Impact of subclinical hypothyroidism on endocrine features in patients with polycystic ovary syndrome.

BACKGROUND

Polycystic ovary syndrome (PCOS) and subclinical hypothyroidism (SCH) are both common endocrine disorders. This study investigates the impact of SCH on the endocrine features of patients diagnosed with PCOS.

METHODS

This retrospective study included 124 women diagnosed with PCOS between January 2020 and November 2022. Participants were divided into two groups: those with PCOS alone (n = 93) and those with both PCOS and SCH (n = 31).Clinical parameters (age, body mass index, blood pressure, age at menarche) and endocrine markers were collected. Hormonal measurements included follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), testosterone (TES), progesterone (PRG), TSH, free triiodothyronine (FT3), FT4, and Anti-Müllerian hormone (AMH). Thyroid autoantibodies, including antithyroid peroxidase (TPO-Ab) and antithyroglobulin antibody (TG-Ab), were also assessed. Antral follicle count (AFC) was evaluated using transvaginal ultrasound.

RESULTS

The study found that patients with PCOS and SCH exhibited significantly higher levels of TSH and PRL compared to those with PCOS alone. However, there were no significant differences in PRG, LH, FSH, TES, and E2 levels between the groups. The PCOS group showed a moderate positive correlation between TSH and AMH, whereas the PCOS with SCH group demonstrated a negative correlation between TSH and FSH, albeit not statistically significant.

CONCLUSIONS

Subclinical hypothyroidism in women with PCOS is associated with altered thyroid-prolactin axis activity and a disrupted correlation between TSH and AMH, while gonadotropin levels and ovarian morphology appear unaffected. These findings warrant confirmation through prospective studies.