Hypothyroidism, infertility and pregnancy complications

Hypothyroidism, when you have a low thyroid hormone level, could be a cause of certain pregnancy complications such as infertility in women with irregular cycles an early miscarriages. If women with hypothyroidism get pregnant there is an increased risk of miscarriage and problems in the baby.

Treatment before pregnancy will improve your chances to get pregnant and will improve your pregnancy outcome. Hypothyroidism is a condition in which the body lacks sufficient thyroid hormone. Up to one in ten women have some from of hypothyroidism before or during pregnancy, though most don’t realize they have it.

The classic symptoms of hypothyroidism

The classic symptoms of hypothyroidism are:

  • Lethargy 
  • Fatigue;
  • Weakness;
  • Weight gain or increased difficulty losing weight;
  • Dry skin; Hair loss;
  • Cold intolerance; 
  • Constipation;
  • Depression;
  • Decreased libido; 
  • Reduced heart rate;
  • Development of a goiter.

However, most women with hypothyroidism have few to none of these typical symptoms, but less dramatic and more subtle ones such as weight gain, skin problems, or abnormal menstrual cycles, irregularity, heavy periods, or loss of periods and ‘dysfunctional uterine bleeding’.

Because some of the symptoms of hypothyroidism such as tiredness and weight gain are already quite common in pregnant women, it is often overlooked and not considered as a possible cause of these symptoms.

Irregular menstrual periods and hypothyroidism 

Women who have irregular menstrual periods and have problems getting pregnant have an increased chance to have hypothyroidism, and hypothyroid women who do get pregnant have an increased risk of miscarriage. The reason for most of these irregular menstrual periods and bleeding are usually ovulation problems and anovulation, not ovulating.

Increased risk of low IQ in babies of mothers with hypothyroidism

Babies born to mothers who have hypothyroidism have been found to have lower IQs, and some doctors have suggested that all pregnant women and those planning to become pregnant routinely be tested for hypothyroidism.

Testing for hypothyroidism in pregnancy

Thyroid testing results in pregnancy can be different than in non-pregnant individuals and sometimes need a special interpretation. A blood test which measures levels of thyroid-stimulating hormone (TSH) can easily diagnose hypothyroidism. High levels of TSH indicate hypothyroidism and inadequate thyroid function.

Causes of hypothyroidism in pregnancy

In most cases of hypothyroidism no specific cause can be found. It may follow an infection of the thyroid and may be part of so-called “autoimmune conditions”, such as a condition called Hashimoto’s disease, or it may follow after surgical removal of parts or all of the thyroid.

Treatment of hypothyroidism in pregnancy

Treatment for hypothyroidism is easy. You are given once a day a pill with synthetic thyroid hormone thyroxine, T4, and you continue taking it throughout pregnancy. After starting this medication it usually takes 8 weeks for thyroid function to return to normal.

There are no side effects for the mother or the baby as long as the proper dose is used.

Women with previously treated hypothyroidism should be aware that their dose of medication may have to be increased during pregnancy.

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