Normal thyroid functions are vitally important for fertility. It is therefore advisable to have your thyroid functions tested as part of the fertility screening exercise.
Testing your Thyroid
The most common test recommended by doctors is the following:
Thyroid Profile Test (TSH, FT3, FT4) – £85
How Thyroid can impact on fertility
Thyroid issues can impact on fertility in the following ways:
Disrupting menstrual cycles
The menstrual cycle is much more complex than you might imagine. It is a carefully orchestrated process that provides a small window of opportunity for an egg to be fertilised by sperm each month.
Thyroid problems can interrupt this complex process and can result in an irregular menstrual cycle or even the absence of menstruation altogether (amenorrhoea).
Interacting with key reproductive hormones to induce Anovulatory cycles
Anovulation means that you are not ovulating i.e. not releasing an egg. Luteinizing Hormone (LH) has the task of stimulating the ovary to release the egg. If thyroid hormone levels are not ideal they cannot support LH to do this. If no egg is released this makes pregnancy impossible. It is still possible to menstruate regularly but not ovulate so you may not be aware of this.
Impeding fetal growth and development
During pregnancy, fetal growth and development is controlled by maternal thyroid hormone, with help from fetal thyroid hormone later in pregnancy. Growth and development continue to be regulated by the thyroid postpartum. Thyroid issues impede fetal growth and its development. For example, there is an increased risk of miscarriage in the early stages of pregnancy if your hyperthyroidism is not under control. Moreover, untreated hyperthyroidism can also lead to complications of high blood pressure in pregnancy, poor growth of the baby and premature delivery.
What can go wrong in thyroid?
Your thyroid can be underactive (Hypothyroidism) or overactive (Hyperthyroidism)
What is hypothyroidism?
Hypothyroidism is the name given to the condition resulting from an under-active thyroid gland. This means that it is not producing enough thyroid hormone for the body’s needs.
What are the symptoms of hypothyroidism?
Typical symptoms include:
- Fatigue and tiredness
- Heavier and longer periods
- Weight gain
- Puffy face and bags under the eyes
- Slow speech, movements and thoughts
- Low mood or depression
- Memory problems
- Difficulty in concentration
- Fertility problems
- Low libido
What causes hypothyroidism?
Autoimmune thyroid disease is the most common cause whereby the body’s immune system attacks the thyroid cells as though they were foreign cells. The most common form is known as ‘Hashimoto’s thyroiditis’
Other causes include a malfunction of the pituitary gland, genetic, radioactive iodine treatment, overdose of antithyroid drugs and some health foods taken in excess, e.g. kelp (seaweed).
How is hypothyroidism diagnosed?
An under-active thyroid is typically associated with a thyroid-stimulating hormone (TSH) level above the reference range and a thyroxin (FT4) level that is below the reference range.
A blood test result showing a slightly raised TSH level with a normal FT4 level indicates that you may have mild thyroid failure or subclinical hypothyroidism, and that you may have an increased risk of eventually developing hypothyroidism.
How is hypothyroidism treated?
Your doctor will prescribe levothyroxine, a synthetic version of the thyroxin produced by the thyroid gland.
What is Hyperthyroidism?
Hypothyroidism is the name given to the condition resulting from an over-active thyroid gland. This means that it is producing too much thyroid hormone for the body’s needs.
An overactive thyroid can affect anyone, but it’s about 10 times more common in women than men and it typically starts between 20 and 40 years of age.
Symptoms of Hyperthyroidism
Typical symptoms include:
- Mood swings
- Nervousness, anxiety and irritability
- Persistent tiredness and weakness
- Sensitivity to heat
- Swelling in your neck from an enlarged thyroid gland
- An irregular and/or unusually fast heart rate (palpitations)
- Twitching or trembling
- Weight loss
Causes of an overactive thyroid
Common causes include Graves’ disease – where the body’s immune system mistakenly attacks and damages the thyroid; lumps (nodules) on the thyroid – this results in extra thyroid tissue, which can mean extra thyroid hormones are produced and certain medications – such as amiodarone, a medication for an irregular heart beat.
How is hyperthyroidism diagnosed?
An over-active thyroid is typically associated with a thyroid-stimulating hormone (TSH) level below the reference range and a thyroxin (FT4) level that is above the reference range.
How is Hyperthyroidism treated?
Your doctor will prescribe medicine called thionamides, this stop your thyroid producing excess hormones. The main types used are carbimazole and propylthiouracil.
Side effects of thyroid medication
If you are taking antithyroid drugs there is a very slight increased risk of the baby developing structural abnormalities so some patients choose to have definitive treatment of Graves’ disease with radioactive iodine or surgery before considering a pregnancy. Also, if the dose of antithyroid drugs is too high, the baby’s thyroid may become under-active and the baby may develop a goitre.
What to do next?
There is strong evidence to suggest that Chinese herbal medication may help DNA fragmentation as many herbs contain anti-oxidants. We will explore with you options that you may wish to take in light of results received.
How do I arrange a test?
Give us a call on 0207 096 0283 and we can arrange the test for you the next day.
We have a wealth of experience in fertility treatment for both males and females at TCM Healthcare – contact us to find the best solution for your situation. Call us on: 0207 096 0283
Professor Shun Au OBE
TCM Healthcare Fertility Clinic