the link between hypothyroidism and infertility

4 Reasons why Hypothyroidism is the enemy of Fertility

Thyroid disorders are conditions that affect the thyroid gland, a butterfly-shaped gland in the
front of the neck. The two main types of thyroid disease are hypothyroidism and
hyperthyroidism. Both conditions can be caused by other diseases that impact the way the
thyroid gland works. Hypothyroidism and hyperthyroidism can each negatively impact
fertility—both the ability to become pregnant and the ability to carry a fetus to term. The presence
of autoimmune antibodies, with or without hyper or hypothyroidism, can also impact your fertility.
Thyroid disorders are the most common endocrine problems in women. In most cases,
the thyroid can lead to infertility or miscarriages. Hypothyroidism is more common among women
and can often be detected with a simple blood test of thyroid-stimulating hormone (TSH). Still,
many women remain undiagnosed, especially women with ill-defined, subclinical hypothyroidism.
Common symptoms of hypothyroidism include:
 Frequent and heavy menstrual cycles
 Fatigue
 Muscle soreness
 Forgetfulness
 Dry skin and hair
 Weight gain
 Intolerance to cold
Hypothyroidism can impact fertility in the following ways:

  1. Disruption of the menstrual cycle, making it harder to conceive.
    Thyroid dysfunction can affect fertility in various ways resulting in anovulatory
    cycles, luteal phase defects, high prolactin (PRL) levels, and sex hormone imbalances. Many
    infertile women with hypothyroidism had associated hyperprolactinemia due to increased
    production of thyrotropin-releasing hormone (TRH) in ovulatory dysfunction. It has been
    recommended that in the presence of raised PRL, the treatment should be first given to correct
    the hypothyroidism before evaluating other causes of raised PRL. Measurement of TSH and PRL
    is routinely done as a part of an infertility workup.
  2. Interference with the release of an egg from the ovaries (ovulation)
    With hypothyroidism, your thyroid gland doesn’t produce enough of certain important
    hormones. Low levels of thyroid hormone can interfere with the release of an egg from
    your ovary (ovulation), which impairs fertility. Having low levels of thyroxine, or T4, or
    elevated thyroid-releasing hormone (TRH) leads to high prolactin levels. This can cause
    either no egg to release during ovulation or an irregular egg release and difficulty
    conceiving. Hypothyroidism can also cause a shortened second half of the menstrual
  3. Increased risk of miscarriage

Prevalence of hypothyroidism in the reproductive age group is 2–4% and has been
shown to be the cause of infertility and habitual abortion. Even minimal hypothyroidism
can increase rates of miscarriage and fetal death and may also have adverse effects on
the later cognitive development of the offspring.

  1. Increased risk of premature birth
    Thyroid hormone levels in the mother is very important in the growth and development
    of the baby, especially early in pregnancy. Thyroid hormones are also important for the
    normal development of the placenta, a critical component to maintaining pregnancy.
    Research has shown that high thyroid hormone levels (hyperthyroidism) or low thyroid
    hormones (hypothyroidism) are associated with poor outcomes for the mother and the
    developing newborn. Pregnant women with mild thyroid dysfunction, such as subclinical
    hypothyroidism, isolated hypothyroxinemia or thyroid peroxidase antibody positivity, are
    more likely to deliver preterm when compared with euthyroid women.
    Therefore, normal thyroid function is necessary for fertility, pregnancy, and to sustain a healthy
    pregnancy, even in the earliest days after conception. A thyroid evaluation should be done on any
    woman who wants to get pregnant with a family history of thyroid problems or irregular menstrual
    cycle or had more than two miscarriages or is unable to conceive after 1 year of unprotected
    intercourse. The comprehensive thyroid evaluation should include T 3, T 4, thyroid-stimulating
    hormone (TSH), and thyroid autoimmune testing such as thyroid peroxidase (TPO) antibodies,
    thyroglobulin/antithyroglobulin antibodies, and thyroid-stimulating immunoglobulin (TSI). Thyroid
    autoimmune testing may or may not be included in the basic fertility workup because the
    presence of thyroid antibodies doubles the risk of recurrent miscarriages in women with
    otherwise normal thyroid function.
    If you have any concerns about your thyroid function while pregnant or trying to become
    pregnant, talk to a reproductive endocrinologist or an obstetrician/gynaecologist trained in fertility
    and hypothyroidism. Call us at 8886592229 or visit and develop a plan
    to ensure that your thyroid disease doesn’t interfere with a healthy pregnancy.

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