Implications of new TSH reference range on infertile Bangladeshi women

Abstract

Background: For over a decade there has been considerable debate about the correct reference interval for TSH. Practitioners are divided, unfortunately they could not reach at a unanimous decision. More recently, researchers have been looking the implications of the new TSH reference range (0.3 to 3.0 mIU/L). Objective: To explore the implications of the newer TSH reference range recommended by AACE and NACB, USA among the infertile women in Bangladesh. Methods: This was a cross-sectional descriptive type of study conducted at Gynaecology & Obstetrics Out Patient Department (OPD) of Rajshahi Medical College Hospital (RMCH), Bangladesh. The sample size was 94. Data on clinical presentations, biochemical and ultrasonographic findings were collected by a preformed Data Collection Sheet. Serum hormone assay TSH, T3, T4, and prolactin (PRL) were done in Centre for Nuclear Medicine and Ultrasound (CNMU), Rajshahi, Bangladesh. Data were analyzed in a computer using SPSS for windows. Descriptive analytical techniques involving frequency distribution, computation of percentage etc. were done. Results: A total of 94 infertile women, new reference range of TSH identified 10 (10.6%) women having clinical hypothyroidism, 8 (80.0%) of them were identified as same by old reference range. New reference range identified 28 (29.8%) infertile women having subclinical hypothyroidism. But old reference range identified 25 (89.3%) of them as euthyroid. Out of 94 infertile women, old reference range Identified 83(88.3%) women as euthyroid but it was reduced to 56 (59.6%) in new reference range polycystic ovary syndrome (PCOS) was identify as a most common (25; 26.6%) cause of infertility among the present study subjects. But if the new TSH reference range was followed instead of the old then majority of the PCOS accompanied with subclinical hypothyroidism. Conclusion: New TSH reference range has a significant implication on Bangladeshi infertile women. Further studies are needed to observe the treatment outcomes of subclinical hypothyroid infertile women identified by application of the new THS reference range.