TSH And AMH in Infertile Women
TSH And AMH in Infertile Women
Infertility is defined as the inability of a couple to achieve pregnancy over an average
 period of one year (in women under 35 years of age) or 6 months (in women above 35 years of
 age) of unprotected sexual intercourse. Infertility can be due to female, male reasons or
 both. It can be either primary or secondary.

 Thyroid dysfunction and autoimmune thyroiditis are known adverse risk factors for pregnancy
 as well as fertility, regardless of the presence of disease in women of reproductive age. In
 particular, hypothyroid women are at an increased risk of menstrual disorders and infertility
 because of altered peripheral estrogen metabolism, hyperprolactinaemia and abnormal release
 of gonadotropin-releasing hormone.

 The prevalence of subclinical hypothyroidism characterized by aberrant high serum
 thyroid-stimulating hormone (TSH) levels with normal free thyroxin (FT4) levels in infertile
 women are reported to be approximately 20% and it is a primary cause of subfertility.

 Indeed, average TSH levels in infertile women were reportedly higher than those in normal
 fertile women. And elevated serum TSH levels were associated with diminished ovarian reserve
 in infertile patients. Moreover, although levothyroxine replacement therapy for subclinical
 hypothyroidism in infertile patients remains debatable, thyroxin supplementation may improve
 fertility to successful pregnancy.

 This data suggests that hypothyroidism is strongly correlated with infertility (Velkeniers et
 al., 2013).

 On the other hand, female fecundity decreases with increasing age, primarily because of
 decreased ovarian function. Anti-mullerian hormone (AMH) is a dimeric glycoprotein belonging
 to the transforming growth factor-beta (TGF-B) super family, which act on tissue growth and
 differentiation. It is produced by the granulosa cells from pre-antral and small antral
 follicles. Ovarian research after oophorectomy showed that serum AMH levels were closely
 correlated with the number of primordial follicles; therefore, AMH is a suitable biomarker of
 ovarian age in women of reproductive age.

 Expectedly, ovarian function may be affected by impaired thyroid function, although this
 association has not been elucidated. In this study, we will evaluate the relationship between
 thyroid function and AMH levels by comparing them in infertile patients and healthy fertile
 women.
Inclusion Criteria:

 1. Age: 20-35 years

 2. Diagnosed as primary infertility.

 3. Duration of marriage more than 1 year.

 4. Controls should be normal fertile women aged 20- 35 years had no history of treatment
 for infertility or thyroid disorders.

 Exclusion Criteria:

 1. Age: above 35 years old.

 2. Women with ovarian dysfunction (PCO, post ovarian surgery).

 3. Treated thyroid dysfunction (Autoimmune thyroiditis, hypothyroidism).