As a thyroid patient, I am amazed at how many underlying conditions improper thyroid hormone levels can cause, including infertility. And when I ask people "Have you had your thyroid checked?" they usually say "Yes." But then they aren't sure what tests they had, or what the results were, other than "normal."
I've also learned how under-educated many physicians are about properly recognizing and treating thyroid symptoms, and how many people differently interpret lab results. They use the word "normal" a lot, even though, really, everyone's definition of normal is different, and for many reasons. Many websites don't even mention thyroid problems as a cause for infertility, which concerns me: if they don't say anything about it, will your doctor?
Infertility problems are apparently very common among our population - and guess what? So are thyroid problems. I find it very hard to believe that so many women are infertile "just because." Many women don't even know they have it, and probably would never suspect it's a cause of why they can't get pregnant or can't carry a pregnancy to term.
When testing you for thyroid dysfunction, many doctors simply order one or two tests, usually a TSH (thyroid stimulating hormone). There is a wide range of normal, and it varies from lab to lab. If you fall somewhere in the "normal" range, that's usually as far as many physicians get. You might have other underlying symptoms that seem normal to you (or none at all, other than you can't get pregnant). It's really important, though, to have a complete panel with more extensive bloodwork done to look at individual hormone levels, rather than just the "big picture" (which sometimes gives a misleading result).
After Googling some fertility clinics and the blood workups they typically order, many will routinely order the TSH, free T3 and T4. That might be enough and it might not be. I have normal TSH and T3/T4 levels, but I still have hypo symptoms because my antibodies are high, which points to Hashimoto's, an autoimmune precursor that slowly destroys the thyroid gland. But your bloodwork (at least the few tests they did) comes back normal - could Hashi's be the cause? Yes!
Because of misleading TSH results, many patients go virtually untreated for hypothyroidism for years, which can result in an accumulation of symptoms and damage to the thyroid gland. Some people are hypo and don't even know it.
For some women, hypothyroidism can impair fertility because it interferes with ovulation. While it's recommended for women to get a complete bloodwork panel done, I wonder how many doctors turn to this first before recommending invasive procedures like IVF or a round of fertility drugs.
Hypothyroidism can also cause menstrual irregularities in some women, which can create whacked out fertility cycles when trying to get pregnant. Scant or very heavy periods are often clues that something is wrong with the thyroid. My grandmother has been on thyroid medication for years, and I only just realized that her extremely heavy periods - which resulted in a hysterectomy at age 40 - were probably from improperly treated hypothyroidism.
Hyperthyroidism - when the thyroid produces too much hormone - can also cause infertility by inhibiting ovulation. It can also produce light periods, which make it harder to track your cycles and conceive. In some women, thyroid problems can cause PCOS, which also inhibits conception. It can also cause repeated miscarriages in many women as well.
If you have had bloodwork done for thyroid and are still having problems getting pregnant, go over your results. Ask what specific tests were done and ask to see the results on paper so you have them for your records. Knowing what tests to ask for - and what they mean - can be the difference between struggling through invasive procedures for months, if not years, and having a baby.
More reading:
Hypothyroidism and Infertility: How thyroid problems can challenge your fertility
PCOS and Thyroid Disorders - What's the connection?
1 comments:
Infertility can be a very emotionally draining problem to combat. Many people will not openly admit that there is a problem because of embarrassment.
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