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Thyroid matters during your IVF treatment.

The thyroid affects fertility in various ways, but is also being affected by fertility treatment medications. Here is how.

The thyroid gland plays an important role in regulating fertility. For ovulation to happen and conception to complete thyroid hormones need to be balanced and well functioning. When a disorder of the thyroid gland happens it make take longer to conceive, and it even may be hard getting to term with the pregnancy, as the risk of miscarriage increases. 

Both underactive (hypothyroidism) and overactive thyroid (hyperthyroidism) can be a problem when trying for a baby, so having your thyroid function checked and, in particular, thyroid hormones, such as TSH, T3 and T4, is an essential part of the initial tests, prior to having fertility treatment. If any abnormality is detected appropriate treatment maybe needed to facilitate conception.

Having noted the association of the thyroid with the reproductive system the next question is whether fertility treatment may affect the thyroid gland. Well, ovarian stimulation with hormonal treatment during IVF produces a state of increased demand for thyroid hormone production. As many follicles develop in both ovaries the increasing level of oestrogens, the hormone produced by ovarian follicles, leads to lower availability of thyroid hormone and this gives a signal to the thyroid gland to increase production of its hormones. So, having IVF treatment means your thyroid  gland will have to increase the production of its hormones, so it is important to know whether the thyroid function is normal right before starting any hormonal treatment, as part of IVF treatment. In any case a normal thyroid will make up for the increased demands.

According to a recent study published by the group of Dr Busnelli in July 2021, if your thyroid function tests come back normal as shown by blood tests prior to starting hormonal treatment, then, there may be no more benefit from repeating testing before having a positive pregnancy test. However, when treated for a thyroid disorder and you are on medical treatment, it is important to have a vigorous thyroid function assessment prior to hormonal stimulation for IVF and whenever judged by your endocrinologist adjustment of the dose you are having. The reason being that when your thyroid is dysfunctional it cannot make up for the increased demands during ovarian hormonal stimulation, so an adjustment in dose maybe needed to support the thyroid function. 

Thyroid function tests are important in checking your thyroid gland as part of fertility investigation. If you get to have IVF treatment, then it is important to have them checked and discuss with your doctor, if any adjustment in thyroid treatment is needed prior to IVF treatment and how often monitoring is required, especially, having a positive pregnancy test.

©2021, Nicholas Christoforidis, Fertility Matters
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