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Dr. Williams Answers your Questions about the Thyroid and Fertility

TW Fertility Centre - January 22, 2021 - 2 comments

Your thyroid might not be the first thing that comes to mind when you think about your fertility. However, a healthy thyroid plays an essential role in your overall health and fertility. 

The thyroid is a butterfly-shaped gland that sits low on the front of the neck. Small but mighty, this two-inch gland is vital for overall health. The thyroid releases hormones that control your metabolism, heartbeat, digestive function, and temperature. It’s also responsible for releasing hormones into the bloodstream, making thyroid function an essential part of men and women’s fertility. 

In honour of Thyroid Awareness Month, we spoke to Dr. Tanya Williams and she answered the most commonly asked questions about the thyroid and fertility.

1. What are the common signs and symptoms of thyroid problems?

If your thyroid isn’t working correctly, it will affect your entire body. There are two different categories of thyroid problems that relate to hormone levels: hyperthyroidism and hypothyroidism

Hyperthyroidism is when your thyroid creates too many hormones. Overactive thyroid symptoms include fatigue, weight loss, tremors, feeling hot, sweating a lot, hair loss, depression, and memory problems. 

Meanwhile, hypothyroidism is when your thyroid doesn’t produce enough hormones. Symptoms of an underactive thyroid include thinning hair, weight gain, cold intolerance, a slow heartbeat, heavy periods and constipation.

2. Do fertility drugs cause thyroid problems?

A recent study shows that taking one of the most commonly used fertility drugs, clomiphene citrate, is associated with an increase in women’s thyroid cancer. Though, the most common types of thyroid cancer have a nearly 100 percent survival rate.

3. Are thyroid problems the reason why I’m experiencing fertility issues?

Undiagnosed thyroid dysfunction makes it more difficult for women to conceive since any thyroid disorder can interfere with ovulation.  

Dr. Tanya Williams says “women with overt hypothyroidism should be treated with thyroid hormone replacement once diagnosed, in order to improve their fertility and their pregnancy outcomes.”  

She adds “what is more controversial is whether treating subclinical hypothyroidism affects fertility rates. Subclinical hypothyroidism is defined as an elevated thyroid stimulating hormone (TSH), with normal free thyroid hormone levels, and the presence of thyroid autoantibodies.”

4. How does thyroid disorders affect my menstrual cycle and fertility?

If you’re experiencing problems with your thyroid, you might notice changes in your menstrual cycle.  Common signs that you may have thyroid dysfunction include having periods closer together or experiencing heavier menstrual flow.

5. How can hypothyroidism or hyperthyroidism affect my baby?

Your body’s thyroid hormones play an essential role in your baby’s brain and nervous system development. Between the two thyroid conditions, untreated hypothyroidism can have the most impact on your growing baby. Without proper medical treatment, moms and babies are at risk for preeclampsia, anemia, low birth weight, stillbirth, IQ problems and other developmental issues. 

6. Did I have a miscarriage because of issues with my thyroid?

Women with thyroid dysfunction are more likely to experience miscarriage, preterm delivery or have babies with developmental problems. The good news is most thyroid diseases can be easily managed with proper medical care.

“Currently there is evidence to support giving thyroid hormone replacement in women with subclinical hypothyroidism as well as in women with overt hypothyroidism in order to reduce miscarriage rates and subsequently increase livebirth rates,” adds Dr. Williams.

7. How are thyroid problems treated during pregnancy?

More than half of those with thyroid problems are unaware of their condition. If you find out that you have hyperthyroidism in pregnancy, you may be treated with a medication called propylthiouracil (PTU). Meanwhile, if you have hypothyroidism, you’ll be treated with a synthetic hormone called levothyroxine, to replace the hormone that the thyroid gland is not making. Be sure to talk to your doctor about how your prenatal vitamin may affect the absorption of your thyroid medication.

8. Do thyroid problems in men affect sperm count?

Men’s thyroid glands are a key player in their overall health and hormones. Men with thyroid disorders have lower quality sperm that is less motile, making it more challenging to fertilize an egg.

9. What are the chances of getting pregnant with hypothyroidism or hyperthyroidism?

“Disorders of thyroid hormone production can cause infertility or subfertility by interfering with reproductive hormones, resulting in changes in ovulation,” explains Dr. Williams. In those not trying to conceive, the normal range for thyroid stimulating hormone (TSH) is 0.5 – 4.5. In women who are trying to conceive, the upper limit of TSH is 2.5.  The incidence of hypothyroidism in adult females is 0.5% and hyperthyroidism is 0.2%. All women who present with infertility, subfertility or recurrent pregnancy loss should be screened for thyroid disease. Once the thyroid dysfunction is treated, and thyroid hormone levels return to normal, a significant proportion of these women will be able to conceive on their own.”

10. Can I get pregnant without a thyroid?

In some circumstances, people with thyroid dysfunction will have had their thyroid fully or partially removed. Patients who receive thyroid cancer treatment are cleared to get pregnant six months after their treatment is completed.   They will be placed on thyroid hormone replacement treatment and once their hormone levels are stable, their chances of having a baby are similar to women who have normal thyroid levels on their own.

Getting your thyroid tested before conceiving

Ensuring that your thyroid is healthy and functioning is essential in preparing your body for conception and pregnancy. If you’re looking to start growing your family and want a clearer picture of you and your partner’s overall health, download our patient referral form and contact us today. 

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