Thyroid Hormones Correlate to the Therapeutic Effect of Ovulation Induction in Infertile Women With Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a prevalent endocrine and metabolic disorder affecting 5%-10% of reproductive-age women, accounting for 50%-70% of anovulatory infertility. Thyroid function, particularly the relationship between subclinical hypothyroidism (SCH) and PCOS, has garnered attention due to its potential impact on metabolic and reproductive health. This study included 143 infertile women with PCOS diagnosed based on the Rotterdam criteria. Participants underwent ovulation induction using clomiphene citrate following pretreatment with Diane-35. Serum levels of triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH) were measured pre- and posttherapy. Outcomes were compared between therapy-responsive (n = 97) and nonresponsive (n = 46) groups. Receiver operating characteristic (ROC) analysis evaluated the predictive value of T3, T4, and TSH levels for treatment outcomes. Significant differences in baseline T3, T4, and TSH levels were observed between responsive and nonresponsive groups (p < 0.001). Posttreatment, serum T3 and T4 increased while TSH decreased in the responsive group, whereas no significant changes were noted in the nonresponsive group. Combined ROC analysis of T3, T4, and TSH improved predictive accuracy (AUC = 0.88, sensitivity = 76.09%, specificity = 86.60%). Endometrial thickness positively correlated with T3 and T4 and negatively with TSH. Thyroid hormones significantly influence the efficacy of ovulation induction in infertile women with PCOS. Combined T3, T4, and TSH measurements enhance predictive accuracy for therapeutic responses, providing a foundation for personalized treatment strategies.