Evaluation of Hormones and Trace Elements in Women with Unexplained Infertility


  • Raid M. H. Al-Salih Chemistry Dept. / College of Science / Thi-Qar University
  • Khansaa A. Hussien
  • Saher A. Ali


Unexplained infertility, PCOS, Hormone, Trace elements, Iron, Copper



This study aims to Evaluation of prolactin (PRL), thyroid stimulating hormone (TSH), luteinizing (LH)and Follicle stimulating hormone(FSH)and trace elements (iron and copper) in women with unexplained infertility (UI). 60 women with unexplained infertility as well as (40) women with polycystic ovarian syndrome (PCOS) aged (20-35) year were included in this study. The women were divided according the type of infertility into primary and secondary groups (1ºUI, 2ºUI, 1ºPCO and 2ºPCO) respectively. Fifty healthy fertile women with the same age were included in this study as a control group. The results showed a significant increase in serum of Prolactin, TSH, LH levels in the two groups of women with explained infertility (pcos) compared to control and the two groups of women with unexplained infertility. In contrast no significant differences in Prolactin, TSH, FSH and LH levels in women with unexplained infertility in comparison with the control.Serum levels of iron and copper significantly increase in unexplained infertility groups in comparison with women with explained infertility and control groups. This study concluded that is Prolactin, TSH and LH hormone are not associated statistically with unexplained female infertility. The increase in Cu and iron may have an important etiological role in the pathogenicity of unexplained infertility.


Taylor A. Extent of the problem. ABC of subfertility. (2003);327:434-436.

Sadri-Ardekani H, Mizrak SC, van Daalen SK, Korver CM. Propagation of human spermatogonial stem cells in vitro. JAMA. (2009);302:2127-2134.

Slobodan V, Čukuranović R, Bjelaković MD. Possible therapeutic use of spermatogonial stem cells in the treatment of male infertility: a brief overview. Sci World J. 2012;8:374-151.

Kakarla N BradshawK. Evaluation and Management of the Infertile. Glowm. (2008).

Centers for Disease Control and Prevention. Infertility FAQs. (2013).

Rowe PJ, Comhaire FH, Hargreave TB, Mahmoud AMA. WHOmanual for the standardized investigation, diagnosis and managementof the infertile male. Cambridge:Cambridge University Press; (2000).

Glenn L. Sandro C. Agarwal A. Unexplained Infertility. Springer Sci Media, LLC. (2015);14:2140-2149.

Collins JA, Burrows EA Harrild K,Mollison J, Wordsworth S, Tay C,Harrold A. The prognosis for live birth among untreated infertile couples. Fertil Steril. (1995);64:22-28.

Bhattacharya S, Harrild K, Mollison J, Wordsworth S, Tay C, Harrold A. Clomifene citrate or unstimulated intrauterine insemination compared with expectant management for unexplained infertility: pragmatic randomised controlled trial. BMJ. (2008);337:716.

Dumesic DA, Oberfield SE, Stener-Victorin E, Marshall JC, Laven JS LR. Scientific statement on the diagnostic criteria, epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome. Endocr Rev. (2015);36:487–525.

McCartney CR,Marshall.MJ. Clinical practice. Polycystic ovary syndrome. N Engl J Med. (2016);375:54-64.

Anderson SA, Barry JA,HardimanPJ. Risk of coronary heart disease and risk of stroke in women with polycystic ovary syndrome: a systematic review and meta-analysis. Int J Cardiol. (2014);176:486-487.

Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE WS. Task Force on the Phenotype of the Polycystic Ovary Syndrome of The Androgen Excess and PCOS Society. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril. 2009;91:456-488.

Uvarova EV,KhaschenkoKE. Polycystic ovarian syndrome according to modern pathogenesis data. Reprodukt Zdorov’e Detei Podrost Russ. (2013);5:54-60.

Wakim AN, Polizotto SL,BurholtDR. Influence of Thyroxine on Human Granulosa Cell Steroidogenesis in vitro. Wakim AN, Polizotto SL, Burholt DR. (1995);12:274-277.

Veeresh T, Moulali D,SarmaD. A Study on Serum FSH, LH and Prolactin Levels in Women with Thyroid Disorders. Int J Sci Res Publ. (2015);5:250-4.

