Ramya, T (2020) Correlation of Hyperprolactinemia with Hypothyroidism in Infertile Women. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION: DEFINITION OF INFERTILITY: Failure to conceive within one or more years of regular unprotected coitus. Primary infertility patients have never conceived ,while secondary infertility indicates previous pregnancy but failure to conceive subsequently. Under ordinary circumstances 80-90%of normal couples conceive during one year of attempting pregnancy. DEFINITION OF FECUNDABILITY: It is the probability of achieving a pregnancy within one menstrual cycle. In a healthy couple it is 20%. Fecunditity deals with child bearing ability and fertility deals with childbearing performance. DEFINITION OF CHILDLESSNES It is defined as women who are currently married for more than 5 years, currently not pregnant, having no terminated pregnancy, never used contraceptives and have no living children portrays similar levels and patterns to that of infertility. AIM OF THE STUDY: 1. To study the correlation of hyperprolactinemia with hypothyroidism in infertile women. 2. To study the correlation of other factors like age, duration of marriage and BMI with prolactin and thyroid levels. STUDY DESIGN: Observational study comprising of 100samples of women with infertility in the age group of 20-35 years ,both primary and secondary infertility included. STUDY POPULATION: Infertile women of 20-35 years of age attending the gynaecology OPD in the study centre meeting inclusion criteria after approval of local ethical committee and obtaining informed consent. SAMPLE SIZE: According to qualitative analysis sample size is 100. STUDY PLACE: GOVERNMENT RSRM LYING IN HOSPITAL, ROYAPURAM, CHENNAI. STUDY PERIOD: 8 months. INCLUSION CRITERIA: 1. Infertile women age between 20-35 years and marriage duration more than 2 years. 2. Infertile women with husband having near normal sperm count. EXCLUSION CRITERIA: 1. Women age more than 35 years. 2. Women with husbands with grossly abnormal semen analysis. 3. Women who have anomalies of genital tract, tubal blockade. STUDY METHODS AND WORK PLAN: Demographics, baseline characteristics and other clinical risk factors of infertile women who consented for the study and meeting inclusion criteria were noted. Blood samples were taken and levels of serum prolactin and thyroid hormones-freeT3,freeT4,TSH were measured. Values of prolactin more than 25 microgram/L is termed as hyperprolactinemia. Based on Canadian medical association, Hyperprolactinemia was categorised into: 1. Mild 26-50 microgram/L. 2. Moderate 51-75 microgram/L. 3. Marked > 100 microgram/L. Other laboratory tests: 1. Haematology-Haemoglobin level, total and differential count and platelet count. 2. Biochemistry- Renal function test and random blood sugar levels. 3. Blood samples of 6-8ml were taken for the above tests. 4. Semen analysis - To look for Volume, appearance, Liquefaction time, Ph, total sperm count, colour, viscosity, motility, pus cells, RBCs, morphology. 5. Sample obtained by ejaculating into a collection cup following a period of abstinence of atleast 72 hours. 6. Hysterosalphingogram- to rule out tubal blockade. 7. Ultrasound. DISCUSSION: This is a prospective observational study done in 100 infertile women attending the gynaecology OPD in GOVT RSRM LYING IN HOSPITAL, ROYAPURAM, CHENNAI. The study population of 100 was tested for prolactin and thyroid hormone levels after excluding male factor infertility and tubal factors. The demographic factors, duration of marriage, BMI, age, freeT3, freeT4, TSH were studied to know their impact on causing infertility. The early detection of these conditions and correction of these hormonal imbalance can help couples conceive early. In our study we find that increasing age, BMI,, period of infertility were associated with high prolactin levels. SUMMARY: In the 100 patients recruited into study 77 were under primary infertility category and 23 belonged to secondary infertility category. The mean age of primary infertility women was 26.69 and secondary infertility women was 27.17, showing that women with secondary infertility were of higher age. The mean duration of marriage in primary infertility was 4.57 and secondary infertility was 5.48. The mean TSH values for primary infertility was 3.4811 and secondary infertility was 5.4492,showing that both primary and secondary infertile women had higher than normal TSH values. The majority of women with high TSH values also had high prolactin values. The majority of women with raised TSH and prolactin also had raised BMI. CONCLUSION: TSH values and prolactin values showed a positive correlation in women with both primary and secondary infertility. Positive correlation of BMI with both prolactin and TSH was observed. BMI also showed a positive correlation with duration of age in years after marriage. This implies that infertile women in general have raised TSH and prolactin values, their BMI is on the higher side. As the duration of years following marriage increases infertility also increases.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221716054 |
| Uncontrolled Keywords: | Hyperprolactinemia, Hypothyroidism, Galactorrhea. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 16 Feb 2021 15:25 |
| Last Modified: | 16 Feb 2021 15:25 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14260 |
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