Context: Unexplained infertility (UI), defined as the inability to conceive after 12 months of unprotected intercourse with no diagnosed cause, affects 10% to 30% of infertile couples. An improved understanding of the mechanisms underlying UI could lead to less invasive and less costly treatment strategies. Abnormalities in thyroid function and hyperprolactinemia are well-known causes of infertility, but whether thyrotropin (TSH) and prolactin levels within the normal range are associated with UI is unknown. Objective: To compare TSH and prolactin levels in women with UI and women with a normal fertility evaluation except for an azoospermic or severely oligospermic male partner. Design, Setting, and Participants: Cross-sectional study including women evaluated at a large academic health system between 1 January 2000 and 31 December 2012 with normal TSH (levels within the normal range of the assay and ≤5 mIU/L) and normal prolactin levels (≤20 ng/mL) and either UI (n = 187) or no other cause of infertility other than an azoospermic or severely oligospermic partner (n = 52). Main Outcome Measures: TSH and prolactin. Results: Women with UI had significantly higher TSH levels than controls [UI: TSH 1.95 mIU/L, interquartile range: (1.54, 2.61); severe male factor: TSH 1.66 mIU/L, interquartile range: (1.25, 2.17); P = 0.003]. This finding remained significant after we controlled for age, body mass index, and smoking status. Nearly twice as many women with UI (26.9%) had a TSH ≥2.5 mIU/L compared with controls (13.5%; P < 0.05). Prolactin levels did not differ between the groups. Conclusions: Women with UI have higher TSH levels compared with a control population. More studies are necessary to determine whether treatment of high-normal TSH levels decreases time to conception in couples with UI.
Context: Unexplained infertility (UI), defined as the inability to conceive after 12 months of unprotected intercourse with no diagnosed cause, affects 10% to 30% of infertile couples. An improved understanding of the mechanisms underlying UI could lead to less invasive and less costly treatment strategies. Abnormalities in thyroid function and hyperprolactinemia are well-known causes of infertility, but whether thyrotropin (TSH) and prolactin levels within the normal range are associated with UI is unknown. Objective: To compare TSH and prolactin levels in women with UI and women with a normal fertility evaluation except for an azoospermic or severely oligospermic male partner. Design, Setting, and Participants: Cross-sectional study including women evaluated at a large academic health system between 1 January 2000 and 31 December 2012 with normal TSH (levels within the normal range of the assay and ≤5 mIU/L) and normal prolactin levels (≤20 ng/mL) and either UI (n = 187) or no other cause of infertility other than an azoospermic or severely oligospermic partner (n = 52). Main Outcome Measures: TSH and prolactin. Results:Women with UI had significantly higher TSH levels than controls [UI: TSH 1.95 mIU/L, interquartile range: (1.54, 2.61); severe male factor: TSH 1.66 mIU/L, interquartile range: (1.25, 2.17); P = 0.003]. This finding remained significant after we controlled for age, body mass index, and smoking status. Nearly twice as many women with UI (26.9%) had a TSH ≥2.5 mIU/L compared with controls (13.5%; P < 0.05). Prolactin levels did not differ between the groups. Conclusions: Women with UI have higher TSH levels compared with a control population. More studies are necessary to determine whether treatment of high-normal TSH levels decreases time to conception in couples with UI.
Authors: D W Cramer; P M Sluss; R D Powers; P McShane; E S Ginsburgs; M D Hornstein; A F Vitonis; R L Barbieri Journal: J Assist Reprod Genet Date: 2003-06 Impact factor: 3.412
Authors: Erik K Alexander; Elizabeth N Pearce; Gregory A Brent; Rosalind S Brown; Herbert Chen; Chrysoula Dosiou; William A Grobman; Peter Laurberg; John H Lazarus; Susan J Mandel; Robin P Peeters; Scott Sullivan Journal: Thyroid Date: 2017-03 Impact factor: 6.568
Authors: Anatte E Karmon; Eden R Cardozo; Irene Souter; Julie Gold; John C Petrozza; Aaron K Styer Journal: J Assist Reprod Genet Date: 2016-02-04 Impact factor: 3.412
Authors: C C Repelaer van Driel-Delprat; E W C M van Dam; P M van de Ven; S Homsma; L van der Kooij; E Vis; R P Peeters; R Schats; C B Lambalk Journal: Hum Reprod Open Date: 2019-02-23