Should we routinely assess ovarian reserve in girls and young women with autoimmune thyroid disease?

Abstract

Background and aims: Some studies report that reproductive aged women with autoimmune thyroid disease (ATD) have a significantly higher risk of diminished ovarian reserve (OR). What is the best time to assessed OR in females with ATD? To answer this question, we assessed OR in girls and young women with ATD and reviewed the current literature regarding on the topic. Methods: The study included 70 patients with ATD, mean 14.4 ± 3.3 years, and 29 age-matched controls. Follicle-stimulating hormone (FSH), luteinizing hormone, estradiol, prolactin, thyroid stimulating hormone, free thyroxin, thyroid peroxidase antibody, thyroglobulin antibody and Anti-Mullerian Hormone (AMH), and Inhibin-B were measured in all participants, if possibly on day 3–5 of the menstrual cycle. Results: Most ATD patients were euthyroid. All participants have normal OR. We found a significantly positive correlation between AMH and Inhibin-B in ATD patients and between Inhibin-B and FSH in both groups. Conclusions: The results of our study and the literature review indicate that euthyroid adolescents with ATD do not have impaired OR. Routine evaluation of OR in adolescents with ATD does not seem necessary. But OR should be assessed in everyone with ATD and hypothyroidism, because not the presence of ATD but euthyroidism matters to OR.

Keywords

• Ovarian reserve
• Thyroid hormones
• Anti-Muellerian hormone
• AMH
• Inhibin B
• Follicle stimulating hormone