Is Hashimoto Thyroiditis a Risk Factor in Male Infertility?

Abstract

Hashimoto's thyroiditis is known as thyroid dysfunction and is one of the most common endocrine diseases worldwide. This study seeks to investigate thyroid dysfunction in the male reproductive system. Normal thyroid function is crucial for male reproduction. Semen quality parameters are among the most critical factors affecting male fertility. The main aim of this research was to investigate the effect of thyroid dysfunction on semen quality parameters such as sperm motility, number, and morphology. This cross-sectional retrospective case-control study was conducted between December 2021 and May 2022 in Bahcesehir University Göztepe Medicalpark Hospital Invitro Fertilization center. Patients with Hashimoto's thyroiditis (n=52) were included in the study as the case group. The control group was selected from age and body mass index (BMI)-matched patients who underwent semen analysis (n=57). The participants’ age and BMI were 30.90±4.45 and 24.49±1.46, respectively. When we evaluated semen analysis results, we found the number of sperms (p<0.001), motility (p<0.01), and morphology (p<0.001) were significantly better in the controls than in the patients with Hashimoto's thyroiditis. Oligozoospermia, asthenozoospermia, and oligo-asthenozoospermia as sperm abnormalities were observed in patients with Hashimoto's thyroiditis. Hashimoto's thyroiditis has a negative effect on semen quality parameters such as sperm motility, number, and morphology. Evaluation of infertile men is recommended in terms of thyroid dysfunction.

Keywords

• male infertility
• Hashimoto
• semen quality
• sperm abnormality

References

1. 1. Houston BJ, Riera-Escamilla A, Wyrwoll MJ, Salas-Huetos A, Xavier MJ, Nagirnaja L, et al. A systematic review of the validated monogenic causes of human male infertility: 2020 update and a discussion of emerging gene–disease relationships. Human reproduction update. 2022; 28(1): 15-29.
2. 2. Yurci A, Gungor N. Impact of Male Aging on Semen Parameters. Gynecol Reprod Health.2021; 5 (2): 1-5.
3. 3. Kups M, Gill K, Rosiak-Gill A, Harasny P, Machalowski T, Grabowska M, et al. Evaluation of selected semen parameters and biomarkers of male infertility–preliminary study. F1000Research. 2022; 11(591): 591.
4. 4. Güngör K, Güngör N, Başar M, Cengiz F, Erşahin S, Çil K. Relationship between serum vitamin D levels semen parameters and sperm DNA damage in men with unexplained infertility. Eur Rev Med Pharmacol Sci. 2022; 26(2): 499-505.
5. 5. Yurci A, Güngör ND. Use of frozen-thawed sperm for ICSI improves fertility outcome in men with azoospermia. Journal of Health Sciences and Medicine. 2021; 4(3): 272-76.
6. 6. Tocci A, Lucchini C. WHO reference values for human semen. Human reproduction update. 2010; 16(5): 559.
7. 7. Alahmar A, Dutta S, Sengupta P. Thyroid hormones in male reproduction and infertility. Asian Pacific Journal of Reproduction. 2019; 8(5): 203.
8. 8. Caturegli P, De Remigis A, Rose N. Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmunity reviews. 2014; 13(4-5): 391-7.

