Evaluation Of Stress Hormones in Women with Primary Infertility

Hormonal and neuroendocrinal factors play a major role in the etiology of infertility by disturbing reproductive homeostasis. This case-control study evaluated stress and thyroid hormones in women with primary infertility. A total of one hundred twenty women within the age range of 20 to 38 years were studied where seventy-six belonged to the category of primary infertility, and forty-four were normal controls. Early follicular phase morning fasting blood sample was used for estimation of serum cortisol, adrenocorticotropic hormone (ACTH), dehydroepiandrosterone (DHEA), and thyroid-stimulating hormone (TSH) through ELISA. The results indicated significantly higher mean values among the infertile group for cortisol (r=0.32, p=0.005), ACTH (r=0.28, p=0.01), and TSH (r=0.25, p=0.02) compared to the control group whereas DHEA did not show any significant association (r=-0.15, p=0.12). This implies that hyperactivation of the hypothalamic–pituitary–adrenal and thyroid axes may be involved in the pathogenesis of impaired fertility, thereby justifying expanded endocrine assessment in the workup of infertility. The results further support ongoing efforts directed at discovering hormonal biomarkers that can inform treatment strategies.