Thyroid Dysfunction Roles in Iraqi Women with Infertility: A Cross-sectional Study

Abstract

Infertility is the inability of a couple to achieve pregnancy after one year of regular, unprotected sexual intercourse. Globally, infertility affects an estimated 60 - 80 million individuals. This study aimed to evaluate the impact of thyroid dysfunction on Iraqi females experiencing both infertility types. This cross-sectional study included 200 females with infertility (primary and secondary cases). This was confirmed by normal semen analysis parameters in their spouses, in accordance with standard reference values. For each participant, detailed demographic and clinical information was collected. A structured and predesigned proforma was used to systematically record relevant data, including age, duration and type of infertility (primary or secondary), and comprehensive menstrual history. This standardized data collection ensured consistency and accuracy in evaluating the association between thyroid dysfunction and infertility. Serum concentrations of thyroid hormones— thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) - were measured using a chemiluminescence immunoassay (CLIA) analyzer (CLIA IIS, China). The assays were performed with commercially available kits (Autobio Diagnostics Co. Ltd., Zhengzhou, China), strictly following the manufacturer’s protocols and procedures. Women experiencing secondary infertility were significantly older, with a mean age of 31.66 ± 8.13 years, compared to 25.89 ± 7.45 years in those with primary infertility (p < 0.0001). Serum T3 levels were also significantly higher in women with secondary infertility (1.46 ± 0.79 ng/mL) than in those with primary infertility (1.12 ± 0.54 ng/mL, p < 0.0001). Women with secondary infertility are significantly older and have higher serum T3 levels compared to those with primary infertility, while other thyroid parameters and menstrual patterns show no significant differences. These findings suggest that age and subtle thyroid hormone variations may influence secondary infertility, highlighting the importance of comprehensive hormonal evaluation in its management.