[Disorders of thyroid function and sterility in the woman]

In 118 successive infertile women (aged 22-40 years, median 30 years) with longstanding infertility from our infertility clinic we performed an endocrinological (TRH-test, TT3, TT4, TBG, antibodies) as well as a morphological thyroid examination (sonography and 99mTc-scintigraphy. The same endocrinological investigations except TRH-test and a thyroid sonography was performed in the control group (50 fertile women, aged 24-39 years, median 33 years). Two patients were hyperthyroid and one patient had primary hypothyroidism. Antibodies against thyroglobulin (TgAK) and thyroid peroxidase (TPO) or microsomal antibodies (MAK) were found in 19 patients (19%). The incidence of biochemical immunological thyroiditis was not significantly different from the control group. But thyroid volume was significantly higher in patients (21 versus 15.6 ml, p < 0.03). Goitre (> 18 ml) was diagnosed in 52% (n = 57) of the patients, although 43 had normal TRH-test results with delta TSH 2.5-12.5 microU/ml. So-called subclinical (latent) hypothyroidism (delta TSH > 12.5 microU/ml) was found in 29 patients; 18 of these infertile women had no goitre. Iodine avidity (99mTc-uptake) increased significantly with the increase in thyroid volume, but showed a tendency to lower values with increasing delta TSH-values and higher iodine avidity in women with thyroid enlargement (n = 109). During follow-up of 12-24 months 10 women with goitre conceived spontaneously after initiation of iodine and/or L-thyroxine 100 micrograms treatment. These data support recent studies, that factors other than TSH cause thyroid enlargement.(ABSTRACT TRUNCATED AT 250 WORDS)