THYROID AND OVARIAN-FUNCTION IN INFERTILE WOMEN
THYROID AND OVARIAN-FUNCTION IN INFERTILE WOMEN
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DOI：
10.1093/oxfordjournals.humrep.a137335
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发表时间：
1991-03-01
影响因子：
6.1
通讯作者：
RUNNEBAUM, B
中科院分区：
文献类型：
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作者：
GERHARD, I;BECKER, T;RUNNEBAUM, B
本研究的目的是更密切地研究不孕妇女甲状腺功能和垂体-卵巢轴之间的相互作用。 在185名无甲状腺功能障碍临床症状的不孕妇女中，TRH试验（TSH基础和200 μ g TRH静脉注射后30分钟）除常规激素检查（促性腺激素、雌二醇、DHEAS、睾酮、催乳素）外，在卵泡早期进行。 这些妇女被分为甲状腺功能正常（n = 74; TSH刺激5-20 mU/l），潜伏性甲状腺功能亢进（n = 31; TSH刺激< 5 mU/l）和临床前甲状腺功能减退（n = 80; TSH刺激> 20 mU/l）。 从冷冻血清中进行以下测定：TSH IRMA、左旋甲状腺素（T4）、甲状腺素结合球蛋白（TBG）、微粒体（Mab）和甲状腺球蛋白（Tab）抗体。 甲状腺参数和垂体-卵巢轴之间的各种相关性被证明。 随着TBG浓度的增加，月经间隔缩短。 总体和自然妊娠率最高的妇女正常（<75百分之）。基础TSH和刺激TSH高（> 75%）T4和低（<25%）mAb. Tab正常或TBG高的妇女分娩率最高（77%对30%），而Tab低或Mab高的妇女流产和输卵管妊娠最常见。 由于仅25例患者出现Mab（> 500 U/ml）或Tab（> 200 U/ml）升高，且与TSH升高和T4正常相关，故无需常规检测甲状腺抗体。 然而，TRH测试应包括在不孕症检查中。
The aim of this study was to examine more closely the interaction between thyroid function and pituitary - ovarian axis in infertile women. In 185 infertile women without clinical signs of thyroid dysfunction, TRH-tests (TSH basal and 30 min after 200-mu-g TRH i.v.) were performed in the early follicular phase in addition to routine hormonal checks (gonadotrophins, oestradiol, DHEAS, testosterone, prolactin). The women were classified as euthyroid (n = 74; TSH stim 5-20 mU/l), latent hyperthyroid (n = 31; TSH stim < 5 mU/l), and preclinical hypothyroid (n = 80; TSH stim > 20 mU/l). From frozen serum, the following determinations were performed: TSH IRMA, laevothyroxine (T4), thyroxine binding globulin (TBG), microsomal (Mab) and thyroglobulin (Tab) antibodies. Various correlations between the thyroid parameters and the pituitary - ovarian axis were demonstrated. With increasing TBG concentrations, the interval between menses decreased. Overall and spontaneous pregnancy rates were highest in women with normal (< 75th perc.) basal and stimulated TSH, high (> 75th perc.) T4 and low (< 25th perc.) Mab. Women with normal Tab or high TBG experienced the highest delivery rate (77 versus 30%), while in women with low Tab or high Mab abortion and tubal pregnancies were most frequent. As only 25 women exhibited elevated Mab (> 500 U/ml) or Tab (> 200 U/ml) which correlated with elevated TSH and normal T4, the routine determination of thyroid antibodies was not necessary. The TRH-test, however, should be included in infertility work-up.