Serum prolactin and reproductive hormones in female autoimmune thyroid patients-a case -control study (original) (raw)
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Investigation of Thyroid Hormones and Prolactin Levels in Fertile and Infertile Women
MIDDLE BLACK SEA JOURNAL OF HEALTH SCIENCE, 2016
Objective: This study was conducted to investigate thyroid hormones and prolactin levels in fertile and infertile women. Materials and Methods: The study enrolled a total of 84 women, 40 infertile and 44 fertile, aged between 15-45 years and applied to Kars Maternity and Child Hospital, Obstetrics Clinic and Artvin State Hospital, Obstetrics and Gynecology Clinic. The study population was divided into 3 groups: Group P (n=30, women having primary infertility), Group S (n=10, women having secondary infertility) and Group F (N=44, fertile women). Blood samples were obtained in early follicular phase and serum thyrotropin (TSH), free triiodothyronine (FT 3) , free thyroxine (FT 4) and prolactin levels were determined by Microparticle Enzyme Immunoasay (MEIA) method. Results: Serum TSH levels were 1.70±0.40, 1.60±0.20 and 0.80±0.20 µIU/ml for the groups F, P and S, respectively (p> 0.05). FT 3 levels were 2.36±0.06, 2.46±0.09 and 2.35±0.2 pg/ml while FT 4 levels were 0.98±0.02, 0.94±0.04 and 1.00±0.03 ng/dl for the groups F, P and S, respectively. There was a significant negative correlation between TSH and FT 4 (p=0.012, r =-0.275) and a significant positive correlation between FT 3 and FT 4 (p=0.002, r = 0.330). Serum prolactin levels were measured as 16.70±2.60, 21.10± 2.10 and 16.00±1.90 ng/ml respectively for the groups F, P and S and no significant difference was detected between the groups with respect to prolactin levels (p >0.05). Conclusion: As a result, there was no difference between the groups in terms of TSH, FT 3 , FT 4 and prolactin levels. Hormone levels were generally within normal limits and therefore we determine no significant relationship between infertility and investigated parameters in this study.
A Study on Serum FSH, LH and Prolactin Levels in Women with Thyroid Disorders
Thyroid disorders both hypo and hyperthyroidism are frequently seen in women, the incidence of hypothyroidism is being much higher than hyperthyroidism. Reported studies in these two conditions on reproductive physiology in women and in experimental female animals have shown that both hypo and hyperthyroidism are associated with delay in onset of puberty, anovulation, various menstrual irregularities, infertility and spontaneous abortions. The present study conducted on the levels of FSH, LH and Prolactin in 36 women subjects between the age group 18 – 35 years out of which 10 are control, 26 are with thyroid disorders. In this 26 thyroid disorder patients 16 are hypothyroid cases and 10 are hyperthyroid cases. The result of the present study indicates that there is significant (>0.001) increased basal levels of serum LH as compared to FSH. Thus the ratio of LH: FSH altered from 1:1 to 6:1, and also there is significant (>0.001) increase in serum prolactin levels in hypothyroidism, where as no change in hyperthyroidism seen.
2016
Background: Thyroid dysfunction and high prolactin levels can affect fertility due to anovulatory cycles, luteal phase defects and sex hormone imbalance. The study was designed to evaluate the status of Thyroid stimulating hormone (TSH) and prolactin in female infertility after exclusion of tubal factor and male factor infertility, and to determine the degree of association of TSH with prolactin in cases of infertility. Material & Methods: The study design was a randomized case control study conducted at Rohilkhand Medical College & Hospital, Bareilly, U.P. The study subjects included 50 infertile and 50 normal fertile women in the age group of 20-40 years attending Gynaecology OPD during one year study period. The TSH and prolactin hormones were assayed using Enhanced Chemiluminescence Immunoassay and Enzyme Linked Immunosorbent Assay. Student's t-test, Analysis of variance and Pearson's correlation were used to analyze the data, with the significant p-level set at <0.05. Results: We found significantly higher mean TSH and prolactin levels in infertile females when compared with the normal fertile females. The mean TSH values were significantly higher in both primary and secondary infertility cases whereas mean prolactin level was significantly increased in primary infertility cases only. TSH and prolactin levels showed significant positive correlation in both primary and secondary infertility cases. Conclusion: There is a greater propensity for thyroid dysfunction and a higher prevalence of hyperprolactinemia in infertile women than the fertile ones and therefore, estimation of thyroid profile and prolactin should be included in the workup for infertile women.
