THE THYROID GLAND AND ENDOCRINE INFERTILITY IN WOMEN WITH OBESITY OR METABOLIC SYNDROME
Keywords:
Thyroid gland; endocrine infertility; obesity; metabolic syndrome; hypothyroidism; insulin resistance; reproductive function; hormonal imbalance; ovulation; women's health.Abstract
The thyroid gland plays a key role in regulating female reproductive function, directly influencing the ovulatory cycle, the hypothalamic-pituitary-ovarian axis, and overall endocrine balance. Thyroid dysfunction, particularly hypothyroidism and subclinical forms of thyroid dysfunction, are often associated with the development of endocrine infertility, especially in women with obesity or metabolic syndrome. Recent research shows that excess body weight and insulin resistance exacerbate thyroid dysfunction, creating a vicious cycle of metabolic and hormonal imbalances. This article examines the pathogenetic mechanisms underlying the relationship between thyroid dysfunction and fertility disorders, presents the clinical and endocrinological characteristics of women with obesity, and analyzes current approaches to the diagnosis and treatment of endocrine infertility associated with metabolic syndrome. Understanding these relationships is essential for developing effective strategies for the prevention and treatment of reproductive dysfunction.
References
Alexander E.K. et al. "2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum." Thyroid, 2017; 27(3): 315–389.
Poppe K., Velkeniers B. "Thyroid disorders in infertile women." Annales d'Endocrinologie, 2021; 82(4): 273–280.
Krassas G.E., Poppe K., Glinoer D. "Thyroid function and human reproductive health." Endocrine Reviews, 2020; 41(5): 671–706.
Arafah B.M. "Hypothyroidism and infertility in women." Thyroid, 2021; 31(6): 895–903.
Ding X., Yang H., et al. "Subclinical hypothyroidism and pregnancy outcomes: a meta-analysis of prospective cohort studies." Endocrine Connections, 2020; 9(5): 360–370.
Kalra S., Unnikrishnan A.G. "Thyroid disorders and obesity: an Indian perspective." Indian Journal of Endocrinology and Metabolism, 2021; 25(1): 12–18.
Papi G., Uberti E.D., et al. "Metabolic syndrome and thyroid dysfunction: a link beyond chance." Endocrine Practice, 2019; 25(8): 775–783.
Zhang Y., Chen Y., et al. "Thyroid hormones and female reproductive system: a comprehensive review of the literature." Reproductive Biology and Endocrinology, 2022; 20(1): 1–12.
World Health Organization. "Obesity and overweight. Fact sheet." Geneva: WHO, 2023.
Biondi B., Cooper D.S. "The clinical significance of subclinical thyroid dysfunction." Endocrine Reviews, 2020; 41(2): 171–201.
