Title: Subclinical Hypothyroidism and Infertility at the Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria

Authors: Ayankunle MO, Adebara Idowu, Adewara Olumide, Adeniyi Adebayo, Busari Olusegun, Gabriel Olusegun, Adeyemo OT, Awoyinka Babatunde

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i7.92

Abstract

Background: Infertility is a problem of global proportions. Reproductive failure has very far social implications on affected couples especially in Africa and other developing nations. Overt hypothyroidism is an accepted cause of female infertility but its milder form, subclinical hypothyroidism, has not been widely accepted as a contributing factor to disturbed reproductive function.

Objective: This case controlled study aims to determine the contribution of subclinical hypothyroidism to infertility at the Federal Teaching Hospital Ido-Ekiti.

Method: Thirty-three eligible women with infertility who presented for evaluation at the gynaecological clinic of Federal Teaching Hospital, Ido-Ekiti were matched in terms of age with a fertile control that was managed at the same period in the study centre. Fasting venous blood samples were obtained and analyzed for serum thyroid stimulating hormone and free thyroxine levels. Ethical clearance was obtained from the institution review board, data analysis was carried out using SPSS version 21 and statistical significance between variables was determined using independent t-test, Chi-square and Fisher’s exact test as appropriate.

Results: All the women in the case and control groups were within the reproductive age group. The mean age of the infertile subjects was 35.3 ± 4.4 years while that of their fertile counterparts was 36 ± 4.6 years. The more frequent type of infertility was secondary (72.7%), mean duration of infertility was 3.2 ± 2.6 years. Less than one-third of the women in the two groups were obese, and the majority had normal menstrual pattern. The mean TSH and free T4 levels in the infertile subjects were 1.49 ± 0.9mIU/L and 1.16 ± 0.3ng/dl respectively; comparable values were obtained in the control group. The serum TSH and free T4 levels were not statistically different between the two groups (P=0.797). In women with infertility, the prevalence of subclinical hypothyroidism was 6.1% while a prevalence of 3% was observed in the control group (P=1.000). The two cases of subclinical hypothyroidism observed among the infertile group occurred in women with secondary infertility.

Conclusion: It is concluded that subclinical hypothyroidism may not be a contributory factor to infertility as there is no statistical significant difference in the prevalence of subclinical hypothyroidism among infertile and fertile women at Federal Teaching Hospital, Ido-Ekiti.

Keywords: hypothyroidism, infertility, subclinical, overt.

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Corresponding Author

Dr Adebara Idowu

Department of Obstetrics and Gynaecology, Afe Babalola University

Ado-Ekiti/ Federal Teaching Hospital, Ido-Ekiti, Nigeria