Radioactive iodine effects of ovarian reserve: A systematic review and meta-analysis

Abstract Background: Differentiated thyroid carcinoma is common and its rate is on the rise globally, radioactive iodine is widely used as an adjuvant therapy or for remnant ablation. There is growing awareness about the effects of radioactive iodine on ovarian reserve. This meta-analysis aimed to assess the effects of radioactive iodine (used for differentiated thyroid carcinoma) on Anti-Müllerian hormone and follicular stimulating hormone levels. Methods: A systematic literature search was conducted in PubMed, MEDLINE, Google Scholar, and EBSCO) for relevant articles published in the English language. The literature search was conducted during March and 2024 and the studies were included without time limitation. (From inception up to November 2023). The keywords used were ovarian reserve, ovarian function, female fertility, radioactive iodine, follicular stimulating hormone, and Anti-Müllerian hormone. A datasheet was used to collect the information. Results: Out of the two hundred and sixty-nine studies retrieved, 160 remained after duplication removal, of them 17 full texts were screened. However, only six were included in the final meta-analysis. No statistically significant change was evident in the Anti-Müllerian hormone level after the radioactive iodine odd ratio, -0.71. 95% CI, -2.66-1.24, P-value, 0.48, Chi-square, 68.95. A significant heterogeneity was observed, I2, 93%. No significant effect was found on follicular stimulating hormone, odd ratio, -1.03. 95% CI, -2.34-0.27, P-value, 0.12, Chi-square, 1.89. No heterogeneity was observed, I2, 0.0%. Conclusion: No significant change in Anti-Müllerian hormone and follicular stimulating hormone levels following radioactive iodine for differentiated thyroid. Randomized controlled trials are needed to solve the issue.