A 33 year old is presented with infertility. she gives a history of easy fatigue weight gain and muscles pain on examination she is found anaemic laboratory results are free T3- 65 ng/dL, total T4- 4ng/dL,TSH-20 millimicro/ml, cholesterol-300 mg/dL. what is the probable diagnosis.
Answers
Explanation:
Objective
To find out the relationship of thyroid hormone profile of females with outcomes after intra cytoplasmic sperm injection (ICSI).
Method
It was a cross sectional study conducted in Islamabad Clinic Serving Infertile Couple from June 2013 till August 2015. T3 (triiodo thyronine), T4 (thyroxine) and TSH (thyroid stimulating hormone) of 168 consented females was estimated after they underwent the first step of treatment protocol (ovarian down regulation) for ICSI. Pregnant group had ß hCG result more than 25 IU/mL while the rest were included in the non-pregnant group. Both groups were compared by using independent sample t-test. Pearson correlation coefficient was used to associate T3 and T4 with other pregnancy variables with their significance.
Results
Non pregnant women had significantly higher mean values for T3 and T4 as compared to pregnant women (p <0.05, p<0.01). Difference in mean TSH value between non-pregnant and pregnant women was not significant p=0.08. It was found that T4 gave significant negative association with grading of embryo-I, blastocysts formed, thickness of endometrium and number of gestational sacs.
Conclusion
Disturbance in thyroid profile with raised T4 levels leads to alteration in endometrial thickness and quality of embryos required for implantation and hence conception.
Keywords: Infertility, Intracytoplasmic sperm injection, Assisted reproductive technique, Thyroid profile, High levels of thyroxin