Assessment of ovarian function in infertile women with compensated autoimmune thyroiditis and premature ovarian insufficiency without clinical definitions

Aim. To assess the ovarian reserve and ovarian response to controlled ovarian hyperstimulation (COS) in patients in assisted reproductive technology (ART) programs with compensated chronic autoimmune thyroiditis (CAIT) and with predicted premature ovarian insufficiency (POI).
Materials and methods. A retrospective study of 166 patients with infertility and compensated CAIT (group I, n = 44), predicted signs of POI (group II, n = 62), tubal infertility factor (group III, n = 60), including a comparative analysis of clinical and patient history data, indicators of ovarian reserve, and the effectiveness of COS (number of oocytes retrieved). The groups are divided by age into subgroups: patients younger than 35 years of age and 35 years and older (Ia, Ib, IIb, IIb, IIIa, and IIIb, respectively).
Results. Significant differences in the values of follicle-stimulating (FSH) and (AMH) were revealed in the study groups under 35 years of age: FSH (7.24 (6.0-9.63) mIU/l and 10.35 (10.13–11.01) mIU/L, respectively; p < 0.001) and AMH (3,2 (1.48–6.80) ng/ml and 0.68 (0.44–2.91 ng/ml), respectively; p = 0.015). The poor ovarian response in COS programs is most often obtained in patients under 35 years of age with infertility with occult POI. In the age groups 35 years and older, the poor ovarian response of COS was equally common in groups I and II. Estradiol levels in the groups of 35 years of age and older were lower in patients with occult POI.
Conclusion. In groups of patients under 35 years of age with compensated CAIT and with tubal infertility factor, higher rates of ovarian reserve and the effectiveness of COS were recorded than in the groups with occult POI. A decrease in estradiol in patients 35 years of age with occult POI and older indirectly indicates a lesion of the ovarian somatic cells, probably as a result of autoimmune aggression.

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