Learn how thyroid conditions like hypothyroidism and hyperthyroidism can impact fertility, and what to do if you’re trying to conceive.

Introduction

Thyroid conditions, such as hypothyroidism and hyperthyroidism, can greatly affect fertility. Women with untreated thyroid issues may experience irregular menstrual cycles, ovulation problems, or difficulties maintaining a pregnancy. Understanding how your thyroid health impacts fertility is essential when trying to conceive. 

In this article, we will explore the connection between thyroid disorders and fertility and share steps you can take to support a healthy pregnancy journey.

1. How Does Thyroid Health Affect Fertility?

• The thyroid gland plays a crucial role in regulating hormones that impact ovulation and menstruation. 
• When thyroid hormone levels are imbalanced, either too high (hyperthyroidism) or too low (hypothyroidism), ovulation can be disrupted, leading to difficulties in conceiving.
• Women with thyroid issues may experience irregular periods or even anovulation, where no egg is released. Addressing thyroid imbalances is essential for restoring fertility.
• Thyroid hormone is also essential for critical processes like formation of the embryo, the receptivity of the uterine lining and the process of embryo implantation into the uterus.

2. Hypothyroidism and Fertility

• Hypothyroidism, characterized by an underactive thyroid, slows down the body’s metabolism, affecting reproductive hormones.
•  Low thyroid levels can lead to irregular cycles and reduce the chances of successful conception. Hypothyroidism can also cause complications during pregnancy, increasing the risk of miscarriage or preterm birth. 
• Women trying to conceive with hypothyroidism should consult a doctor for proper medication and monitoring.

3. Thyroid Autoimmunity (TAI):

TAI is the most common autoimmune disorder affecting women of reproductive age. Its increased incidence has been observed in women struggling with infertility.

Presence of anti-thyroid antibodies or TAI signifies an immune imbalance that may be linked to implantation failure of embryos. Also, women with TAI show a higher prevalence of presence of other autoimmune antibodies, which further contributes to difficulty in conceiving or miscarriages.

4. Hyperthyroidism and Fertility

• Hyperthyroidism, an overactive thyroid, accelerates the body’s metabolism, causing excessive production of thyroid hormones. 
• This condition can also impact ovulation and make it harder to get pregnant. Additionally, untreated hyperthyroidism during pregnancy can lead to complications such as preeclampsia and premature birth. 
• Proper medical management is key to balancing thyroid hormone levels and improving fertility.

5. Managing Thyroid Conditions for Better Fertility

• If you’re diagnosed with a thyroid condition, it’s important to work with your healthcare provider to manage it before trying to conceive. 
• Regular thyroid function tests, medication adjustments, and a balanced diet can all help optimize fertility. 
• It’s also vital to monitor your thyroid throughout pregnancy, as your hormone levels may need additional regulation to support a healthy pregnancy.
• International medical guidelines suggest to maintain TSH levels below 2.5 mUI/L. This target should be attained at least four weeks before starting your IVF cycle. 
• Patients with TSH value of  2.5–4 mU/L and thyroid autoimmunity undergoing assisted reproduction require thyroid supplements.

6. When to Seek Medical Advice

• If you’ve been trying to conceive for more than six months and suspect a thyroid issue, seek advice from a fertility specialist.
• Testing for thyroid disorders is a simple process, and early intervention can improve your chances of conceiving. 
• It’s crucial to maintain optimal thyroid health, both for conception and throughout pregnancy, to reduce complications and support fetal development.

Conclusion

• Thyroid health plays a significant role in fertility, affecting both the ability to conceive and maintain a healthy pregnancy. For patients undergoing Fertility treatments, achieving a euthyroid state prior to start of treatment is essential to achieve the desired outcomes.
• Whether you’re dealing with hypothyroidism or hyperthyroidism, managing your condition through proper medical care can greatly improve your fertility outcomes. 
• If you’re trying to conceive either naturally or via fertility treatments, be sure to discuss thyroid health with your doctor for a smoother journey to parenthood.

Ref: https://doi.org/10.1016/j.dsx.2023.102876

FAQs:

1. How is thyroid-related infertility diagnosed?

Thyroid-related infertility is diagnosed through blood tests that measure levels of thyroid hormones (TSH, free T3, and free T4). Your doctor may also check for other hormonal imbalances.

2. Should I continue taking thyroid medication during pregnancy?

Yes, it’s crucial to maintain appropriate thyroid hormone levels throughout pregnancy. Your doctor may adjust your medication dosage to ensure a healthy pregnancy for both you and your baby.

3. Can I conceive if I have hypothyroidism?

Yes, with proper medication and monitoring, many women with hypothyroidism can conceive successfully. It’s important to control thyroid hormone levels before and during pregnancy.