9. 9. Feghali K, Atallah J, Norman C. Manifestations of thyroid disease post COVID-19 illness: Report of Hashimoto thyroiditis, Graves’ disease, and subacute thyroiditis. Journal of Clinical and Translational Endocrinology: Case Reports. 2021; 22: 100094.
10. 10. Gungor K, Dokuzeylul Gungor N. Antithyroid antibodies may predict serum beta HCG levels and biochemical pregnancy losses in euthyroid women with IVF single embryo transfer. Gynecological Endocrinology. 2021; 37(8): 702-5.
11. 11. Agarwal A, Baskaran S, Parekh N, Cho C-L, Henkel R, Vij S, et al. Male infertility. The Lancet. 2021; 397(10271): 319-33.
12. 12. Organization WH. WHO laboratory manual for the examination and processing of human semen. 2021 Sixth edition.
13. 13. Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior research methods. 2009; 41(4): 1149-60.
14. 14. Sengupta P, Dutta S, Tusimin MB, İrez T, Krajewska-Kulak E. Sperm counts in Asian men: Reviewing the trend of past 50 years. 2018.
15. 15. Candemir C. Estimating the semen quality from life style using fuzzy radial basis functions. Int J Mach Learn Comput. 2018; 8(1): 44-8.
16. 16. Blay RM, Pinamang AD, Sagoe AE, Owusu EDA, Koney NK-K, Arko-Boham B. Influence of lifestyle and environmental factors on semen quality in ghanaian men. International journal of reproductive medicine. 2020; 2020.
17. 17. Reddy NS, Vembu R. Thyroid Dysfunction and Infertility. Journal of Global Obstetrics and Gynecology 2021; 1(1).
18. 18. Rabinowitz M, Bowring M, Kohn T, Levy J, Herati A. Impact of Environmental and Socioeconomic Factors on Semen Quality in the United States. The Journal of Sexual Medicine. 2022; 19(4): S111-S2.
19. 19. Jurewicz J, Hanke W, Radwan M, Bonde JP. Environmental factors and semen quality. Int J Occup Med Environ Health. 2009; 22(4): 305-29.
20. 20. Kumar N, Singh AK. Impact of environmental factors on human semen quality and male fertility: a narrative review. Environmental Sciences Europe. 2022; 34(1): 1-13.
21. 21. Kavrut M, Güngör ND, Yurci A, Güngör K, Çil K. Semen analysis results are negatively affected in patients with vitiligo: A cross-sectional study from Turkey. Zeynep Kamil Med J. 2022; 53(2): 68-74.
22. 22. Abalovich M, Levalle O, Hermes R, Scaglia H, Aranda C, Zylbersztein C, et al. Hypothalamic-pituitary-testicular axis and seminal parameters in hyperthyroid males. Thyroid. 1999; 9(9): 857-63.
23. 23. Krassas G, Pontikides N, Deligianni V, Miras K. A prospective controlled study of the impact of hyperthyroidism on reproductive function in males. The Journal of Clinical Endocrinology & Metabolism. 2002; 87(8): 3667-71.
24. 24. Li X, Gao H, Li P, Chen W, Tang S, Liu L, et al. Impaired sperm quantity and motility in adult rats following gestational and lactational exposure to environmentally relevant levels of PBDE-47: A potential role of thyroid hormones disruption. Environmental Pollution. 2021; 268: 115773.
25. 25. Krassas GE, Pontikides N. Male reproductive function in relation with thyroid alterations. Best Practice & Research Clinical Endocrinology & Metabolism. 2004; 18(2): 183-95.
26. 26. Sengupta P, Dutta S. Thyroid disorders and semen quality. Biomedical and Pharmacology Journal. 2018; 11(1): 01-10.
27. 27. Clyde HR, Walsh PC, English RW. Elevated plasma testosterone and gonadotropin levels in infertile males with hyperthyroidism. Fertility and Sterility. 1976; 27(6): 662-6.
28. 28. KIDD GS, GLASS AR, VIGERSKY RA. The hypothalamic-pituitary-testicular axis in thyrotoxicosis. The Journal of Clinical Endocrinology & Metabolism. 1979; 48(5): 798-802.
29. 29. Lisovskaya T, Dubrovina O, Treshchilov I, Senturina L, Sevostyanova O, Mayasina E, et al. Thyroid disorders and pathospermia in the ART clinic patients. Gynecological Endocrinology. 2021; 37(sup1): 4-7.
30. 30. Niroomand H, Binaafar S, Nasiri M, Mansournia N, Bagheri Behzad A. Sperm abnormalities: Adverse effects of thyroid dysfunction. Journal of Basic Research in Medical Sciences. 2018; 5(1): 47-50.