How hypothyroidism affects male and female fertility

Hipotiroidismo

We spoke to Dr Elena Santiago of Vida Fertility about how hypothyroidism affects male and female fertility.

Elena

What is hypothyroidism?

Hypothyroidism is a clinical condition resulting from reduced activity of the thyroid gland. The thyroid hormones (T4 and T3), whose synthesis is regulated by TSH secreted in the pituitary gland, are responsible for regulating the body’s metabolic reactions.

When thyroid hormones decline, as in hypothyroidism, TSH secretion increases in an attempt to get the thyroid to work as hard as possible to restore normal thyroid hormone levels.

Types of hypothyroidism

We can differentiate between primary and secondary:

  • Primary hypothyroidism: This is when the problem is directly in the thyroid. For some reason, the thyroid gland becomes more active than normal and produces too much hormone.
  • Secondary Hypothyroidism: Occurs when another part of the body, such as the pituitary gland in the brain, sends excessive signals to the thyroid to produce more hormones, even though they are not needed.

Symptoms of hypothyroidism

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People with hypothyroidism may experience a variety of symptoms, all related to a decrease in the functional activity of all body systems. The most common are fatigue, cold intolerance, apathy and indifference, depression, impaired memory and concentration, dry skin and hair, weight gain and drowsiness.

In women, it can disrupt menstrual cycles, and in men, it may affect sexual function. In addition, hyperthyroidism can affect fertility in both men and women by unbalancing the hormones that regulate the reproductive system.

However, with proper treatment, many people with hyperthyroidism can improve their fertility and have a healthy pregnancy.

Hypothyroidism and female fertility

Hypothyroidism can significantly affect female fertility in several ways:

  • Alterations in the menstrual cycle: Can cause irregular or anovulatory cycles, making conception difficult.
  • Endometrial receptivity: Hypothyroidism can affect the quality of the endometrium, which is crucial for embryo implantation.
  • Follicular development: Suboptimal thyroid function may influence follicular development and egg quality.

Hypothyroidism and masculine fertility

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Although less studied, hypothyroidism can also affect male fertility:

  • Sperm quality: There may be a decrease in sperm motility and volume.
  • Libido: Hypothyroidism can reduce libido, affecting the frequency of sexual intercourse.

What can I do to get pregnant if I have hypothyroidism?

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If you have hypothyroidism and wish to become pregnant, it is important to create an optimal environment for conception and healthy pregnancy development. Here are some steps we recommend at Vida Fertility:

  • Consultation with an endocrinologist: The first step is to get an accurate diagnosis of your condition and understand the extent of your hypothyroidism. Blood tests to measure your thyroid hormone levels (TSH, T3 and T4) and prescribe the appropriate treatment, usually levothyroxine to normalise your hormone levels.
  • Once you start treatment, you will need regular monitoring of your thyroid hormone levels. This may involve adjustments to the dosage of your medication.
  • Consultation with a fertility specialist: If you are having difficulty conceiving, we can offer additional counselling and evaluate other possible causes of infertility. We will perform additional tests for you and your partner and recommend assisted reproductive treatments if necessary.
  • Maintain a healthy lifestyle that includes a balanced diet, regular exercise and avoiding tobacco and alcohol. This not only helps manage hypothyroidism, but also improves your fertility.
  • If you do manage to get pregnant, it is crucial to continue monitoring your thyroid hormone. Hypothyroidism can affect foetal development, so it is important to make sure your hormone levels remain stable throughout your pregnancy.
  • Emotional support: Consider seeking support from support groups, therapy or through social support networks.

Many women with hypothyroidism have achieved successful, healthy pregnancies with proper monitoring of their hormone. The key is to work closely with your healthcare team to ensure the best care for both you and your future baby.

Diagnosis of hypothyroidism

To diagnose hyperthyroidism, doctors perform blood tests that measure thyroid hormone levels.

The normal ranges for thyroid hormones in adults are:

  • TSH between 0.4 and 4.5 muI/L but for pregnancy it must be < 2.5muI/L
  • T3 between 3.5 and 7.8 pmol/mL.
  • T4 between 9 and 25 pmol/L.

Sometimes, they may also need images of the thyroid to see its size and shape.

Assisted reproductive treatment and hypothyroidism

Dr Elena Santiago highlights “The importance of monitoring thyroid hormone levels if you are considering assisted reproductive treatment“. 

Ovarian stimulation may increase estradiol and thyroxine levels, intensifying subclinical hypothyroidism. It is crucial to assess for autoimmune disorders, which are common in patients with reproductive difficulties, as they may affect the pregnancy rate and increase the risk of miscarriage.

Thyroid hormones are essential for implantation and early placental development, so ensuring their balance is vital to improving the chances of a successful pregnancy and carrying it to term.

In order to have a baby with hypothyroidism it is vital to keep thyroid hormone levels balanced. If you dream of becoming a mother and suffer from hypothyroidism, we encourage you to seek advice and support from fertility specialists like us.

Your happiness and that of your future baby are our top priority. Don’t hesitate to contact us to start your journey towards motherhood.

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