Female infertilityInfertilityPCOS

Thyroid Problems and Fertility

Your thyroid is a small butterfly-shaped gland found at the base of your neck, just below what is called Adam’s apple. The thyroid produces hormones, which control many activities in your body, including how fast you burn calories and how fast your heart beats.

Do you know that your thyroid may be overactive or underactive and depending on how much or how little hormone it makes, you may often feel restless or tired, or you may lose or gain weight and women are more likely to have thyroid diseases?

Thyroid issues are commonly diagnosed alongside Polycystic Ovarian Syndrome (PCOS) as both involve abnormal hormone levels. Thyroid disorders can hurt male fertility too. Hypothyroidism in men can lead to a variety of fertility issues – reduced sperm volume and motility, sperm defects, a lower libido, problems sustaining an erection, and lowered male fertility hormones such as testosterone.

A diagnosis of hyperthyroidism or hypothyroidism could portend adverse consequences. Hyperthyroidism occurs when the thyroid overproduces hormones. If you have hyperthyroidism, you may suffer from anxiety, tremors, rapid heart rate, weight loss, more frequent bowel movements, intolerance to heat, and brittle hair among others. Infertility symptoms can include loss of libido and menstrual cycle irregularities. Hypothyroidism on the other hand, occurs when your thyroid under-produces hormones. Common symptoms include fatigue, low energy, muscle weakness, weight gain, depression, constipation, intolerance to cold, and dry skin. Infertility symptoms with this condition include menstrual cycle abnormalities with heavier menstrual cycles, a low Basal Body Temperature.

I wish to inform you that undiagnosed thyroid dysfunction can make it difficult to conceive. It can also cause problems during pregnancy. Once the over- or under-active thyroid is under control, however, there is no reason why you should not have a successful pregnancy and a healthy baby.

As mentioned earlier, women are more likely than men to have thyroid disease. For instance, 1 in 8 women will develop thyroid problems during their lifetime.

Thyroid diseases can cause problems with your menstrual period because your thyroid helps control your menstrual cycle. Too much or too little thyroid hormone can make your periods very light, heavy, or irregular.

Thyroid disease also can cause your periods to stop for several months or longer (amenorrhea). If your body’s immune system causes thyroid disease, other glands, including your ovaries, may be involved. This can lead to early menopause.

It is known that when thyroid disease affects the menstrual cycle, it also affects ovulation and this can make it harder for you to get pregnant. For women generally, there is sometimes a link between hypothyroidism and infertility.

The most common cause of an overactive thyroid or hyperthyroidism is Graves’ disease. If this disease is untreated you may have lighter, irregular periods and find it difficult to conceive.

With hypothyroidism, your thyroid gland doesn’t produce enough of certain important hormones. Low levels of the thyroid hormone can interfere with the release of an egg from your ovary (ovulation), which impairs fertility. In addition, some of the underlying causes of hypothyroidism, such as certain autoimmune or pituitary disorders, may impair fertility.

Thyroid problems during pregnancy can equally cause health problems for a mother and her baby.

There are times, symptoms of thyroid problems could be mistaken for menopause symptoms. However, thyroid disease, especially hypothyroidism, is more likely to develop after menopause

Symptoms of hypothyroidism typically develop slowly, often over several years. You may feel tired and sluggish and may later develop other signs and symptoms of a slowed metabolism, including constipation, muscle weakness, unexplained weight gain, joint or muscle pain, tiredness, etc.

After treatment, you should first have a blood test to check your thyroid function before planning to her pregnant. But normal fertility often returns quickly afterwards.

If previously you have been diagnosed with Graves’ disease it is important to relate your medical history to your obstetrician even if your thyroid function has returned to normal and even if you are on treatment for an underactive thyroid.

In men, hyperthyroidism can cause a marked reduction in sperm count, resulting in reduced fertility. The sperm count usually returns to normal once the thyroid condition has been treated.

During pregnancy, an overactive thyroid may pose problems. As it is possible for drugs to cross the placenta, the lowest possible dose is prescribed so that your baby is less likely to be affected.

Thyroid surgery may not be required but if needed, it is recommended to be ideally performed during the 4th to 6th months of pregnancy. There are several complications to be aware of if you have or had hyperthyroidism. For one, there is an increased risk of miscarriage in the early stages of pregnancy if the condition is not under control.

If you are taking antithyroid drugs there is a very slight increased risk to the baby so definitive treatment is given before considering pregnancy.

When trying to conceive or during pregnancy, it is best that you do not stop taking antithyroid drugs. The point to note is that there is a greater risk to pregnancy from an untreated overactive thyroid gland than from taking antithyroid medication.

You should arrange to have your blood tested few months after delivery and at intervals thereafter. If you stopped taking antithyroid drugs during your pregnancy you should see your doctor if you notice any symptoms of hyperthyroidism.

Research shows that only small amounts of antithyroid drugs cross into breast milk so if you are on antithyroid drugs, you can breast-feed provided the dose is low, but check first with your doctor.

Antithyroid drugs are best taken in smaller doses over two or three times a day following a feed. If you require higher doses of antithyroid drugs to control hyperthyroidism then your baby can have a blood test to check whether its thyroid is being affected.

If you have an untreated (or undertreated) underactive thyroid gland (hypothyroidism) you are likely to find it more difficult to conceive. You may have longer or heavier periods, which can cause anaemia, or your periods may stop completely. Once you are taking medication and your thyroid hormone levels are back to normal your chances of becoming pregnant should improve dramatically.

If you are planning a pregnancy you should let your doctor know and ideally have a blood test before you conceive. It is recommended that you are closely monitored by a qualified medical practitioner to lower risk of miscarriage.

You should have regular blood tests throughout your pregnancy so that your dose can be adjusted if necessary.

The bottom line is that for women, treating hypothyroidism is important to correct infertility. If infertility remains after hypothyroidism has been corrected, other interventions to treat infertility may be needed.

If you have hypothyroidism and hope to become pregnant, work with your doctor to make sure your hypothyroidism is under control. Seek additional help from an infertility specialist.

If you have hypothyroidism and become pregnant, tell your doctor promptly. Close monitoring of your thyroid hormone level during pregnancy can promote normal fetal development and reduce the risk of miscarriage.

It is essential to know that a healthy lifestyle always supports fertility. Maintaining normal weight can contribute to hormonal balance in women and men as well. Exercise regularly, keep stress low, avoid smoking and limit alcohol and caffeine. A healthy diet rich in iodine, whole grains, vegetables, and lean protein can also help.  Resolving thyroid issues will depend on how much hormone levels are imbalanced as well as if there are any other medical issues present.  If you have infertility due to thyroid issues, before any fertility treatment can be prescribed, your thyroid hormone levels must be balanced. This may be all that you require to effect natural conception.

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