CORRELATION OF PROLACTIN AND THYROID STIMULATING HORMONE LEVEL IN INFERTILE WOMEN
High Prolactin levels interferes with normal Hypothalamo Pituitary Ovarian axis resulting in menstrual abnormalities , disturbances in ovulation, imbalance in hormone secretion and reduce the chances for conception. Hence this study was undertaken to include estimation of serum Prolactin while treating infertile patients. Hypothyroidism also contributes to anovulatory cycles in reproductive age group.
CORRELATION OF PROLACTIN WITH THYROID-STIMULATING HORMONE AND FEMALE SEX HORMONES IN INFERTILE WOMEN
Hormonal and biochemical disturbances play an important role in development of infertility cases. Therefore, this study was conducted to evaluate the prolactin level and to explore the association between prolactin and thyroid stimulating hormone (TSH) and other hormones in the diagnosed infertile women in Ma\'an governorate. The study was performed on 151 women (age group 20–40 years) who visited the Gynecology and Obstetrics Department at Ma\'an governmental hospital. The study sample was divided into three groups: fertile group (n= 27), primary infertile group (n= 82) and secondary infertile group (n= 42). The results showed high incidence of prolactin abnormalities in both primary and secondary infertile women (90% and 92%, respectively). Furthermore, TSH abnormalities were found in 90% of primary infertile and % 93 of secondary infertile women. In addition, the results revealed the positively significant correlation between TSH and the fertility. Positive correlations were found between the levels of prolactin and TSH in primary and secondary infertility. Also, there were positive correlations between the levels of prolactin and other hormones, including luteinizing hormone, follicle-stimulating hormone, testosterone, estradiol and progesterone. In conclusion, the present study revealed a significant correlation between prolactin and TSH and other hormones in infertile women. Therefore, assessment of serum TSH and prolactin levels are mandatory in the work up of all infertile women, especially those presenting with menstrual irregularities.
Hyperprolactinaemia and its Comparision with Hypothyroidism in Primary Infertile Women
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2013
Aim and Objective: To study the serum prolactin levels and the serum TSH in primary infertile females. Material and Method: In this study, we investigated thirty women who were diagnosed cases of primary infertility, who attended the Biochemistry Department, Sir JJ Group of Hospitals, Mumbai, India, for hormonal evaluations. Thirty fertile women with similar ages were enrolled as the controls. The status of the thyroid dysfunction and the levels of serum prolactin were reviewed in infertile women and in the controls. The serum Prolactin and the thyroid stimulating hormone levels were measured by using Siemens kits in IMMULITE 1000 chemiluminescence immunoassays. Results: In our study, the serum prolactin levels in the infertile group were found to be high as compared to those in the control group and they were highly significant (p<0.0001). The serum TSH levels in the infertile group were found to be high, as compared to those of control group and they were highly significant (p<0.0001). Conclusion: There is a higher incidence of hyperprolactinaemia in infertile patients. There is also a greater propensity for thyroid disorders in infertile women than in the fertile ones. The incidence of hypothyroidism in the hyperprolactinaemic subjects in the study population was found to be highly significant than the normal controls.
IP innovative publication pvt. ltd, 2019
Introduction: Hypothyroidism during reproductive age group is responsible for menstrual irregularities, infertility along with miscarriages and congenital malformation s during pregnancy. It has a prevalence of 5-20% in child bearing age. Autoimmune thyroiditis is the common cause of subclinical hypothyroidism in adult female population. Presence of thyroid autoantibodies is high in subclinical hypothyroidism. American Thyroid Association (ATA) & American Association of Clinical Endocrinologist (AACE) recommends for treatment of these patients. Lack of obvious signs and symptoms in subclinical hypothyroidism creates dilemma and challenge for diagnosis. Hypothesis: This was a retrospective study conducted in Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar during the period from January 2017 to January 2019. Women of reproductive age group having thyroid swellings were subjected to Fine needle aspiration cytology (FNAC), Thyroid function test and Anti TPO Ab levels in serum. Cytological grading was done and it was correlated with clinical presentation and serological parameters. Results: Out of 120 cases, 56.7% patients were hypothyroid. Increased titre of Anti- TPO Ab levels in serum was observed in 91.4%, 95.3% and 95% cases of Grade I, Grade II & Grade III categories of autoimmune thyroiditis respectively. Conclusion: Autoimmune thyroiditis is the common cause of hypothyroidism in adult females. Early detection and management with low dose of thyroxine will prevent the complications during reproductive period.
