Exploring the Interplay of Thyroid-Stimulating Hormone, Prolactin, and Central Obesity in Polycystic Ovary Syndrome Among Infertile Women

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder affecting 8 to 13% of women of reproductive age, significantly increasing the risk of infertility. Metabolic dysregulation is a key component of PCOS pathophysiology. Recent studies suggest that thyroid-stimulating hormone (TSH) and prolactin play significant roles in the metabolic and obesity-related aspects of PCOS and infertility, though their exact relationship remains unclear. This study aims to investigate the relationship between TSH, prolactin, and central obesity in infertile women with PCOS to better understand how these hormones may contribute to metabolic disturbances in this population. In this cross-sectional study conducted at Milad Infertility Treatment Center, Imam Reza Hospital, Mashhad, Iran, 254 infertile women aged 18 to 45 diagnosed with PCOS between January and October 2023 were evaluated. Anthropometric measures including waist circumference, weight, height, and waist-to-height ratio (WHtR) were assessed alongside prolactin and TSH levels. The regression analysis revealed a significant association between TSH levels and BMI (P-value = 0.03, B = 0.247, R2 = 0.266). However, after adjusting for BMI, no significant associations were found between TSH and anthropometric indices (P-value > 0.05). A significant positive correlation was observed between prolactin and BMI at the “at risk” level of WHtR (r = 0.377, P-value = 0.015), but this association lost significance after BMI adjustment (P-value > 0.05). Given the significant impact of TSH and prolactin on metabolic health, routine screening for thyroid dysfunction and prolactin levels in PCOS patients may be beneficial. However, the associations between TSH, prolactin, and anthropometric indices were no longer significant after adjusting for BMI, indicating the importance of considering BMI to be a confounding factor. Clinicians should include thyroid function tests and prolactin measurements in the standard diagnostic and treatment protocols for PCOS, with a focus on weight management to improve metabolic health and fertility outcomes.