Assessment of Ovarian Reserve Among Infertile Women with Hypothyroidism

Open Access

Abstract

Background: Infertility in women is influenced by multiple factors, including thyroid dysfunction, which can disrupt ovarian function, menstrual regularity, and overall fertility. Hypothyroidism, particularly due to autoimmune thyroid disease, has been linked to diminished ovarian reserve, making the evaluation of thyroid status essential in assessing reproductive potential. Objective: The aim of the study was to evaluate ovarian reserve and its association with thyroid function in infertile women with hypothyroidism. Methods & Materials: This cross-sectional study at the Department of Obstetrics and Gynaecology, Bangladesh Medical University (BMU), Dhaka, Bangladesh, from January to December 2025, included 60 infertile women with hypothyroidism. Thyroid function (TSH) and ovarian reserve (AMH, AFC, basal FSH, estradiol) were measured, with reserve classified as normal or diminished. Participants were stratified by thyroid status, and correlations between TSH and ovarian reserve were analyzed using SPSS v25 (p < 0.05). Results: In 60 infertile hypothyroid women (mean age 29.0 ± 4.4 years; BMI 25.1 ± 3.7 kg/m²), 73.3% had primary infertility. Mean TSH was 7.8 ± 2.9 mIU/L (63.3% subclinical, 36.7% overt). Ovarian reserve showed mean AMH 1.9 ± 0.8 ng/mL, AFC 9.1 ± 3.4, and basal FSH 8.7 ± 2.1 IU/L, with 53.3% having diminished AMH. Overt hypothyroidism had lower AMH and AFC and higher FSH than subclinical, and TSH negatively correlated with AMH (r = −0.41) and AFC (r = −0.36). Conclusion: Thyroid dysfunction, particularly overt hypothyroidism, is associated with reduced ovarian reserve in infertile women, emphasizing the importance of thyroid evaluation in fertility management.