Thyroid Hormone Dysregulation and Ovulatory Pathogenesis in Women: A Systematic Review and Meta-Analysis of Endocrine and Reproductive Biomarkers
Thyroid Hormone Dysregulation and Ovulatory Pathogenesis
Keywords:
Polycystic Ovary Syndrome, Thyroid Hormones, Thyrotropin, Triiodothyronine, Thyroxine, Ovulation Disorders, Infertility, Meta-AnalysisAbstract
Background: Thyroid hormones play a major role in the maintenance of the hypothalamic-pituitary-ovarian axis and any form of imbalance may significantly impact on reproductive physiology. This meta-analysis and systematic review study aims at establishing the linkage between thyroid dysfunction and ovulatory disturbances in relation to its implication on reproductive health and infertility treatment. Methods: The study followed PRISMA guidelines and articles published till 2024 were retrieved from PubMed, Scopus, Web of Science, and the Cochrane Library. Studies that examined the association between thyroid malfunctioning and ovulatory/menstrual abnormalities were included. Studies lacking quantitative data for thyroid or ovulatory disorders were excluded. Risk of bias was measured using Newcastle-Ottawa Scale, and the quality of evidence was determined through GRADE assessment. Meta-analysis was performed using MetaAnalysisOnline tool. Results: The findings indicated a positive correlation between thyroid dysfunction and ovulatory defects (pooled risk ratio 3.20, 95% CI: 2.00–5.13, p < 0.0001). The heterogeneity was moderate (I² = 74.9%, p < 0.0001) and sensitivity analysis supported the accuracy of the study results. Conclusion: Subclinical hypothyroidism was the most commonly implicated condition, especially in women with Polycystic Ovary Syndrome (PCOS), reduced ovarian reserve and unexplained infertility. Additional longitudinal studies with standardized assessment protocols of hormones are needed to resolve the causality and to develop optimal patient-specific treatment strategies.
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Copyright (c) 2025 Nimra Asghar, Zuha Tariq, Minahil Tahir, Fatima Ali, Muhammad Akram, Ejaz Khan, Khaleeq Ullah (Author)
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