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Posts Tagged ‘thyroid and infertility’

When thinking of infertility, everyone turns to women who don’t have children. But what happens in those cases when a women already has a child, or two and is going through years of pain and anguish from being unable to conceive again?

Inability is generally measured as no success after one year of trying if you’re under 35, or six months of trying if you’re over 35. It can be caused by reductions in fertility due to age or there can be a variety of reasons for secondary infertility.

Thyroid problems play a big part in this, an STI, or ovarian cysts. And lets not overlook that woman’s tubes can be blocked after the previous delivery.

Doctors take this issue lightly, or at least they did. If after years of trying women goes into unexplained miscarriage she is sent home with little or no explanation. The easiest way to explain is always “a generic disorder”. But no one ever explains what causes it in healthy couples.

Today more than 80% of American women suffer from thyroid problems, starting as early as teen years. Only 30% are treated with medication and are provided help. For the remaining 50% there are unexplained health problems that can cause:

Unexplained female problems (tumors, fibroids, ovarian cysts, endometriosis, PMS, cramps, (dysmenorrhea), amenorrhea, female cancers, spontaneous abortion, cyclic seizures, dry vagina and infertility), weight problems (usually high, sometimes low), gallbladder disease (six times higher in women with excess estrogen or on birth control pills or ERT), heart disease, cancer, colon problems, low blood sugar, attention deficit disorder (ADD), adrenal exhaustion from excess secretion of adrenaline, and osteoporosis (from excess estrogen leading to excess adrenaline and then to excess cortisol), depression.

The screening blood tests provided in the hospitals for thyroid are only 30% accurate, which leaves all those women sent home without any explanation on why they are going trough so many health issues. It is common for a hypothyroid person to have a completely normal thyroid panel.  This is why the Thyroid Panel is considered by many to be inadequate. They are mostly treated for something that has nothing to do with the issue at hand.

It is common for a hypothyroid person to have a low TSH value, which is usually interpreted as hyperthyroidism, not the reverse, despite many symptoms of low thyroid (depression, dry skin, weight problems, chronic infections, female problems, hair loss, low blood sugar, and so on).

TSH tests are not as scientifically accurate as they need to be. TSH tests are not as high in sensitivity as the tests that identify if you have anemia. If you are told by your doctor that your TSH test came back normal despite all your symptoms talk to him about more testing. Let him know that you are informed about test not being as high in sensitivity and specificity as red and white counts.

There is a sophisticated test to reveal even mild low thyroid and it is the TRH (Thyrotropin Releasing Hormone) test. This test requires an injection, followed by one or more blood draws at 15, 30 and 45 minute intervals. This test is accurate, but is expensive and inconvenient for both patient and the lab.

If you are experiencing secondary infertility, or you have had an unexplained miscarriage talk to your doctor, ask questions about the possible health problems such as thyroid problems, an STI, tubal blockage, or ovarian cysts. Seek more tests, and look at the issue from every possible way.

Source: Suzana Uzelac (aka Firefly)

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Thyroid has a lot to do with our fertility and ovulation.  I have posted some information here regarding the variety of thyroid conditions.  This is a standard test that should be done to rule out this possibility, however there is a thyroid antibody test that is rarely done.  I myself am someone who has been affected by this condition. It has taken me almost 3 years and 2 miscarriages to figure this out.  I just happen to ask about getting my thyroid antibody test done and it came back positive.  So do your research and ask for all the tests, you never know!  This is the last place I suspected to find the answers.

Hyperthyroidism – or having an overactive thyroid gland – can pose special concerns during pregnancy. When the body delivers too much thyroid hormone, both the mother and the baby can suffer. Miscarriages, premature births, and intrauterine growth retardation can occur when the disorder goes undiagnosed or untreated. Pregnant women with hyperthyroidism can also develop high blood pressure, and are at greater risk of heart conditions.

While a thyroid condition can sometimes complicate the process of getting – or staying – pregnant, the good news is that when your disease is properly managed, most of you with thyroid conditions — whether hypothyroid or hyperthyroid — can have a safe, uneventful pregnancy and delivery. Taking your medications, keeping your thyroid levels — including TSH and T4 — under control, getting regular care with a specialist familiar with treating pregnant thyroid patients, and taking charge of your own health appears to be key to a successful outcome.

In some cases, pregnancy can actually lessen the symptoms of thyroid disease, and you may be one of the many women who enjoy a nine-month respite from some of the undesirable effects of thyroid conditions.

If I could urge women with thyroid disease who are contemplating pregnancy to do one thing, it would be to become educated about how thyroid dysfunction can affect fertility and pregnancy – and what to do about it. Read all you can, ask questions, and urge your doctors to perform the necessary blood tests to keep your levels in check.

Will my thyroid disease hamper my ability to get pregnant?

