Association between thyroid autoimmunity and ovarian reserve in women with hypothyroidism

Morales-Martínez, Felipe Arturo; Sordia-Hernández, Luis H.; Ruiz, Martha Merino; Garcia-Luna, Selene; Valdés-Martínez, Otto H.; Vidal-Gutierez, Oscar

doi:10.1186/s13044-021-00095-0

Cited by 12 publications

(13 citation statements)

References 32 publications

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“…Adamska et al [20] also reported a negative correlation between serum AMH and the percentage of body fat mass, as estimated by bioimpedance analysis, in a group of 39 women with Hashimoto's thyroiditis, but not in 46 control women. By contrast, no correlation between AMH and BMI was observed in two older studies [11,18]. Recently, AMH was evaluated in women with polycystic ovarian syndrome, and was found to be significantly and negatively correlated with BMI and waist-to-height ratio [28].…”

Section: Discussionmentioning

confidence: 93%

“…A literature search conducted at the end of 2021 identified several papers in which AMH and thyroid function and/or autoimmunity were evaluated. The studies involved had mainly been conducted in centres for human reproduction, and no agreement emerged on the role of the thyroid in AMH secretion or indirectly on the ovarian reserve [11][12][13][14][15][16][17][18][19][20][21]. In 2015, a study involving a large number of women undergoing screening for infertility, in which a cross-sectional retrospective analysis of AMH, free-thyroxine (f-T4), TSH and thyroperoxidase antibody (TPOAb) was conducted, concluded that thyroid autoimmunity and function were not associated with low ovarian reserve [12].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of anti-Müllerian hormone in pre-menopausal women stratified according to thyroid function, autoimmunity and age

Giusti

Mittica²

2022

Thyroid Res

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Background AMH is a reliable index of ovarian reserve. It is not clear whether, or how much, thyroid function and/or thyroid autoimmunity can impair ovarian function and AMH secretion in the long term. Aim This retrospective cross-sectional study compared AMH levels in pre-menopausal women with/without positive thyroid autoimmunity or hypofunction. Methods From January 2019 to May 2022, AMH was evaluated in 250 pre-menopausal women not undergoing assisted fertility procedures who were referred to a secondary endocrine centre. Thyroid function and autoimmunity, sonographically measured thyroid volume, FSH and E2 in the early follicular phase, and PRL and progesterone in the luteal phase were also evaluated. Exclusion criteria were: age < 18 years, genetic hypogonadism, pregnancy and previous treatments that have potentially damaging effects on gonads. Results We evaluated 171 women (mean age ± SD: 31.5 ± 9.0 years) off L-T4 treatment and 79 women on L-T4 treatment (39.7 ± 9.5 years; P < 0.001). AMH (median, IQR, CI) was 16.1 pmol/l (7.1 – 35.7 pmol/l, 21.4 – 29.9 pmol/l) and 7.6 pmol/l (1.4 – 17.8 pmol/l, 8.6 – 14.7 pmol/l; P < 0.001), respectively. When the women were stratified according to age (18-25, 26-30, 31-35, 36-40, 41-45, > 46 years) no significant difference emerged between those on/off L-T4 treatment in groups of the same age-range. In women on- or off-L-T4 treatment, AMH was negatively related with age on univariate and multivariate analyses (P < 0.0001). In both groups, AMH was negatively related to FSH (P < 0.0001). On multivariate analysis, AMH was positively related to the age of the mother on spontaneous menopause (P = 0.006) and negatively to thyroid volume (P = 0.02) in women on L-T4. AMH levels were significantly (P = 0.03) higher in TPOAb-negative than in TPOAb-positive women, but age was significantly (P = 0.001) lower in TPOAb-negative than in TPOAb-positive women. Conclusions In our cohort of women, age proved to be a better predictor of AMH levels than any of the other factors linked to thyroid function and autoimmunity. Our data do not support the hypothesis that subclinical hypothyroidism and/or autoimmunity are associated with decreased ovarian reserve. However, a larger number of cases is needed in order to obtain conclusive data.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Evaluation of anti-Müllerian hormone in pre-menopausal women stratified according to thyroid function, autoimmunity and age

