Hypothyroidism and Infertility

Among a number of fairly common autoimmune diseases, known to cause recurrent IVF failure, is a thyroid disease called hypothyroidism. In this article, we find out what is thyroid disease – and hypothyroidism specifically; what symptoms it produces and how it affects fertility, as well as what treatment is available, especially if you are trying to conceive, whether naturally or through an assisted reproductive therapy (ART) such as IVF (in vitro fertilization).

The article below is based on a live webinar in which Dr Antonio Rodrigues, a reproductive medicine specialist and a founder and director of Medfem Fertility Clinic in Sandton, Johannesburg, South Africa, explained the impact of hypothyroidism on IVF success. You can also click here to watch the full hour-long webinar.

What is Hypothyroidism?

Thyroid disease – which is an autoimmune disease – is very common.

The thyroid gland is a small butterfly shaped organ located in the front of and at the base of the neck. It is a gland, which, like other glands in the body, create and release necessary substances. The thyroid makes hormones that assist in the control of many vital body functions and plays a critical role in cellular health and cellular metabolism.

The thyroid releases and controls the thyroid hormones that regulate metabolism – the process in which the food you eat is turned into the energy that keeps your body’s systems working correctly. As the thyroid hormones are used by the body, they are replaced by the thyroid.

The two thyroid hormones created by the thyroid are T4 (thyroxine) and T3 (triiodothyronine) and these hormones tell your body’s cells how much energy to use. When your thyroid is healthy, it will produce the right number of hormones to keep your metabolism working at the right rate.

The level of thyroid hormones in the bloodstream is monitored and controlled by the pituitary gland in the brain. If the pituitary gland detects a lack of or too much thyroid hormones, it will adjust the amounts with its own hormone called thyroid stimulating hormone (TSH). This hormone is sent to the thyroid and tells it what to do to correct the hormone levels.

If the thyroid is diseased, it impacts your entire body. Sometimes, people develop antibodies against a particular tissue in their bodies. Autoimmune thyroid disease is a common example of this: the body’s immune system actually attacks and damages the thyroid.

If the thyroid is overactive and produces too much thyroid hormone, a condition called hyperthyroidism can develop. If the thyroid is underactive and makes too little thyroid hormone, the result is hypothyroidism. Both of these conditions require medical treatment.

What Are the Symptoms of Hypothyroidism?

If your thyroid makes too little thyroid hormone – resulting in hypothyroidism – it can make you feel tired, gain weight and become intolerant to cold temperatures, or have cold hands and feet. Some other symptoms include constipation, dry skin and brain fogginess.

Hypothyroidism also affects fertility – and is a known among other common autoimmune diseases to cause recurrent IVF failure.

Most failed IVF cycles are related to abnormal embryos, as well as embryos failing to implant successfully in womb. In fact, the two essential factors for a successful IVF cycle are: healthy embryos; and a hospitable uterine environment in which embryos can implant successfully.

Autoimmune diseases like hypothyroidism can play a significant role in recurrent IVF failures because it negatively affects these two essential factors for a successful IVF cycle.

For women, the effect of hypothyroidism on fertility is evident in a lack of proper ovulation and/or a very thin or very thick lining in the uterus.

Hypothyroidism also causes poor egg quality. This causes problems with the ability of the sperm to bind to the egg, and to fertilize the egg naturally. It also results in poor quality embryos. In addition, a very thin or thick uterus lining is not receptive to an embryo implanting. These factors lead to infertility or recurrent miscarriages.

In men, the effect of hypothyroidism on fertility is evident in an abnormal semen analysis and problems with the sperm motility and count.

In addition, studies have also shown that the presence of thyroid antibodies in a woman’s body is associated with two factors in the uterus. The first is uterine receptor problems, referring to problems with the ability of the uterus to respond properly to estrogen and progesterone, and the implantation of an embryo. The second factor is that if there are antibodies, it’s a marker for other immune causes of recurrent implantation miscarriages and reduced live birth rates.

What Treatments Are Available

The cause of thyroid disease is probably related to the fast pace and excessive stress levels of modern life.

Hypothyroidism is quite common, and affects men and women, young and old. However, women are many times more likely than men to have this autoimmune disease. In fact, approximately 30% of women will have an underactive thyroid or hypothyroidism. However, a growing percentage of men are also being diagnosed with hypothyroidism.

It is very important to have a correct diagnosis, especially if you are trying to conceive, because the symptoms are similar to that of other diseases.

Thyroid disease can be detected is through simple and straightforward tests that determine the levels of the two hormones produced by the thyroid, T4 (thyroxine) and T3 (triiodothyronine), as well as the level of TSH (thyroid stimulating hormone) which produced by the pituitary gland when it detects a lack of or too much thyroid hormones in the blood. The level of TSH must be 2.5. In terms of fertility, a TSH level above 2.5 is abnormal.

To control hypothyroidism, you need to have thyroid hormone replacement therapy that perfectly controls the levels of thyroid hormones in your body. Fortunately, it is simple and cost-effective to treat hypothyroidism.

At Medfem Fertility Clinic, we use a treatment protocol that – from our experience – manages the condition perfectly. The thyroid hormone treatment involves taking the thyroid hormone called Levothyroxine in a tablet form every day. In addition, with regard to the antibodies, we use a treatment including 80 to 100 milligrams of Dispirin to help the blood supply to the uterus, cortisone in small doses to inhibit the antibodies, and immunoglobulins, both before embryo transfer, preferably during a natural cycle in terms of timing, as well as for the first 10 weeks of pregnancy, when the demand for thyroid hormone in the woman’s body increases.

Where To Get Treatment if Your are Trying to Conceive

Understanding the impact of autoimmune diseases on pregnancy and IVF success rates, our team at Medfem Fertility Clinic tests both male and female partners for autoimmune diseases and aggressively manage these issues before IVF treatment, to ensure the highest chance of conception. In addition, we use high-tech methods such as pre implantation genetic diagnosis (PGD) and pre implantation genetic screening (PGS) to screen eggs and embryos for specific abnormalities to improve the chances of success of an IVF cycle.

If you would like to know more about autoimmune diseases and their effect on fertility, or if you are concerned that you have an autoimmune disease that is affecting or could affect the success of your IVF treatment, we would be happy to answer your questions.

To meet one of our fertility specialists at Medfem Fertility Clinic, simply click here to book an initial consultation or contact us telephonically on +27 (11) 463 2244.

We look forward to meeting you!

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