CLINICAL, ANAMNESTIC AND REPRODUCTIVE CHARACTERISTICS OF WOMEN WITH INFERTILITY ASSOCIATED WITH AUTOIMMUNE THYROIDITIS

Objective. To identify the clinical, anamnestic and reproductive characteristics of infertile women with autoimmune thyroiditis (AIT). Materials and methods. This comparative observational study included 190 infertile women aged 20–44 years. The study group comprised 100 women with verified AIT aged 21–44 years, and the comparison group comprised 90 women without clinical or laboratory evidence of thyroid autoimmunity aged 20–41 years. Age, infertility duration and type, obstetric history, infertility-factor distribution, gynaecological and comorbid conditions, previous operations and hysterosalpingography findings were assessed. Odds ratios (ORs) with 95% confidence intervals were calculated; key outcomes were additionally analysed by logistic regression adjusted for age, infertility duration and infertility type. Results. Women with AIT were older (32.09±5.31 vs 29.92±5.03 years; p=0.004) and had a longer duration of infertility (8.44±4.55 vs 7.11±4.01 years; p=0.034). The distribution of infertility factors differed between groups (p<0.001). Combined-factor infertility was more frequent with AIT (34.0% vs 13.3%; OR=3.35, 95% CI 1.61–6.98; p=0.001), whereas isolated tubal-factor infertility was less frequent (18.0% vs 44.4%; OR=0.27, 95% CI 0.14–0.53; p<0.001). The associations remained significant after adjustment. Breast disorders, uterine fibroids and previous diagnostic hysteroscopy were more frequent in the AIT group. Endometrial-polyp frequencies did not differ significantly. Conclusion. Infertility in women with AIT was characterised by a longer duration, a predominance of combined reproductive factors and a greater burden of selected comorbid conditions. AIT should be considered a potential clinical and pathogenetic modifier rather than the sole cause of infertility.