Poppe K, Velkeniers B,Glinoer D. Thyroid Disease and Female Reproduction. ClinEndocrinol. (2007);309-21:309-321.

Zollner U, Lanig K, Steck T,Dietl J. Assessment of Endocrine Status in Patients Undergoing In- Vitro Fertilization Treatment. Is It Necessary? Arch GynecolObstet. 2001;265:16-20.

Mishra R, BavejaR, Gupta V. Prolactin Levels in Infertility with Menstrual Irregularities. J Obs Gyynecol India. (2002);52:40-43.

Bouchard, P., Lagoguey, M., Brailly, S., Schaison G. Gonadotropin-releasing hormone pulsatile administration restores luteinizing hormone pulsatility and normal testosterone levels in males with hyperprolactinemia. J Clin Endocrinol Metab. (1985);60:258–262.

Zinaman, M.J., Cartledge, T., Tomai, T., Tippett, P., Merriam GR. Pulsatile GnRH stimulates normal cyclic ovarian function in amenorrheic lactating postpartum women. J Clin Endocrinol Metab. (1995);80:2088–2093.

Palm, I.F., van der Beek, E.M., Swarts, H.J., Van der Vilet, J., Wiegant, V.M., Buijs, R.M., Kalsbeek A. Control of the estradiol-induced prolactin surge by the suprachiasmatic nucleus. Endocrinology. (2001);142:2296–2302.

Fritz MA, Speroff L editors. Clinical gynecologic endocrinology and infertility. 8th ed Philadelphia Lippincott Williams Wilkins. (2011):501-18.

Pasha, Q., Malik, S. A., Iqbal, J., Shabeen, N., Shah MH. Screening of trace metals in the plasma of breast cancer patients in comparison with a healthy population. Hum Ecol Risk Assess. 2009;12:1016-1032.

Fraga CG. Relavance, essentiality and toxicity of trace elements in human health. Mol Asp Med. (2005);26:235-244.

Boffetta P. Carcinogenicity of trace elements with reference to evaluations made by the International Agency for Research on Cancer. Scand J Work Env Heal. (1993);1:67-70.

Pantopoulos K, Porwal SK,Tartakoff A. Mechanisms of mammalian iron homeostasis. Biochemistry. (2012);51:5705–24.

Kodama, H., Fujisawa C. Copper metabolism and inherited copper transport disorders: molecular mechanisms, screening and treatment. Metallomics. (2009);1:42-52.

Robertson J. D. Determination of Trace elements Levels in Human Plasma and Radiated Mice Tongue by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Missouri Univ. (2012).

Beyazit F., Yilmaz N., Balci O. AM. Evaluation of Oxidative Stress in Women with Polycystic Ovarian Syndrome as Represented by Serum Ischemia Modified Albumin and Its Correlation with Testosterone and Insulin Resistance. Intern Med. (2016);55:2359-2364.

Verit F.F., Zeyrek F. F. , Zebitay A. G. Cardiovascular risk may be increased in women with unexplained infertility. Clin Exp Reprod Med. (2017);44:28-32.

George K. R. and Malini N. A. The Prevalence and Etiology of Polycystic Ovarian SyndromE (PCOS) as a Cause of Female Infertility in Central Travancore. An Int Q J life Sci. (2014);9:1-6.

Shah A. K, Sarin M, Karunanand B, Mohapatra SC. Association of Hormonal status with Anthropometric & Biochemical Parameters in women with Polycystic Ovarian Syndrome. Community Heal Manag January. (2017);4:30-34.

Diamond MP, Legro RS, Coutifaris C, Alvero R, Robinson RD, Casson PA, Christman GM, Huang H, Hansen KR, Baker V, Usadi R, Seungdamrong A, Bates GW, Rosen RM, Schlaff W, Haisenleder D, Krawetz SA, Barnhart K, Trussell JC, Santoro N, Eisenberg E, Zhang H. Sexual Function in Infertile Women with Polycystic Ovary Syndrome and Unexplained Infertility. Am J Obstet Gynecol. (2017);217:191.e1-191.e19.

Spandana J. C. ShettyP.K. A study on the clinical, biochemical and hormonal profile of polycystic ovary syndrome patients attending tertiary care hospital. Int J Reprod Contracept Obs Gynecol. (2017);6:1986.

