Prevalence of Hypothyroidism in Infertile Women Attending a Tertiary Care Centre in West Bengal, India - A Prospective Observational Study

Abstract

BACKGROUND Hypothyroidism is the most common endocrinological problem affecting women who present with ovulatory dysfunction resulting in infertility. Its milder form, subclinical hypothyroidism (SCH) characterised by mildly elevated thyroid stimulating hormone (TSH) levels and normal free thyroxin (FT4) levels, may also contribute to disturbed reproductive function. The prevalence of SCH has been reported to be 0.7 % - 2.3 % in large series of unselected infertile women. Undiagnosed and untreated thyroid diseases can be a cause for infertility as well as sub fertility. Prevalence of hypothyroidism in the reproductive age group ranges from 2 - 4 %. We wanted to study the prevalence of hypothyroidism as one of the causes of infertility in infertile women who attended a tertiary care centre, to study the prevalence of clinical / subclinical hypothyroidism in infertile women and to assess the thyroid status in infertile women. METHODS This is a prospective observational study done in the Gynaecology and Obstetrics outpatient department at R.G. Kar Medical College and Hospital, Kolkata, India from 1st January 2017 to 1st July 2018. 314 infertile women in the reproductive age of 20 - 40 years attending the outpatient department were included in this study RESULTS In our study out of the total of 314 cases, 270 patients (86 %) were suffering from primary infertility and 44 patients (14 %) had secondary infertility. Prevalence of hypothyroidism (both clinical and subclinical) was 21.9 % (69 cases) among the infertile patients attending outpatient department of a tertiary care centre. Clinical hypothyroidism was detected in 7.3 % (23 cases) and subclinical hypothyroidism was seen in 46 cases (14.6 %). Among the hypothyroid infertile patients, 75.4 % (52 cases) was of primary infertility. CONCLUSIONS Hypothyroidism is an emerging cause of infertility (both primary and secondary). Subclinical hypothyroidism is more prevalent than clinical hypothyroidism in infertile women. KEYWORDS Hypothyroidism, Subclinical Hypothyroidism, Infertility, Tertiary Care Centre