanthosis Nigricans (AN) was documented. All data were statistically analyzed and compared using the chi-square or fissures’ exact test. p-value <0.05 considered significant.Results: A total of 200 patients with PCOS were included in the study, of which 41% were obese, 18% lean. The mean age was 24.44±5.62 years. Menstrual complaints were present in 88% -oligomenorrhea (49%) being the most common. 59% had hirsutism,38% of severe grade. Acanthosis nigricans was present in 33% of the patients. Correlation between hirsutism and alopecia, waist to hip ratio (WHR); acanthosis and WHR were statistically significant.Conclusions: PCOS is an ill-defined symptom complex where ethnicity plays a vital role, hence creating a greater need to know the characteristics of the syndrome in different populations and ethnicity. All women presenting with oligomenorrhea or other menstrual complaint should be investigated for PCOS and treated accordingly. The syndrome usually occurs with multiple characters. Though obesity is common in PCOS, non-obese are also at risk. The prevalence of AN and Hirsutism in PCOS were comparable. This mandates a need to increase awareness regarding the syndrome in the general population.

scholarly journals Comparative study on association between serum TSH concentration and Thyroid cancer

2017 ◽  
Vol 4 (8) ◽  
pp. 2800
Author(s):  
Prasad C. ◽  
Supreet Kumar ◽  
Tej Tej Y.
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Tertiary Care ◽  
Follicular Carcinoma ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Thyroid Malignancy ◽  
Tertiary Care Centre ◽  
Serum Tsh ◽  
Tsh Levels

Background: In India, thyroid cancer accounts for less than 1% of all malignancies (2% of women and 0.5% of men). Thyroid cancer is responsible for 6 deaths per 1 million persons annually. Serum TSH is a well-established growth factor for thyroid nodules, however its role in thyroid malignancy is inconclusive hence this study was conducted with the objective to determine the association between serum Thyroid stimulating hormone (TSH) concentrations with thyroid carcinoma.Methods: Case control study was conducted in a tertiary care centre. 120 Benign and malignant thyroid subjects respectively were included in the study. Newly diagnosed and record based data collection was done. Measurements of serum TSH concentrations were performed by automated immune chemiluminescent assay. Data was analyzed using SPSS 22 version software, Chi-square test was used as test of significance for qualitative data, p value of <0.05 was considered as statistically significant.Results: Majority of them were females in the age group 26 to 40 years in both the groups and were diagnosed to have solitary thyroid nodule. In malignant thyroid nodules 51.7% were diagnosed to have follicular carcinoma, 46.7% had papillary carcinoma and 1.7% were diagnosed to have Hurthle cell carcinoma. Significant association was observed between TSH levels and diagnosis of thyroid lesions. TSH was raised (>4mIU/L) in 46.6% of malignant nodules and in 15% of benign nodules. Raised TSH had an odds ratio of 4.958 for Thyroid malignancy compared to benign nodulesConclusions: Higher TSH levels were associated with Thyroid malignancy and the risk of malignancy rises in parallel with serum TSH within normal range, and high levels of serum TSH concentrations was associated with advanced stage of thyroid cancer. 

scholarly journals Prevalence of anti-thyroid peroxidase antibodies in the first trimester pregnancy and its impact on maternal and fetal outcomes in a tertiary care centre in Bangalore

2021 ◽  
Vol 8 (2) ◽  
pp. 182-187
Author(s):  
Shruthi H S ◽  
Nalini Arunkumar ◽  
Ravi N Patil
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
First Trimester ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Thyroid Peroxidase ◽  
American Thyroid Association ◽  
Tertiary Care Centre ◽  
Mother And Child ◽  
Tsh Levels

: Hypothyroidism during pregnancy has an adverse effect on both mother and child. The maternal and foetal risk is higher in TPOAb (Thyroid peroxidase antibody) positive women compared to women with negative TPO Ab. The recent ATA (American Thyroid Association) guidelines recommend that pregnant women with TSH (Thyroid Stimulating Hormone) concentration above 2.5mU/L should be evaluated for TPOAb status and LT4(levothyroxine) treatment should be considered with TSH values between 2.5mU/L and 4.0mU/L only when TPOAb status is positive.: All the pregnant women booked in first trimester underwent testing for TSH levels and subsequently for anti TPO Ab if TSH levels were between 2.5-4 mIU/ml. The hospital based prevalence of women with anti TPO Ab positive status was determined. These pregnancies were followed till term and the maternal and foetal complications associated with TPO Ab positive and negative status were compared. Total of 400 pregnant women were included. The hospital prevalence of women with anti TPO antibodies in first trimester of pregnancy with TSH values between 2.5- 4 mIU/ml was found to be 23.5%. Anti TPO antibody positive status was significantly more associated with antenatal complications especially GDM and IUGR as compared to patients with anti TPO antibody negative status (47.8% v/s 23.2%, p value 0.001).: Women with TPO Ab positive status are to be vigilantly monitored for early detection and management of various antenatal complications. Determining anti TPO Ab status helps in avoiding unnecessary treatment of the women with TPO Ab negative status and TSH between 2.5-4mIU/ml.

scholarly journals Thyroid status and treatment responses of hypothyroid infertile women: a study in a tertiary care hospital of Bangladesh

