The end of April marks Infertility Awareness Week. Because many complex factors are involved in reproduction it takes a great deal of effort to properly diagnose and work through any obstructing conditions. One of the more common instigators of infertility is a thyroid condition. The thyroid is highly integrated with numerous bodily processes such as one’s metabolism, cell and brain function, and even reproduction. Unexplained infertility is frequently blamed on physical or psychological stress. However, when there is no obvious reason why one is experiencing reproductive issues it is often due to the presence of an untreated thyroid condition. Unfortunately, many are unaware that the source of their fertility issues may be linked to an undiagnosed thyroid condition.
According to the Thyroid Federation International, there are over 300 million people living with an undiagnosed thyroid condition. Because thyroid conditions are more frequently found among women, the likelihood of such a disorder impacting their reproductive ability is increased. Although it is well-documented that thyroid disorders are frequently causal to one’s infertility issues, thyroid testing is not common during pre-conception doctor visits or suggested by many ob-gyns and fertility clinics. Perhaps the reason is because, according to the journal Thyroid, only 63% of doctors are well-informed regarding the association between the thyroid and fertility. Being educated on the powerful effect of the thyroid and its relation to infertility is important not only for those planning on pregnancy, but for one’s overall health as well.
The Thyroidal Influence
Even minor fluctuations in thyroid function can influence one’s fertility. Regardless of whether one’s thyroid is underperforming or overproducing the results can impact one’s reproductive ability.
Fertility: Reduced Thyroid Function
An underactive thyroid, also known as hypothyroidism, is one of the most common thyroid conditions. Unfortunately, it is also an instigator of infertility. When one’s thyroid is not providing adequate hormones, the body acts to stabilize the imbalance. To reinstate normal thyroid function, the body releases additional TRH (thyroid-releasing hormone) to stimulate the release of TSH (thyroid-stimulating hormone). Although TRH is a necessary piece in thyroid stimulation it also increases production of prolactin. This hormone promotes lactation but also negatively impacts ovulation. Excess prolactin in one’s system causes the ovaries to be incapable of releasing a monthly egg. Irregular and inconsistent ovulation can make it incredibly challenging to achieve pregnancy.
Studies have found that pregnant women with hypothyroidism have increased risk of miscarriage and other gestational morbidities. In part, this could be attributed to poor metabolization of sex hormones, which is associated with hypothyroidism. Improper utilization of hormones can interfere with reproductive cycles, pregnancy, and induce ovulatory disorders. A study published by the Journal of Clinical Endocrinology and Metabolism investigated TSH levels and pregnancy results among hypothyroid women utilizing thyroid replacement therapy. The study consisted of over 50,000 hypothyroid women. It was found that appropriately regulating TSH levels during pregnancy was critical to its success. Furthermore, researchers recommended that thyroid dosage be increased soon after conception to appropriately accommodate the additional need of thyroid hormone. Carefully monitoring one’s thyroid, particularly during pregnancy, is critical for those with a thyroid condition.
Fertility: Increased Thyroid Function
On the other end of the spectrum, if one’s thyroid is overactive, excess levels of thyroid hormone can be present in one’s system. An overload of thyroid hormone increases sex hormone metabolization which can inhibit their efficacy. If a hormone such as estrogen is unable to appropriately complete its duties, one’s endometrium (uterine lining) can be severely weakened. A fragile endometrium can lead to uterine bleeding and becomes incapable of providing a healthy environment for fetal growth. Furthermore, without a fully formed and strong endometrium, it may be impossible to complete implantation of a fertilized egg.
Being Pregnant with a Thyroid Condition
Living with a thyroid condition is already quite difficult. However, pursuing pregnancy while also having thyroidal difficulties is an even greater challenge. If you have already been diagnosed with a thyroid condition and plan on becoming pregnant, it is prudent to schedule a pre-conception appointment. This important meeting with your doctor should optimally take place at least 3 months before pregnancy. Engaging in this preparatory process can uncover thyroid imbalances and possible autoimmune disorders that inhibit thyroid function.
Hypothyroid women require additional thyroid support, up to a 50% increase in medication, during the early stages of pregnancy. Throughout the first trimester, a baby’s neurological development relies on the availability of the mother’s thyroid hormones. Studies have found that improper hormone levels can cause unborn babies to develop poorly. Notably underdeveloped psychomotor skills, cognitive function, and brain development have been linked to hormonal imbalances during pregnancy. Because of the increased demand for thyroid hormones that occurs during the early stages of pregnancy it is important to appropriately prepare for it. Proper medical testing and care will allow for greater tuning of one’s medication and treatment. If you have a confirmed pregnancy, immediately consult your physician regarding thyroid supplementation.
Finding the Solution
The journey of pregnancy can be a fantastic experience or an exceptionally challenging and frustrating one. Those who have experienced or continue to suffer through infertility understand the exhausting and heartbreaking process of undergoing numerous tests and unsuccessful pregnancies. If one is living with unexplained infertility, it is worth the investment to have their thyroid examined. Regardless of the way one’s thyroid is imbalanced the thyroid has great impact on the uterus. An appropriately functioning thyroid is critical for proper reproductive function. Conversely, a malfunctioning thyroid can lead to infertility and miscarriages.
Properly balancing and optimizing the thyroid may not just improve bodily function but it may also be the key to alleviating reproductive difficulties. The best course of action is to take care of one’s thyroid through proper testing, treatment, and regulation. In some cases, restoring thyroid function to its optimal level can resolve infertility woes and make pregnancy possible.