Thyroid Research, 2012
Background: The so called "big-big" prolactin (Prl), also known as macroprolactin is formed by Prl-immunoglobulin (Prl-IgG) complexes and may cause elevation of serum Prl concentrations measured by standard assays, potentially leading to unnecessary investigations and/or treatment. In our study, we have endeavoured to assess the prevalence of macroprolactinaemia in euthyroid, regularly menstruating women with thyroid disease, as well as to assess whether autoimmune thyroid disease may result in an increased prevalence of macroprolactinaemia. Material and methods: We measured serum Prl in 182 regularly menstruating women aged 32.7 ± 7.5 years (mean ± SD, range 17-46 years) who attended endocrine clinic either for investigation of non-toxic goitre (n = 86, age 33.2 ± 7.8 years) or with autoimmune thyroid disease (n = 96, age 32.3 ± 7.2 years). Autoimmune thyroid disease was defined as raised titre of at least one anti-thyroid antibody [anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-Tg) and/or anti-TSH-receptor (anti-TSH-R) antibodies]. All women were clinically and biochemically euthyroid, either without or on treatment with L-thyroxine. In those with raised Prl (i.e., above 530 mIU/l) we ruled out the presence of macroprolactinaemia by polyethylene glycol (PEG) precipitation method. Results: There was no significant age difference between women with and without autoimmune thyroid disease (p = 0.84). Raised Prl concentrations were found in 10 women with thyroid disease (5.5%), and of those a significant macroprolactinaemia (i.e., reduction of Prl concentrations of more than 60% after PEG precipitation) was found in 9 subjects (4.94%). There were no differences in the prevalence of macroprolactinaemia between women with autoimmune thyroid disease (4 out of 96), and without autoimmune thyroid disease (5 out of 86, p = 0.75). Conclusions: Approximately one out of twenty women with regular menses is likely to have raised serum Prl that is usually caused by the presence of macroprolactinaemia. Though structure of macroprolactin involves Prl-IgG complexes, there is no evidence that autoimmune thyroid disease is associated with raised prevalence of macroprolactinaemia.
STATUS OF THYROID AND PROLACTIN HORMONE LEVELS AMONG PRIMARY INFERTILITY PATIENTS
Objective: Infertility is defined as the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Hyperprolactinemia and thyroid dysfunction are associated with reproductive dysfunction and infertility. Hypothyroidism and hyperprolactinemia are found to be closely interrelated. This study aimed to observe the level of serum prolactin, free Tri-iodothyronine (fT3), free Thyroxine (fT4) and Thyroid stimulating hormone (TSH) in women with primary infertility and to correlate the level of serum prolactin with TSH. Methods: The study was conducted on patients visiting OPD because of infertility at the Medicine and Gynecology and Obstetrics department of Services Hospital Lahore for one year duration from May 2019 to May 2020. The study included 50 women with primary infertility and 50 healthy controls of same age. Serum prolactin, fT3, fT4 and TSH levels were measured in all subjects. Results: The mean age of participants was 26.8 years. The median serum prolactin (21.8) and TSH levels (4.5) were found to be significantly high in the case group (p<0.001). Out of the total subjects with hyperprolactinemia, 51.1% were found to have hypothyroidism. There was a moderately strong, positive and significant correlation between serum prolactin and TSH levels (r=0.62, p<0.05). ROC curve analysis showed that at a cutoff value of 22.5 ng/ mL for serum prolactin, a sensitivity of 86% and specificity of 82% could be achieved for detecting hypothyroidism. Conclusion: The high incidence of hyperprolactinemia and thyroid disorders in primary infertility underlines the fact that all women coming to consult for infertility should be advised to undergo thyroid function tests and assess prolactin in the early stages of infertility control.