2021 ◽  
Vol 8 (5) ◽  
pp. 1450
Author(s):  
A. H. M. Aktaruzzaman ◽  
Afsar Ahmmed ◽  
Sabina Yasmin ◽  
M. Shafiqul Islam Dewan
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Reproductive Age ◽  
Care Hospital ◽  
Thyroid Status ◽  
Infertile Women ◽  
Orthopedic Rehabilitation ◽  
Treatment Responses ◽  
Reproductive Age Group

Background: Recently, the prevalence of hypothyroidism in the reproductive age group is found up to 4%. In many studies it had been claimed that, thyroid status is directly involved in women reproductive system. Hypothyroidism can be easily detected by assessing serum thyroid stimulating hormone (TSH) levels. The aim of this study was to dig out the prevalence of hypothyroidism in infertile women and to assess their responses in treatment procedures.Methods: This observational study was conducted National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh during the period from January 2019 to December 2019 in total 236 women of Endocrinology Department treatment. Patients were followed up for six months even if pregnancy was attained.Results: In total 22% (n=52) patients were hypothyroid. Among them 35 (15%) were subclinical hypothyroid and 17 (7%) were frank hypothyroid. Besides these, 73% (n=172) were euthyroid and the rest 5% (n=12) were hyperthyroid. On the other hand, in analysing the outcome (treatment responses) among the hypothyroid subjects we observed regular menstruation, normal ovulation, clinical pregnancy and chemical pregnancy were achieved by 92.31% (n=48), 88.46% (n=46), 50% (n=26) and 69.23% (n=36) subjects respectively.Conclusions: According to the study, the careful diagnosis and treatment of hypothyroidism can ensure benefit a lot rather than going for unnecessary hormone assays and costly invasive procedures in for women of infertility.

Cord Blood Thyroid-Stimulating Hormone Level: Interpretation in Light of Antenatal and Perinatal Factors

2018 ◽  
Vol 32 (4) ◽  
pp. 87-92
Author(s):  
Ravi Bhatia ◽  
Dinesh Rajwaniya ◽  
Indira S. Paul
Keyword(s):  
Cord Blood ◽  
Fetal Distress ◽  
Thyroid Stimulating Hormone ◽  
Normal Vaginal Delivery ◽  
P Value ◽  
Perinatal Factors ◽  
Cross Sectional ◽  
Normal Delivery ◽  
Tsh Levels ◽  
Stimulating Hormone

Objective: To study the influence of antenatal and perinatal factors on umbilical cord blood thyroid-stimulating hormone (CB TSH) levels. Design: Cross-sectional study. Setting: Private Medical College. Methods: CB TSH levels were measured in 1147 neonates using chemiluminescence immunoassay. The effect of antenatal and perinatal factors on CB TSH values was analyzed statistically. Results: The mean TSH value was 6.811 mIu/mL. A total of 44 neonates (3.83%) had a CB TSH value greater than 20 mIu/mL and had to be recalled for a repeat workup. CB TSH was significantly raised in first-order births, those born via normal vaginal delivery, and in those whom the lower section caesarean section (LSCS) was done for fetal distress (all P value <.05). Male babies had a significantly higher CB TSH value as compared to the females. Babies having Apgar < 7 at 1 min also had a significantly higher CB TSH value. Maternal hypothyroidism did not have any significant effect. On multivariate analysis, we found a positive correlation between birth weight, Apgar, and gestational age with CB TSH values. Conclusion: The incidence of neonates having a CB TSH greater than 20 mIu/mL was 3.83%. Male children, those delivered via normal delivery, those delivered via LSCS where fetal distress was an indication, and those requiring resuscitation, were significant factors affecting CB TSH values.

Causes of Epilepsy in Elderly Patients Presenting in a Tertiary Care Hospital of Karachi

2020 ◽  
Keyword(s):  
Elderly Patients ◽  
Cerebrovascular Disease ◽  
Neurodegenerative Disorder ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Traumatic Head Injury ◽  
Keywords Epilepsy ◽  
College Hospital ◽  
Cross Sectional

Background: Epilepsy is fairly a frequent occurrence in the elderly. It is commonly diagnosed after the episode of two or more unprovoked seizures. Unprovoked seizures in elderly are recurrent rather than younger individuals. This study was designed to estimate the concrete burden of frequent causes of epilepsy. Methods: A descriptive cross-sectional study with a total of 153 patients diagnosed case of epilepsy were included in this study at Jinnah Medical College Hospital from February 2018-August 2018. Mean was calculated for age, duration of disease of the patients. Causes of epilepsy, gender, and education was calculated and presented as percentages. Electrolyte readings were taken i.e., Sodium, Calcium and Magnesium levels and imaging was planned to rule out stroke, primary neurodegenerative disorders and tumors. Post stratification Chi square test was applied and p-value less than or equal to 0.05 was considered significant. Results: The mean age of the patients was 63.91±5.68 years and mean duration of the disease was 4.61± 1.07 months. The common causes of epilepsy were found to be cerebrovascular disease 56.9%, cryptogenic 54.2%, neurodegenerative disorder 20.3%, traumatic head injury 11.8%, metabolic abnormalities or electrolyte disturbances 10.5% and brain tumor 7.8%. Conclusion: Elderly patients with first seizure should present to a facility designed in a way that neurologist, cardiologist, rehabilitation and geriatrics work together to identify and treat the condition in a better way. Keywords: Epilepsy; Seizures; Cerebrovascular Disease; Neurodegenerative Disorder.

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