Thyroid Hormone in Fertility

1
Thyroid and Fertility

• Femelife Fertility

• www.femelife.com

2
What is subclinical hypothyroidism?

• SCH is classically defined as a thyrotropin
• (TSH) level above the upper limit of normal
• range (4.5-5.0 mIU/L) with normal free thyroxine
• (FT4) levels.

3
Should non-pregnant women be treated for SCH
(subclinical Hypothyroidism)?

• There is no benefit from the standpoint
• of lipid profile or alteration of cardiovascular
• risk in non-pregnant women.

4
How does your thyroid affect your pregnancy?

5
Thyroid affects Pregnancy

• TSH levels outside the normal pregnancy range are
• associated with an increased risk of such
• obstetric complications as placental abruption,
• preterm birth, foetal death, and preterm
• premature rupture of membranes (PPROM).

6








Can you get pregnant if you have thyroid
problems?

• Unexplained infertility and ovulatory disorders
  can cause infertility in patients with low
  thyroid levels.

7
Can a thyroid problem cause a miscarriage?
Low thyroid hormone is associated with adverse
reproductive outcomes including miscarriage,
pregnancy complications, and delayed foetal
neurodevelopment. There is fair evidence that
thyroid autoimmunity (positive thyroid antibody)
is associated with miscarriage and infertility.
Treating TSH levels gt4.0 mIU/L is associated with
improved pregnancy and miscarriage rates
8
What should be the thyroid level during
pregnancy?

• The Endocrine Society recommends the following
  pregnancy trimester guidelines for TSH levels
• 2.5 mIU/L is the recommended upper limit of
  normal in the first trimester, 3.0 mIU/L in the
  second trimester, and 3.5 mIU/L in the third
  trimester.

9
Does thyroid affect baby?

Untreated maternal hypothyroidism can cause
delayed fetal neurological development, impaired
school
performance, and lower intelligence quotient (IQ)
among offspring.
10
Should there be universal screening
for hypothyroidism in the first
trimester of pregnancy?
11
Conclusion

• The American College of Obstetricians and
  Gynaecologists does not recommend routine
  screening for hypothyroidism in pregnancy unless
  women have risk factors for thyroid disease.
• While universal screening of thyroid function in
  pregnancy is not recommended, women at high risk
  for thyroid disease should be screened.
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