Mohammed S., Awooda H. A., Rayis D. A., Hamdan H. Z., Adam I. LMF. Thyroid function/antibodies in sudanese women with polycystic ovarian disease. Obs Gynecol Sci. (2016);60:187-192.

Kumar AN, Naidu JN, Stayanarayana U. Past, present and future of insulin gene and its related genes in relation to polycystic ovary syndrome. J Mol Genet Med. (2014);8:107.

Poppe K,Velkeniers B. Thyroid disorders in infertile women. Ann Endocrinol.( 2003);64:45-50.

Frey KA,Patel KS. Initial evaluation and management of infertility by the primary care physicians. Mayo Clin Proc. (2004);79:1439-1443.

Valvekar U., Lakshmi S,KumarAN. Hypothyroidism and hyperprolactinemia showed positive correlation in women with primary and secondary infertility. Int J Reprod.(2016);5:2079-2083.

Sultana A,NadirS. Pituitary gonadotropic hormones in women with oligo/amenorrhea. J Ayub Med Coll Abbottabad. J Ayub Med Coll Abbottabad. (2008);20:62-65.

Najem F, Elmehdawi R,Swalem A. Clinical and Biochemical Characteristics of Polycystic Ovary Syndrome in Benghazi- Libya; A Retrospective study. Libyan J Med. (2008);3:71-74.

Alwais A. A., Hamad A.R. Obiadat M. and Al-Al-Daghistani H. I. Study The Relationship Between Trace Elements and Hormones Among Jordanian Infertile Women. ejbps. (2016);3:589-598.

Li M. , Tang Y., Li C., Huang Q., Le D. H i Y. Serum macroelement and microelement concentrations in patients with polycystic ovary syndrome. Biol Trace Elem Res. (2016);176:73–80.

Rashid B. H, Shams S, Shariat M, Jaliseh H. K, Mohebi M, Haghollahi F. Evaluation of serum hepcidin and iron levels in patients with PCOS. Ital Soc Endocrinol. (2017);40:779–784.

Mishra A,TiwariA. Iron overload in Beta thalassaemia major and intermedia patients. Maedica (Buchar). (2013);8:328-332.

Singer S, Vichinsky E, Gildengorin G, van Disseldorp J, Rosen M CM. Reproductive capacity in iron overloaded women with thalassemia major. Blood. (2011);118:2878-2881.

Taghavi M Fatemi S,AyatollahiH. Evaluation of body iron stores in non- Overweight women with polycystic ovarian syndrome and its correlation with Insulin resistance. Iran J Endocrinol Metab. (2009);10:600-603.

AL-Saraf M. K. AL-Asadi A. Faris A.H. Copper and Zinc status in women with unexplained Infertility. AJPS. (2005);2:72-75.

Bawa R. TyagiS. Correlation of microelements like plasma copper and zinc concentrations with female infertility. Int J Reprod Contracept Obs Gynecol. (2017);6:2351-2353.

Muyan Li., TangY., Lin C., Huang Q., Lei D. HY. Serum Macroelement and Microelement Concentrations in Patients with Polycystic Ovary Syndrome: a Cross-Sectional Study. Springer Sci Media New York. (2016);176:73–80.

Kurdoglu Z, Kurdoglu M, Demir H. Serum trace elements and heavymetals in polycystic ovary syndrome. HumExp Toxicol. (2012);31:452–456.

David L. Watts D. The Nutritional Relationships of Copper. J Orthomol Med. (1989);4:99-108.

Watts D,David L. Trace Elements and Other Essential Nutrients. 4th Writ B-L-O-C-K Ed USA. (2003).

Celik C, Bastu, Bastu E, Abali R. The relationship between copper, homocysteine and early vascular disease in lean women with polycystic ovary syndrome. J Gynecol Endocrinol.( 2013);29:488–491.

Chen TS, Chen YT, Liu CH, Sun CC. Effect of chromium supplementation on element distribution in a mouse model of polycystic ovary syndrome. Biol Trace Elem Res. (2015);168:472–480.

Chasapis CT, Loutsidou AC, Spiliopoulou CA. Zinc and human health. Arch Toxicol. (2012);86:521–534.

Chakraborty P,Ghosh S, Goswami SK, Kabir SN, Chakravarty B, Jana K. Altered trace mineralmilieu might play an aetiological role in the pathogenesis of polycystic ovary syndrome. Biol Trace Elem Res. (2013);152:9-15.