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Thyroid And Infertility In Women

Women may experience fertility issues for multiple reasons, and often times it is hard to determine the exact cause. However, the possibility of an undiagnosed thyroid condition is one factor that many women with fertility issues may not be aware of.

Thyroid is a tiny gland found in the neck. Everything in our body (from the temperature to metabolism) is controlled by thyroid through the hormones it releases. The pituitary gland sends a message to the thyroid gland via thyroid-stimulating hormone (TSH) and releases triiodothyronine (T3), thyroxine (T4), and calcitonin. Women are more prone to Thyroid conditions. While it is known that an imbalance of T3, T4 and TSH can alter a person’s weight or mood, not many are aware that it can also impact one’s menstrual cycle and fertility.

Hyperthyroidism:

Production of high levels of thyroid hormones in the thyroid gland results in hyperthyroidism. Weight loss, increased appetite, stress, nervousness and anxiety, difficulty in sleeping, hair loss, lighter menstrual cycles, excessive sweating and heat intolerance are some of the symptoms of Hyperthyroidism.

Hypothyroidism:

Production of low levels of thyroid hormones in the thyroid gland results in hypothyroidism. Weight gain, fatigue, constipation, thinning hair, pale skin and heavier menstrual cycles are some of the common symptoms of Hypothyroidism. Polycystic Ovarian Syndrome (PCOS) and Hypothyroidism have common similarities which is why doctors usually check thyroid hormones when evaluating patients PCOS or hypothyroidism.

Thyroid & Infertility:

Bodily hormone changes occurred due to hypothyroidism may lead to irregular menstrual cycles and other menstrual issues that can affect fertility. Both hyper & hypothyroidism prevent ovulation (process in which an egg is released every month to be fertilised). Even if one is having regular menstrual cycle, if no egg is released, one cannot conceive.

Thyroid disorders can cause infertility in many other ways as well. Hypothyroidism can cause cysts on the ovaries. In addition, it can also lead to increase in the production of a hormone called prolactin which controls lactation or milk production in women who are not pregnant. Ovulation might not occur when prolactin levels are high.

Risk of miscarriage is also linked to hypothyroidism. Miscarriage is more likely to be seen in women with hypothyroidism than women without hypothyroidism. There is also a risk of having babies with developmental problems and low IQ levels among women with untreated hypothyroidism.

Treatment for thyroid disorders:

Risk for any issues impacting your ability to conceive can be decreased if thyroid disorders are treated before trying to have kids. Hyper and hypothyroidism are treated depending on the severity of symptoms, however they can also be addressed with medications prescribed by an endocrinologist.

Hypothyroidism and Pregnancy:

It is important to monitor one’s thyroid hormone levels throughout pregnancy once conceived. Medication dosage needs to be adjusted to keep one’s TSH level under control. Pregnancy or fetus might not get affected due to mildly low thyroid hormone levels most of the time. However, severe hypothyroidism could lead to miscarriage and fetal death. Therefore, consumption of medication throughout pregnancy is vital.

There is also an increased risk for postpartum thyroiditis, or inflammation of the thyroid post pregnancy. This happens to five to ten out of every 100 women within the first year after childbirth which in turn can lead to temporary hypothyroidism, hyperthyroidism, or hyperthyroidism followed by hypothyroidism.

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Dr. Vaishali Sharma

Guest Author Consultant – Reproductive Medicine, Milann Fertility Centre & Hospital, Delhi

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