Investigating the Correlation Between Thyroid-Stimulating Hormone (TSH) and Key Reproductive Hormones: A Cross-Sectional Study

• Mustafa Mohamed Drah

  Faculty of Medical Science, University of Misrata, Misrata, Libya

  Author

• Hajar Sulaiman Al-Mansouri

  Faculty of Medicine, Family and Community Medicine Department, Derna University, Derna, Libya

  Author

• Fathia Faid

  Faculty of Health Science, Nutrition Department University of Misrata, Misrata, Libya

  Author

Thyroid-Stimulating Hormone (TSH) serves as a primary indicator of thyroid function, and its dysregulation has been clinically associated with various reproductive disorders. The study aimed to investigate the statistical correlation between serum TSH levels and concentrations of Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), Estradiol (E2), and Prolactin (PRL) in a clinical dataset. Methods: A retrospective, cross-sectional analysis was conducted on a dataset comprising 1,007 individuals. Following the exclusion of records with missing values for the hormones of interest, a final analytical sample of 120 participants was included. Descriptive statistics were computed, and both Pearson and Spearman correlation coefficients were calculated to assess linear and monotonic relationships between TSH and the four reproductive hormones. Statistical significance was defined as P-value < .05 (two-tailed). Results: Mean (±SD) hormone concentrations were as follows: TSH, 2.371 ± 2.904 mIU/L; FSH, 7.210 ± 5.994 IU/L; LH, 6.059 ± 3.507 IU/L; E2, 48.350 ± 60.374 g/mL; and PRL, 17.151 ± 13.528 ng/mL.Correlation analysis revealed no statistically significant associations between TSH and any of the reproductive hormones using either, TSH, FSH R = 0.031, P-value = 0 .735; P-value = 0.028, P-value = 0.762), TSH vs. LH (R = 0.056, P-value = 0.543; P-value = 0.049, P-value = .598), TSH. E2 (R= 0.105, P-value = 0.256; P-value = 0.098, P-value P-value = 0.289), and TSH, PRL (R = 0 .116, P-value = 0.206; P-value = 0 .103, P-value = 0 .264). Conclusion: Within this cohort, no significant linear or monotonic correlation was detected between serum TSH levels and concentrations of FSH, LH, E2, or PRL. These findings are constrained by notable limitations, including a high proportion of missing data (88.1% exclusion rate), sample heterogeneity, and lack of clinical stratification. The results underscore the complexity of the thyroid-reproductive axis and suggest that direct correlations may not be evident without accounting for clinical status, age, sex, and other potential confounding factors.

1. Hajar Sulaiman Al-Mansouri , Faculty of Medicine, Family and Community Medicine Department, Derna University, Derna, Libya

   Family and Community Medicine Department

American Society for Reproductive Medicine. (2022). Subclinical hypothyroidism in the infertile female population: A guideline. Fertility and Sterility, 118(3), 414–425. https://doi.org/10.1016/j.fertnstert.2022.06.024 DOI: https://doi.org/10.1016/j.fertnstert.2022.06.024

Brown, E. D. L., Obeng-Gyasi, B., Hall, J. E., & Shekhar, S. (2023). The thyroid hormone axis and female reproduction. International Journal of Molecular Sciences, 24(12), 9815. https://doi.org/10.3390/ijms24129815 DOI: https://doi.org/10.3390/ijms24129815

Busnelli, A., Paffoni, A., Fedele, L., & Somigliana, E. (2016). The impact of thyroid autoimmunity on IVF/ICSI outcome: A systematic review and meta-analysis. Human Reproduction Update, 22(6), 775–788. https://doi.org/10.1093/humupd/dmw023 DOI: https://doi.org/10.1093/humupd/dmw019

Cho, M. K. (2015). Thyroid dysfunction and subfertility. Clinical and Experimental Reproductive Medicine, 42(4), 131–135. https://doi.org/10.5653/cerm.2015.42.4.131 DOI: https://doi.org/10.5653/cerm.2015.42.4.131

Halici, M., Seker, M. E., Gebedek, I. Y., & Yildirim, M. (2023). Thyroid hormones and ovarian reserve: A comprehensive study of women seeking infertility care. BMC Women's Health, 23(1), 570. https://doi.org/10.1186/s12905-023-02725-1 DOI: https://doi.org/10.1186/s12905-023-02725-1

Johnson, M. H. (2018). Essential reproduction (8th ed.). Wiley-Blackwell.

Jonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., Cooper, D. S., Biondi, B., & Ross, D. S. (2014). Guidelines for the treatment of hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid, 24(12), 1670–1751. https://doi.org/10.1089/thy.2014.0028 DOI: https://doi.org/10.1089/thy.2014.0028

Korevaar, T. I. M., Mínguez-Alarcón, L., Messerlian, C., de Poortere, R. A., Williams, P. L., Broeren, M. A., Steegers, E. A., Hooijkaas, H., Jaddoe, V. W., Medici, M., & Chavarro, J. E. (2018). Association of thyroid function and autoimmunity with ovarian reserve in women seeking infertility care. Thyroid, 28(10), 1349–1358. https://doi.org/10.1089/thy.2017.0582 DOI: https://doi.org/10.1089/thy.2017.0582

Krassas, G. E., Poppe, K., & Glinoer, D. (2010). Thyroid function and human reproductive health. Endocrine Reviews, 31(5), 702–755. https://doi.org/10.1210/er.2009-0041 DOI: https://doi.org/10.1210/er.2009-0041

Melmed, S., Auchus, R. J., Goldfine, A. B., Koenig, R. J., & Rosen, C. J. (2020). Williams textbook of endocrinology (14th ed.). Elsevier.

Okosieme, O., Gilbert, J., Abraham, P., Haigh, R., Lazarus, J., Perros, P., Ramtoola, K., Smith, D., Srinivasan, V., & Vanderpump, M. (2016). Management of primary hypothyroidism: Statement by the British Thyroid Association Executive Committee. Clinical Endocrinology, 84(6), 799–808. https://doi.org/10.1111/cen.12824 DOI: https://doi.org/10.1111/cen.12824

Palomba, S., Colombo, C., Busnelli, A., Caserta, D., & Vitale, G. (2023). Polycystic ovary syndrome and thyroid disorder: A comprehensive narrative review of the literature. Frontiers in Endocrinology, 14, 1251866. https://doi.org/10.3389/fendo.2023.1251866 DOI: https://doi.org/10.3389/fendo.2023.1251866

Poppe, K., Velkeniers, B., & Glinoer, D. (2007). Thyroid disease and female reproduction. Clinical Endocrinology, 66(3), 309–321. https://doi.org/10.1111/j.1365-2265.2007.02752.x DOI: https://doi.org/10.1111/j.1365-2265.2007.02752.x

Redmond, G. P. (2004). Thyroid dysfunction and women's reproductive health. Thyroid, 14(Suppl 1), S5–S15. https://doi.org/10.1089/105072504323024543 DOI: https://doi.org/10.1089/105072504323024543

Van den Boogaard, E., Vissenberg, R., Land, J. A., van Wely, M., van der Post, J. A., Goddijn, M., & Bisschop, P. H. (2011). Significance of (sub)clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: A systematic review. Human Reproduction Update, 17(5), 605–619. https://doi.org/10.1093/humupd/dmr024 DOI: https://doi.org/10.1093/humupd/dmr024

Verma, I., Sood, R., Juneja, S., & Kaur, S. (2012). Effects of hypothyroidism on female fertility and pregnancy. Journal of Human Reproductive Sciences, 5(3), 220–225. https://doi.org/10.4103/0974-1208.105697

Wu, Y., Zhao, L., Wang, X., Li, Y., & Zhang, Y. (2021). Correlation analysis between ovarian reserve and thyroid function in infertile women. Frontiers in Endocrinology, 12, 734568. https://doi.org/10.3389/fendo.2021.734568 DOI: https://doi.org/10.3389/fendo.2021.745199

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