en ارتباط سطوح بالاتر هورمون TSH در محدوده طبیعی با ناباروری ایدیوپاتیک: یک مطالعه مقطعی Reproductive Endocrinology Original Article Original Article <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">از آنجایی که هورمون&shy;های تیروئید نقش اساسی در تولید انرژی، رشد اولیه جفت انسان، رشد جنین و لانه&shy;گزینی دارند، اختلال در عملکرد تیروئید می‌تواند به طور قابل توجهی بر نتایج بارداری تأثیر بگذارد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مطالعه حاضر با هدف بررسی تأثیر سطوح بالاتر هورمون محرک تیروئید (</span></span><span dir="LTR" style="font-size:10.0pt">TSH</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) در محدوده طبیعی در زنان یوتیروئید با ناباروری ایدیوپاتیک انجام شد.</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش&shy; ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در این مطالعه مقطعی، داده‌های 300 زن یوتیروئیدی در سنین 18 تا 39 سال با سطوح طبیعی </span></span><span dir="LTR" style="font-size:10.0pt">TSH</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> (</span></span><span dir="LTR" style="font-size:10.0pt">mIU/L</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">5</span></span><span dir="LTR" style="font-size:10.0pt">&le; </span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) مراجعه‌کننده به پژوهشکده علوم تولیدمثل یزد از سال 1397 تا اسفند 1400 در 2 گروه: گروه مورد (با ناباروری بدون دلیل) و گروه شاهد (با عامل ناباروری مردانه) مورد بررسی قرار گرفت. در نهایت، سن، شاخص توده بدن و سطح سرمی </span></span><span dir="LTR" style="font-size:10.0pt">TSH</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> از پرونده پزشکی شرکت‌کنندگان استخراج و بین گروه‌ها مقایسه شد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">میانگین سن و سطح </span></span><span dir="LTR" style="font-size:10.0pt">TSH</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> شرکت‌کنندگان به ترتیب 52/3 </span></span><span lang="FA" style="font-size:10.0pt">&plusmn;</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 52/31 سال و 59/2 </span></span><span lang="FA" style="font-size:10.0pt">&plusmn;</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 24/1</span></span><span dir="LTR" style="font-size:10.0pt">mIU/L </span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">&nbsp;بود. 142 زن (3/%47) </span></span><span dir="LTR" style="font-size:10.0pt">TSH</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> کمتر از 5/2 و 158 زن (7/%52)</span></span><span dir="LTR" style="font-size:10.0pt">TSH </span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:">&nbsp;بالاتر یا مساوی </span></span><span dir="LTR" style="font-size:10.0pt">mIU/L</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 5/2 داشتند. زنان مبتلا به ناباروری ایدیوپاتیک سطوح </span></span><span dir="LTR" style="font-size:10.0pt">TSH</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> به طور قابل توجهی بالاتر از گروه شاهد در همان محدوده طبیعی بودند (62/0 در مقابل 64/0 </span></span><span dir="LTR" style="font-size:10.0pt">mIU/L</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، 001/0 </span></span><span dir="LTR" style="font-size:10.0pt">p <</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">). اگرچه درصد قابل توجهی از زنان در گروه مورد دارای سطوح</span></span><span dir="LTR" style="font-size:10.0pt">TSH </span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:">&nbsp;کمتر از </span></span><span dir="LTR" style="font-size:10.0pt">mIU/L</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 5/2 بودند، اما ارتباط معنی‌داری بین سطح </span></span><span dir="LTR" style="font-size:10.0pt">TSH</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> و سن یا شاخص توده بدنی پیدا نشد.</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></span></span></span></span></span><br> <b><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه&shy; گیری: </span></span></b><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">زنان با ناباروری ایدیوپاتیک، سطح سرمی </span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">TSH</span></span><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> بالاتری در محدوده طبیعی (</span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">mIU/L </span></span><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">5/2</span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">&ge; </span></span><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) نسبت به گروه کنترل داشتند. بنابراین تأثیر درمان </span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">TSH</span></span><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> بر این زنان باید مورد توجه قرار گیرد.</span></span></div> <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:normal"><span style="text-autospace:none"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Background: </span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Since thyroid hormones have an essential role in energy production, early development of the human placenta, embryo development, and implantation, abnormalities in thyroid function can significantly affect pregnancy outcomes. </span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="text-autospace:none"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Objective: </span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">The present study aimed to investigate the effect of higher thyroid-stimulating hormone (TSH) levels in the normal range in euthyroid women with unexplained infertility.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="text-autospace:none"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Materials and Methods:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> In this cross-sectional study, we evaluated the data for 300 euthyroid women aged between 18 and 39 yr with normal TSH levels (&le; 5 mIU/L) referred to Yazd Reproductive Sciences Institute, Yazd, Iran from December 2018-March 2021 in 2 groups: the case group (with unexplained infertility) and the control group (with male factor infertility). Finally, age, body mass index, and serum levels of TSH were extracted from participants&#39; medical records and compared between groups.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="text-autospace:none"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Results: </span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">The mean age and TSH level of participants were 31.52 &plusmn; 3.52 yr and 1.24 &plusmn; 2.59 mIU/L, respectively. 142 women (47.3%) had TSH < 2.5, and 158 women (52.7%) had TSH &ge; 2.5 mIU/L. The women with unexplained infertility had significantly higher TSH levels than controls in the same normal range (0.62 vs. 0.64 mIU/L, p < 0.001). Although a more significant proportion of women in the case group had TSH levels > 2.5 mIU/L, we did not find a significant association between TSH levels and age or body mass index. </span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="text-autospace:none"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Conclusion: </span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Women with unexplained infertility have a higher level of serum TSH in the normal range (&ge; 2.5 mIU/L) than the control group. So, the effect of TSH treatment on these women should be considered.</span></span></span></span></span></span></div> تیروتروپین, ناباروری, هورمون‌های تیروئید, زنان Thyrotropin, Infertility, Thyroid hormones, Women. 357 362 http://ijrm.ir/browse.php?a_code=A-10-675-4&slc_lang=en&sid=1 Mahdiehsadat Jalili mahdiehjalily@gmail.com 0000-0002-6264-371X No Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Reyhaneh Azizi raihane.azizi@yahoo.com 0000-0002-0996-045X Yes Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Abbas Aflatoonian abbas_aflatoonian@yahoo.com 0000-0002-2896-6136 No Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Akram Ghadiri-Anari ghadiriam@yahoo.com 0000-0002-9430-4894 No Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.