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不孕女性甲状腺功能减退症的患病率及甲状腺功能减退症治疗对不孕影响的评估

Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility.

作者信息

Verma Indu, Sood Renuka, Juneja Sunil, Kaur Satinder

机构信息

Department of Biochemistry, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.

出版信息

Int J Appl Basic Med Res. 2012 Jan;2(1):17-9. doi: 10.4103/2229-516X.96795.

Abstract

CONTEXT

Prevalence of hypothyroidism is 2-4% in women in the reproductive age group. Hypothyroidism can affect fertility due to anovulatory cycles, luteal phase defects, hyperprolactinemia, and sex hormone imbalance.

AIMS AND OBJECTIVES

To study the prevalence of clinical/sub-clinical hypothyroidism in infertile women and the response of treatment for hypothyroidism on infertility.

MATERIALS AND METHODS

A total of 394 infertile women visiting the infertility clinic for the first time were investigated for thyroid stimulating hormone (TSH) and prolactin (PRL). Infertile women with hypothyroidism alone or with associated hyperprolactinemia were given treatment for hypothyroidism with thyroxine 25-150 μg.

RESULTS

Of 394 infertile women, 23.9% were hypothyroid (TSH > 4.2 μIU/ml). After treatment for hypothyroidism, 76.6% of infertile women conceived within 6 weeks to 1 year. Infertile women with both hypothyroidism and hyperprolactinemia also responded to treatment and their PRL levels returned to normal.

CONCLUSION

Measurement of TSH and PRL should be done at early stage of infertility check up rather than straight away going for more costly tests or invasive procedures. Simple, oral hypothyroidism treatment for 3 months to 1 year can be of great benefit to conceive in otherwise asymptomatic infertile women.

摘要

背景

育龄期女性甲状腺功能减退症的患病率为2% - 4%。甲状腺功能减退症可因无排卵周期、黄体期缺陷、高催乳素血症和性激素失衡而影响生育能力。

目的

研究不孕女性中临床/亚临床甲状腺功能减退症的患病率以及甲状腺功能减退症治疗对不孕的疗效。

材料与方法

对首次到不孕门诊就诊的394例不孕女性进行促甲状腺激素(TSH)和催乳素(PRL)检测。对单纯甲状腺功能减退症或合并高催乳素血症的不孕女性给予25 - 150μg甲状腺素治疗甲状腺功能减退症。

结果

394例不孕女性中,23.9%患有甲状腺功能减退症(TSH > 4.2μIU/ml)。甲状腺功能减退症治疗后,76.6%的不孕女性在6周至1年内受孕。同时患有甲状腺功能减退症和高催乳素血症的不孕女性对治疗也有反应,其PRL水平恢复正常。

结论

在不孕检查的早期阶段应进行TSH和PRL检测,而不是直接进行更昂贵的检查或侵入性操作。对于无症状的不孕女性,简单的口服甲状腺功能减退症治疗3个月至1年对受孕可能有很大益处。

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