Giusti

Mittica²

2022

Thyroid Res

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“…Thus, enhanced glycolysis may increase recruitment from the primordial follicle pool, resulting in a higher density of small preantral follicles in PCOS patients. POI is not only induced by genetic and iatrogenic factors but is also associated with autoimmune conditions, such as hypothyroidism [ 40 , 41 ] and diabetes [ 42 ]. It has been reported that a downregulated lncRNA-ALDOA in granulosa cells and the gene variant of HK3 are associated with POI [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Enhanced glycolysis in granulosa cells promotes the activation of primordial follicles through mTOR signaling

Zhang

Wang

et al. 2022

Cell Death Dis

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In mammals, nonrenewable primordial follicles are activated in an orderly manner to maintain the longevity of reproductive life. Mammalian target of rapamycin (mTOR)-KIT ligand (KITL) signaling in pre-granulosa cells and phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt)-forkhead Box O3a (FOXO3a) signaling in oocytes are important for primordial follicle activation. The activation process is accompanied by the enhancement of energy metabolism, but the causal relationship is unclear. In the present study, the levels of glycolysis-related proteins GLUT4, HK1, PFKL, and PKM2 were significantly increased in granulosa cells but were decreased in oocytes during the mouse primordial-to-primary follicle transition. Both short-term pyruvate deprivation in vitro and acute fasting in vivo increased the glycolysis-related gene and protein levels, decreased AMPK activity, and increased mTOR activity in mouse ovaries. The downstream pathways Akt and FOXO3a were phosphorylated, resulting in mouse primordial follicle activation. The blockade of glycolysis by 2-deoxyglucose (2-DG), but not the blockade of the communication network between pre-granulosa cells and oocyte by KIT inhibitor ISCK03, decreased short-term pyruvate deprivation-promoted mTOR activity. Glycolysis was also increased in human granulosa cells during the primordial-to-primary follicle transition, and short-term pyruvate deprivation promoted the activation of human primordial follicles by increasing the glycolysis-related protein levels and mTOR activity in ovarian tissues. Taken together, the enhanced glycolysis in granulosa cells promotes the activation of primordial follicles through mTOR signaling. These findings provide new insight into the relationship between glycolytic disorders and POI/PCOS.

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“…It has been determined that hypothyroidism, which is common in autoimmune thyroid disease, also affects the menstrual cycle. Although some studies argue that women with hypothyroidism commonly experience oligomenorrhea during the menstrual cycle, some claim the opposite (17,18) Studies have shown that hypothyroidism is significantly higher in women with low ovarian reserve due to genetic reasons. According to the results of one study, approximately half of women with low ovarian reserve due to Turner syndrome have subclinical hypothyroidism.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Premature Ovarian Failure in Patients With Autoimmune Thyroiditis

et al. 2022

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Introduction and Aim: Premature ovarian failure is the loss of function of the ovaries under the age of forty that autoimmunity is a factor in some cases. Anti-Müllerian hormone is secreted by the granulosa cells of the ovarian follicles. Ovarian reserve can be accurately assessed with AMH measurements. This study aimed to evaluate the ovarian reserve by Anti-Müllerian hormone level in women who were diagnosed with autoimmune thyroiditis. Methods: This is a retrospective study, covers the 10-year period between January 2011 and May 2021. Women under the age of 35 who were followed up and treated for autoimmune thyroiditis constitute the sample of the study. Participants' ovarian reserves were analyzed using age specific AMH levels. Thyroid hormone levels were measured in the radioimmunoassay laboratory in the health center where the study was conducted. Results: Some participants did not have infertility (66.6%). 147 (38.7%) of the participants were euthyroid. 197 participants (51.8%) had a low ovarian reserve, 229 (60.3%) of the participants had high anti-TPO and 217 (57.2%) had high anti-TG levels. Participants with low ovarian reserve show a statistically significant difference between the groups in terms of thyroid hormone analysis results (p

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Association between thyroid autoimmunity and ovarian reserve in women with hypothyroidism

Cited by 12 publications

References 32 publications

Evaluation of anti-Müllerian hormone in pre-menopausal women stratified according to thyroid function, autoimmunity and age

Evaluation of anti-Müllerian hormone in pre-menopausal women stratified according to thyroid function, autoimmunity and age

Enhanced glycolysis in granulosa cells promotes the activation of primordial follicles through mTOR signaling

Prevalence of Premature Ovarian Failure in Patients With Autoimmune Thyroiditis

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