Title: Thyroid Hormones and Ovarian Reserve: A Comprehensive Study of Women Seeking
Infertility Care
Version: 3 Date: 07 Aug 2023
Reviewer:  Phuc Nhon Nguyen
Reviewer's report:
Ho Chi Minh City, Vietnam, 8th August, 2023
Dear authors,
I read with the interest of your paper submitted to BMC Women’s Health, Ref: Submission ID
75de106e-e538-402c-9107-3689c48faf11, entitled: “Thyroid Hormones and Ovarian Reserve:
A Retrospective Study of 1443 Women Seeking Infertility Care”. In this work, the authors find
a correlation between TSH and ovarian reserve in infertile women. The number of patients is
great and the findings are significant. However, some points needed to be addressed before
publication.
- Definition of regular and irregular menstruel must be given. Types of abnormal uterine bleeding
for reproductive-age women following FIGO consensus could be mentioned.
- The population included the patient with uterine lesions and ovarian cystes? Please clarify.
- Please describe the label machine, kit test and quality technique for the concentration of AMH,
TSH, FSH.
- Study flowchart with number cases should be added.
- How the study sample size was calculated?
- The patient from 20-45 years old had a large interval with the variability of AMH. Thus, a
supplementary table of age subgroups is necessary.
- PCOS is also related to ovarian reserve (AMH). Did the authors exclude these patients from
population study? + Ran Y, Yi Q, Li C. The Relationship of Anti-Mullerian Hormone in
Polycystic Ovary Syndrome Patients with Different Subgroups. Diabetes Metab Syndr Obes.
2021;14:1419-1424. Published 2021 Mar 25. doi:10.2147/DMSO.S299558).
+ Butt, M.S., Saleem, J., Aiman, S. et al. Serum anti-Müllerian hormone as a predictor of
polycystic ovarian syndrome among women of reproductive age. BMC Women's Health 22, 199
(2022). https://doi.org/10.1186/s12905-022-01782-2.
+ Teede H, Misso M, Tassone EC, Dewailly D, Ng EH, Azziz R, Norman RJ, Andersen M,
Franks S, Hoeger K, Hutchison S, Oberfield S, Shah D, Hohmann F, Ottey S, Dabadghao P,
Laven JSE. Anti-Müllerian Hormone in PCOS: A Review Informing International Guidelines.
Trends Endocrinol Metab. 2019 Jul;30(7):467-478. doi: 10.1016/j.tem.2019.04.006. Epub 2019
May 31. PMID: 31160167.
- Similarly, endometriosis may affect to AMH level. Please clarify this issue.
+ Romanski PA, Brady PC, Farland LV, Thomas AM, Hornstein MD. The effect of
endometriosis on the antimüllerian hormone level in the infertile population. J Assist Reprod
Genet. 2019;36(6):1179-1184. doi:10.1007/s10815-019-01450-9.
+ Garavaglia E, Sala C, Taccagni G, Traglia M, Barbieri C, Ferrari S, Candiani M, Panina-
Bordignon P, Toniolo D. Fertility Preservation in Endometriosis Patients: Anti-Müllerian
Hormone Is a Reliable Marker of the Ovarian Follicle Density. Front Surg. 2017 Jul 25;4:40.
doi: 10.3389/fsurg.2017.00040. PMID: 28791295; PMCID: PMC5524724.
- FT3, FT4 levels as well as treatment methods of thyroid disease (frequency, percentage) should
be added in common characteristics table of population study.
- The patients followed strictly the treatment of thyroid disease or not, this entity should be
described?
- Was the mean size of AFC calculated on ultrasound?
- The retrospective study, without control group (women without infertility) is the limitation and
this issue must be included in the paper.
After revision, the paper can be considered for publication.
I’m looking forward to receiving your revised manuscript.
Best regards,
Phuc Nhon Nguyen MD, MSc
Tu Du Hospital, Ho Chi Minh City, Vietnam