Your thyroid might not immediately come to mind when considering fertility, but it plays a crucial role in your overall health and reproductive well-being.
This butterfly-shaped gland sits low on the front of your neck. Although small, measuring about two inches, the thyroid is vital for maintaining overall health. It releases hormones that regulate metabolism, heartbeat, digestive function, and body temperature. As well, by controlling hormone release into the bloodstream, the thyroid significantly impacts fertility for both men and women.
In honour of Thyroid Awareness Month, we spoke with Dr. Tanya Williams, who answered the most commonly asked questions about thyroid health and fertility.
1. What are the common signs and symptoms of thyroid problems?
When your thyroid isn’t functioning correctly, it affects your entire body. Thyroid issues generally fall into two categories based on hormone levels: hyperthyroidism and hypothyroidism.
Hyperthyroidism occurs when your thyroid produces too many hormones. Symptoms of an overactive thyroid include fatigue, weight loss, tremors, feeling hot, excessive sweating, hair loss, depression, and memory problems.
Hypothyroidism happens 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 clomiphene citrate, one of the most commonly used fertility drugs, is linked to an increased risk of thyroid cancer in women. However, the most common types of thyroid cancer have nearly a 100 percent survival rate.
3. Is thyroid dysfunction causing my fertility issues?
Undiagnosed thyroid problems can make it harder for women to conceive, as any thyroid disorder may disrupt ovulation.
Dr. Tanya Williams says, “Women with overt hypothyroidism should receive thyroid hormone replacement once diagnosed to improve both their fertility and pregnancy outcomes.”
She adds, “The more controversial issue is whether treating subclinical hypothyroidism affects fertility rates. Subclinical hypothyroidism is characterized by elevated thyroid-stimulating hormone (TSH) levels with normal free thyroid hormone levels and the presence of thyroid autoantibodies.”
4. How do thyroid disorders affect my menstrual cycle and fertility?
Thyroid problems can lead to noticeable changes in your menstrual cycle. Common signs of thyroid dysfunction include having periods that come closer together or experiencing heavier menstrual flow.
5. How can hypothyroidism or hyperthyroidism affect my baby?
Your thyroid hormones are crucial for your baby’s brain and nervous system development. Among the two thyroid conditions, untreated hypothyroidism poses the greatest risk to your growing baby. Without proper medical treatment, both you and your baby may face risks such as preeclampsia, anemia, low birth weight, stillbirth, IQ problems, and other developmental issues.
6. Did thyroid issues cause my miscarriage?
Women with thyroid dysfunction face higher risk of miscarriage, preterm delivery, and developmental problems in their babies. Fortunately, most thyroid conditions can be effectively managed with proper medical care.
Dr. Williams notes, “Current evidence supports using thyroid hormone replacement for women with both subclinical and overt hypothyroidism to reduce miscarriage rates and improve live birth rates.”
7. How do doctors treat thyroid problems during pregnancy?
More than half of those with thyroid issues are unaware of their condition. If you discover you have hyperthyroidism during pregnancy, doctors may treat you with a medication called propylthiouracil (PTU). For hypothyroidism, you will receive a synthetic hormone called levothyroxine to replace the thyroid hormone your body is not producing. Be sure to discuss with your doctor how your prenatal vitamin might affect the absorption of your thyroid medication.
8. Do thyroid problems in men affect sperm count?
Men’s thyroid glands play a crucial role in their overall health and hormone balance. Thyroid disorders in men can lower sperm quality and motility, making it more difficult 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. However, 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%. Moreover, 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. Therefore, 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.
