Exploring the relationship between Hashimoto's thyroiditis and male fertility: A meta-analytic and meta-regression perspective on hormonal and seminal factors

Abstract

Objective: To explore the relationship between Hashimoto's autoimmune hypothyroidism (HT) and male fertility, focusing on hormonal and seminal factors.

Methods: A systematic literature search was conducted across databases such as PubMed, Web of Science, EMBASE, Scopus, Cochrane, and Google Scholar, covering studies published from January 2000 to March 2024. Studies investigating the impact of HT on semen quality parameters and reproductive hormones were included. Pooled effect estimates were calculated using standard mean difference (SMD) and 95% confidence intervals (CI).

Results: A total of 8 studies with 8965 participants were included. HT significantly affected semen quality and reproductive hormone levels. Specifically, there was a notable decrease in progressive morphology (SMD= -0.78; 95% CI: -1.40 to -0.17; P=0.01) and sperm motility (SMD= -1.151; 95% CI: -1.876 to -0.425; P=0.002). In addition, there were no significant changes in reproductive hormones, although there were elevated levels of luteinizing hormone (SMD=0.437; 95% CI: 0.000 to 0.874; P=0.050) and follicle-stimulating hormone (SMD=0.293; 95% CI: -0.171 to 0.758; P=0.216), with a slight impact on testosterone levels (SMD= -1.143; 95% CI: -2.487 to 0.200; P=0.095).

Conclusions: This systematic review and meta-analysis provides robust evidence of the detrimental effects of HT on semen quality and reproductive hormones, underscoring the necessity for thorough evaluation and management of thyroid function in male infertility assessments.

Keywords

Hashimoto thyroiditis / Male fertility / Semen quality / Reproductive hormones / Meta-analysis / Meta-regression

Conflict of interest statement

The authors declare no competing interests.

Funding

The study has received no extramural funding.

Data availability

The datasets analyzed during the current study are available in the main text, tables, and figures.

Authors’ contributions

Seyed Sobhan Bahreiny conducted the data analysis and was primarily responsible for drafting the initial manuscript. Mojtaba Aghaei, Mohammad Reza Dabbagh, and Mahdi Amraei were instrumental in the conceptualization, design, and oversight of the study. These authors also played key roles in writing the final version, critically reviewing, and substantially editing the manuscript to ensure the validity and accuracy of the results. All authors meticulously reviewed the final manuscript, provided essential feedback, and approved it before submission for publication.

Publisher’s Note

The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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