Hypothyroidism and hyperprolactinemia in infertility: Bangladesh perspective

Abstract

Background: Infertility is the highest in Bangladesh among all South Asian countries. Hypothyroidism specially subclinical hypothyroidism is a prevailing cause of infertility and habitual abortion. Objective: To find out the prevalence of hypothyroidism specially subclinical hypothyroidism as well as hyperprolactinemia in infertility. Methods: This was a cross-sectional comparative type of study conducted at Obstetrics & Gynaecology Out Patient Department (OPD) of Rajshahi Medical College Hospital (RMCH), Bangladesh. The sample size was 94. Data on nature of infertility, clinical presentations and biochemical findings were collected by a preformed Data Collection Sheet. Serum hormone assay TSH, T3, T4, and prolactin (PRL) were done in Institute of Nuclear Medicine and Allied Sciences (INMAS), Rajshahi, Bangladesh. Pearson's chi-square and student's 't' test were applied to determine differences in proportions and means respectively. Results: Prevalence of clinical hypothyroidism, subclinical hypothyroidism and hyperprolactinemia were 10.6%, 29.8% and 22.3% respectively in study subjects. Prevalence of hypothyroidism and hyperprolactinemia were significantly higher in primary than in secondary infertility. Prevalence of subclinical hypothyroidism was 37.7% in primary and 15.2% in secondary infertility. Prevalence of hyperprolactinemia was 27.9% in primary and 12.1% in secondary infertility. The mean TSH and Prolactin values in primary infertile women (3.14±2.21 mIU/L and 507+206 mIU/L) were significantly higher than those of secondary infertile women (1.35±1.87 mIU/L and 422+136 mIU/L). There was no correlation between TSH and prolactin levels in both primary and secondary infertility. Conclusion: Hypothyroidism specially subclinical hypothyroidism and hyperprolactinemia are important health disorders in Bangladeshi infertile women. Further studies are needed to clarify the etiology of the hypothyroidism and hyperprolactinemia for better management of infertility cases.