Thyroid Disorder and Infertility – What’s The Connection?

Did you know that the thyroid gland is as essential for our body as any other vital organ?

It releases hormones T3 and T4, which regulate body functions such as metabolism, body temperature, heart rate, breathing, body weight, menstrual cycle, etc.  Any imbalance in these hormones can cause disorders such as hypothyroidism and hyperthyroidism. These disorders can, in turn, be a cause for other problems such as infertility.

It has been found that there is 2-4% prevalence of hypothyroidism in the reproductive age group and it is a major cause of infertility in this group.

What’s the connection?

Untreated thyroid disease in both, men and women, can cause decreased sexual desire (libido) that can be a reason for infertility. Individually, thyroid dysfunction can cause infertility in females due to anovulatory cycles (ovary releases no egg for fertilisation), high prolactin (PRL) levels, luteal phase defect, and sex hormone imbalance. It can cause infertility in males too as the development of sperm requires normal thyroid hormone levels.

Infertility symptoms in relation to hypo and hyperthyroidism

A man or woman with thyroid dysfunction will complain of certain problems or symptoms that are related to fertility and inability to conceive even after regular and unprotected sexual intercourse. 

Hyperthyroidism

Signs and symptoms of infertility in women:

• Loss of libido or sexual desire
• No menstrual period

Signs and symptoms of infertility in men:

• Enlarged mammary glands
• Loss of libido or sexual desire
• Feminisation or female-like characteristics

Hypothyroidism

Signs and symptoms of infertility in women:

• Problematic or abnormal menstrual cycle
• Elevated levels of prolactin hormone
• Milk flow from the breast without any pregnancy or childbirth
• Low basal body temperature (BBT)

Signs and symptoms of infertility in men:

• Decreased libido or sexual desire that can impair testicular testosterone synthesis
• Enlarged mammary glands

One thyroid dysfunction symptom or the other can directly impact the chances of pregnancy. The trick is to find out if these symptoms are due to thyroid dysfunction and need thyroid gland management. That is why every couple who wishes to conceive is advised to undergo a thyroid profile test to figure out the levels of these essential hormones for smooth conception and a healthy pregnancy thereafter.

Diagnosis of thyroid dysfunction

Thyroid dysfunction can be easily diagnosed with a simple blood test. The level of thyroid hormones T3, T4, and TSH are evaluated to find out any abnormality. In most cases, the levels will confirm the under-or over-activity of the thyroid gland. But in some cases, other tests such as ultrasound of the gland, thyroid scans, or fine needle aspiration and biopsy may be necessary for diagnosis.

Treatment for thyroid-related infertility

Thyroid disorders can be very well-managed by medication and rarely remain a cause of infertility after treatment. In fact, it has been found that fertility is quickly restored after the restoration of a patient’s thyroid function. In most of the cases, the couple can successfully conceive and have a healthy baby after the right diagnosis and treatment.

Effects of thyroid disorder with respect to pregnancy

Untreated (or poorly treated) thyroid problems can cause serious complications for the baby and the mother.

Complications for the mother:

• Miscarriage
• Preeclampsia
• Anaemia (iron deficiency)
• Early detachment of the placenta from the uterine wall (placental abruption)
• Postpartum haemorrhage

Complications for the baby:

• Preterm or early birth
• Thyroid disorders in the baby
• Low birth weight
• Stillbirth
• Birth defects

The most important and crucial point is awareness of the thyroid status in a childless couple. It should be brought to public knowledge that thyroid disorder is a reversible or preventable cause of infertility, and one that can be managed. People who are already diagnosed with a thyroid disorder should promptly inform their doctor before or after conception so that the medication dose can be adjusted to meet the increased demand for the hormones during the first three months of pregnancy.