İlker ÇALIKOĞLU, Gürkan YAZICI, Güzin AYKAL, Bahar TAŞDELEN

Kadın infertilitesinde Tiroid Stimülan Hormon - Anti Müllerian hormon ilişkisi

Amaç Hipotiroidizmin infertilitede risk faktörü olabileceği, artmış Tiroid Stimulan Hormon (TSH) düzeyinin over rezerviyle ilişkisi tartışılmaktadır. Anti Müllerian Hormon (AMH) over rezervini belirlemede iyi bir belirteçtir. İnfertil kadınlarda serum ortalama TSH ile AMH düzeyleri arasındaki ilişkiyi ve TSH'ın fertiliteye etkisini araştırdık. Yöntem: Mersin Şehir Hastanesi Kadın Hastalıkları Doğum polikliniğine 01.01.2018-1.03.2019 arasında başvuran, infertilite tanılı, 19-40 yaş kadınların yaş, kilo, boy, ek hastalık, tedavi öyküleri ve kontrol amacıyla başvuran sağlıklı, en az bir doğum yapmış, benzer demografik özelliklere sahip kadınların verileri hastane kayıtlarından alındı. Polikistik Over, hirsutism, amenore, menapozal durumlar, endometriozis, bilinen tiroid bezi hastalığı olanlar ve tedavi alanlar, kanser tanılılar, obezler, kaşektikler çalışmadan çıkarıldı. Başvuruda serum AMH ve TSH düzeyleri bakılmışların değerleri kaydedildi. Bulgular: İnfertil (160) ve fertil (34) kadına ait ortalama serum AMH ve TSH düzeyleri karşılaştırıldı. İnfertillerde AMH düzeyi 1.65±1.70 fertillerde 3.01±1.56 ng/ml olup, istatistiksel farklıydı (p=0.00002). İnfertillerdeki TSH düzeyi (2.20±1.26 μIU/mL) fertillerden (1.76±0.72 μIU/mL) yüksek olup istatistiksel sınırda farklıydı (p=0.05). İnfertillerde AMH-yaş (r=-0.34, p=0.01) ve AMH-TSH düzeyleri ters korele bulundu (r=-0.20, p=0,0001). Fertillerde serum AMH düzeyi yaş ile azalırken (r=-0.40, p=0.01), AMH-TSH düzeyleri arasında korelasyon izlenmedi (r=-0.17, p=0.31). Sonuç: Çalışmamız infertillerde AMH ve TSH düzeyleri arasındaki negatif ilişkiyi ve infertilite etiyolojisinde TSH yüksekliğinin gözden kaçırılmaması gerektiğini düşündürmektedir.

Anahtar Kelimeler:

Tiroid Stimülan Hormon, Anti Müllerian Hormon, infertilite

The relationship between Thyroid Stimulating Hormone - Anti Mullerian Hormone in women infertility

Objective: Hypothyroidism may be a risk for infertility, the relationship between increased Thyroid Stimulating Hormone (TSH) and ovarian reserve is discussed. Anti-Mullarian Hormone (AMH) is a good predictor of ovarian reserve. We investigated the relationship between TSH and AMH levels in infertile women and the effect of TSH on fertility. Methods: Age, weight, height, additional diseases and treatment history of patients aged 19-40 years who were admitted to Mersin City Hospital Gynecology and Obstetrics Clinic between 01.01.2018 and 01.03.2019 were obtained from hospital records. Women data with similar demographic characteristics who were healthy, had at least one birth, applies to the same center for control on the same date were taken from records. Patients with polycystic ovary, hirsutism, primary amenorrhea, menopausal conditions, endometriosis, known thyroid disease and treatment, cancer, obese, cachectic were not included. Serum AMH and TSH levels were recorded. Results: The mean serum AMH and TSH levels of infertile (160) and fertile (34) women were compared. Mean AMH level in infertil women was 3.01±1.56 and 1.65±1.70ng/ml in fertilizers (p=0.00002). TSH levels in infertil women were higher (2.91±1.26μIU/mL) than fertilizers (1.76±0.72μIU/mL) and it was different at the statistical border (p=0.05). AMH-age (r=-0.34, p=0.01) and AMH-TSH levels were inversely correlated in infertil women (r=-0.20, p=0.0001). In fertilizers AMH levels were decreased with age (r=-0.40, p=0.01), but there was no correlation between AMH-TSH levels (r=-0.17,p=0,31). Conclusion: Our study suggests negative relation between AMH-TSH levels in infertile women and TSH elevation should not be overlooked in the etiology of infertility.

Keywords:

Thyroid Stimulating hormone, Anti-Mullarian hormone, infertility,

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