Features of fertility indicators in women with autoimmune thyroiditis without thyroid dysfunction

Authors

  • Y.I. Beliakova V.P. Komisarenko Institute of Endocrinology and Metabolism of the NAMS of Ukraine, Kyiv, Ukraine
  • Y.V. Buldyhina V.P. Komisarenko Institute of Endocrinology and Metabolism of the NAMS of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0002-9219-2737

DOI:

https://doi.org/10.18370/2309-4117.2026.83.41-46

Keywords:

autoimmune thyroiditis, ovarian reserve, anti-Müllerian hormone, follicle-stimulating hormone, antral follicles, antibodies to thyroid peroxidase, antibodies to thyroglobulin, thyroid-stimulating hormone

Abstract

Background. Autoimmune thyroiditis (AIT) is one of the most common endocrine disorders in women of reproductive age and may affect fertility even under euthyroid conditions. The impact of thyroid autoimmunity on ovarian reserve remains insufficiently studied.

Objective of the study: to investigate the effect of autoimmune thyroiditis on ovarian reserve by analyzing the relationships between thyroid function parameters, thyroid antibody levels, and fertility markers.

Materials and methods. A two-center cross-sectional analytical study was conducted involving 107 women of reproductive age (18–40 years) with AIT (main group). The control group included 20 women without thyroid pathology. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine, antibodies to thyroid peroxidase (TPOAb), antibodies to thyroglobulin (TgAb), anti-Müllerian hormone (AMH), and follicle-stimulating hormone (FSH) were measured. Antral follicle count (AFC) was assessed using transvaginal ultrasound.

Results. Patients with AIT demonstrated significantly higher levels of TSH, TPOAb, and TgAb compared to controls (p < 0.001), with no significant differences in free thyroxine levels. FSH levels were significantly higher (p < 0.005), and AFC was significantly lower (p < 0.001) in women with AIT, whereas AMH levels did not differ significantly between groups (p > 0.05). A correlation analysis revealed a significant inverse relationship between TSH and FSH (r = –0.50; p = 0.03), while no significant associations were found between other thyroid parameters, antibody levels, and ovarian reserve markers.

Conclusions. Autoimmune thyroiditis is associated with early functional and morphological changes in ovarian reserve even in euthyroid patients. A decrease in AFC combined with elevated FSH in the presence of preserved AMH may indicate early stages of ovarian reserve decline. The observed association between TSH and FSH suggests a potential interaction between thyroid and gonadotropic axes, whereas the lack of correlation with thyroid antibodies may indicate a limited direct impact of autoimmune activity on ovarian reserve. These findings highlight the importance of comprehensive evaluation of reproductive potential in women with AIT.

Author Biographies

Y.I. Beliakova, V.P. Komisarenko Institute of Endocrinology and Metabolism of the NAMS of Ukraine, Kyiv

junior research fellow, Department of General Endocrine Pathology

Y.V. Buldyhina, V.P. Komisarenko Institute of Endocrinology and Metabolism of the NAMS of Ukraine, Kyiv

DSc, leading research fellow, Department of General Endocrine Pathology

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Published

2026-05-14

How to Cite

Beliakova, Y., & Buldyhina, Y. (2026). Features of fertility indicators in women with autoimmune thyroiditis without thyroid dysfunction. REPRODUCTIVE ENDOCRINOLOGY, (83), 41–46. https://doi.org/10.18370/2309-4117.2026.83.41-46

Issue

No. 83 (2026)

Section

Interdisciplinary problems

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