Sometimes – but certainly not always – thyroid disease can affect your fertility. According to Dr. Sheldon Rubenfeld, a practicing thyroidologist, and Founding Chairman of the Thyroid Society for Education and Research, fairly common problems caused by thyroid dysfunction are anovulation (no ovulation, or release of an egg) and menstrual irregularities. With no egg to fertilize, conception is impossible.

Thyroid dysfunction can halt ovulation by upsetting the balance of the body’s natural reproductive hormones. One way to tell if you’re ovulating is to test the level of a pituitary hormone called LH (or luteinizing hormone) by using an ovulation predictor kit. LH stimulates the ovaries to release an egg. The kit will show you if you have that surge in LH that indicates ovulation. If there is too much or too little thyroid hormone, ovulation might not occur. Remember…even though you may be menstruating regularly, you may not be ovulating – and may never know that fact until after years of infertility.

In addition, some women experience a short luteal phase. The luteal phase is the timeframe between ovulation and onset of menstruation. The luteal phase needs to be of sufficient duration — a normal luteal phase is approximately 13 to 15 days — to nurture a fertilized egg. A shortened luteal phase can cause what appears to be infertility, but is in fact failure to sustain a fertilized egg, with loss of the very early pregnancy at around the same time as menstruation would typically begin.

Dr. Rubenfeld said that “the mechanisms by which thyroid problems interfere with fertility are often unknown, but there is no question that other aspects of thyroid function affect fertility.” For example, Dr. Rubenfeld said that hypothyroidism can cause an increase in prolactin, the hormone produced by the pituitary gland that induces and maintains the production of breast milk in a post-partum woman. Excess prolactin has a negative effect on fertility – sometimes preventing ovulation, or sometimes causing irregular or absent monthly cycles.

The increase in prolactin may be caused by an elevation of a hormone from the hypothalamus called TRH (or thyrotropin releasing hormone) that stimulates the pituitary gland to send out both prolactin and TSH.

Some women with hypothyroidism also have polycystic ovaries, or cysts on the ovaries, which hamper ovulation and can cause fertility problems as well.

This all sounds pretty grim. Should I even bother trying? What can I do to maximize my chances of getting pregnant?

Yes, you should bother trying – there are many, many success stories (I happen to be one of them, as it only took a few months to get pregnant with my daughter). You shouldn’t go into this thinking it’s going to be a long, arduous process. But attempting pregnancy with a thyroid condition may require a little preparation.

First of all, talk to your doctor about when you should attempt conception. Many doctors think TSH levels of 3, 4, or even 5 may acceptable to try to get pregnant. But research suggests otherwise. In 1994, a study in the Journal of Clinical Endocrinology and Metabolism looked at pregnant women with thyroid antibodies and TSH in the normal range. The study found that women with autoimmune thyroid disease had TSH values significantly higher, though still normal, in the first trimester than in women with healthy pregnancies used as controls.

The higher TSH level of the women with autoimmune thyroid disease? 1.6.

The normal TSH level for the control group of pregnant woman without autoimmune thyroid disease? 0.9. A TSH of .9 is a far cry from the so-called “normal” TSH levels of 3 or 4 or 5 that some doctors feel are no impediment whatsoever to getting — or staying — pregnant.

My endocrinologist at the time I was trying to get pregnant believed very firmly that most women with a thyroid problem should be maintained at a TSH level of between 1 and 2 in order to help them get pregnant — and maintain the pregnancy.

Second, ascertain whether you’re ovulating. An excellent, empowering book is Toni Wechsler’s Taking Charge of Your Fertility.. You can learn how to use basal temperature and other fertility signs to chart your monthly hormonal cycle. You can also use an over-the-counter ovulation predictor kits, available for around $10 at the drugstore, to confirm ovulation. Or the more expensive ovulation predictor electronic devices can also be used.

What if I can’t get pregnant, but my thyroid tests “normal?” Or what if I test positive for “antibodies?”

Some women who have fertility problems actually have underlying autoimmune thyroid problems, but they and their doctors are not aware. If you or someone you know is having difficulty getting pregnant, or is suffering recurrent miscarriage, thyroid antibodies should be tested.

Many doctors do not appear to know about this link between antibodies and infertility, yet it is published in conventional research journals. The respected journal Obstetrics & Gynecology reported that the presence of antithyroid antibodies increases the risk of miscarriage. And according to U.S. research reported in the Journal of Clinical Endocrinology and Metabolism, that risk of miscarriage can be twice as high for women who have antithyroid antibodies.

Researchers have also demonstrated that antithyroid antibodies can cause greater difficulty conceiving after in vitro fertilization, regardless of whether or not there are clinical symptoms of hypothyroidism. The researchers had greater success in achieving successful pregnancies when they gave low doses of heparin (an anti blood clotting agent) and aspirin and/or intravenous immunoglobulin G (IVIG) to women who had antithyroid antibodies.

Thyroid INFO by Mary Shomon

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