EP1309 - ECE_2687 - Empirical evaluation of Thyroid function and ovarian reserve using one-way ANOVA

Abstract

Ovarian reserve (OR) reflects follicular quantity and quality and determines female reproductive potential. Diminished ovarian reserve (DOR) is associated with reduced fertility and lower effectiveness of assisted reproductive technologies.1 Beyond aging, hypothyroidism significantly contributes to OR impairment. Thyroid hormone imbalance disrupts folliculogenesis, ovulation, and steroidogenesis via the hypothalamic–pituitary–gonadal axis, accelerating follicular depletion.2 Immuno-inflammatory processes, including systemic inflammation, oxidative stress, may further promote follicular atresia and adverse reproductive outcomes. To evaluate the association between thyroid function and ovarian reserve in women of reproductive age, with particular emphasis on hormonal, inflammatory markers. A total of 100 women aged 18-38 years were enrolled and divided into 3 groups: healthy euthyroid women with normal OR(control, n = 20); women with DOR and hypothyroidism(DOR + hypothyroidism, n = 40); and women with DOR and euthyroid status (DOR+euthyroidism, n = 40). Serum levels of thyroid-stimulating hormone (TSH), anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), C-reactive protein (CRP), complement C3, ceruloplasmin were measured. Blood samples were collected in the early follicular phase (cycle days 2-4). One-way ANOVA with Dunnett's T3 post-hoc test was applied for statistical analysis. TSH levels were significantly higher in the DOR+hypothyroidism group (6.97 ± 0.61 mIU/L) compared with controls (1.57 ± 0.12 mIU/L) and the DOR+euthyroidism group (1.76 ± 0.08 mIU/L) (P < .001). AMH levels were significantly lower in women with DOR+hypothyroidism (0.57 ± 0.05 ng/mL) than in controls (3.98 ± 0.17 ng/mL) and women with DOR+euthyroidism (0.98 ± 0.08 ng/mL) (P < .001). No significant intergroup differences were observed for FSH (P = .973). CRP levels were highest in the DOR+hypothyroidism group (30.25 ± 1.58 mg/L), compared with controls(3.09 ± 0.48 mg/L) and the DOR+euthyroidism group (13.53 ± 0.94 mg/L) (P < .001). Complement C3 and ceruloplasmin followed a similar pattern, being maximal in the DOR+hypothyroidism group (6.76 ± 0.64 and 84.55 ± 4.59), intermediate in the DOR+euthyroidism group (2.57 ± 0.30 and 51.35 ± 2.14), and minimal in controls (1.18 ± 0.06 and 34.30 ± 2.08) (P < .001). Age did not differ significantly between groups (P = .156). Hypothyroidism is associated with a more pronounced decline in ОR, reflected by significantly reduced AMH levels compared with euthyroid women with DOR. Elevated inflammatory markers indicate that systemic inflammation and oxidative stress contribute to ovarian dysfunction in hypothyroid patients. Routine assessment and timely correction of thyroid dysfunction should be considered essential in the evaluation and management of women with DOR and infertility.