Infertile with "Normal" Thyroid Tests? Experts Recommend Little-Known TRH Test

Israeli researchers looked at the possibility of subclinical hypothyroidism in women suffering from infertility who had normal Thyroid Stimulating Hormone (TSH) tests. TSH testing is considered by conventional physicians to be the "gold standard" test to diagnose hypothyroidism. In the study, the researchers looked at 87 infertile women (39 had ovulation disorders and 48 had other causes of infertility) and administered a Thyrotropin-Releasing Hormone (TRH) stimulation test. The TRH test is a dynamic test that measures the response of the thyroid in action, as compared to the TSH test, which takes a static picture of the thyroid's overall function at one point in time.

The experts found that the prevalence of subclinical hypothyroidism -- which was detected by the TRH test but not the TSH test -- was significantly higher in the women who had ovulation disorders, as compared to women who had normal ovulation. Interestingly, 8% of the women who had abnormal TRH tests also developed elevated TSH levels within two to four months after the initial testing.

Overall, the researchers recommend that the TRH stimulation test be performed in women experiencing ovulation disorders who have normal basal TSH levels, and that additional assessment and treatment be considered for those with abnormal results.

Note: Some practitioners believe the dynamic nature of the TRH test makes it useful in diagnosing subtle cases of hypothyroidism in the population in general. This is discussed in this article here at About.com.

Also, find out more about overcoming infertility and having a healthy pregnancy with thyroid disease here at the About.com site.

Source: Eldar-Geva, T et. al. "Subclinical hypothyroidism in infertile women: The importance of continuous monitoring and the role of the thyrotropin-releasing hormone stimulation test." Gynecol Endocrinol. 2007 Jun;23(6):332-7.

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