Did you know that January is thyroid awareness month? The thyroid plays an important role in regulating your body’s hormones not just during pregnancy but is essential for daily function. In the United States, more than half of the people who have a thyroid disorder are undiagnosed. For women, 1 in 8 will develop a thyroid disorder during their lifetime. In this blog post, we will explore the importance of thyroid health across all aspects of your trying-to-conceive journey.

What is your thyroid?

Your thyroid gland is a small butterfly-shaped gland located at the base of your neck. It is responsible for producing thyroid hormones that impact almost every system in your body. These hormones regulate metabolism, meaning they affect how the body’s uses energy. Thyroid hormones are essential for growth, development, and regulation of your body’s essential processes. If the thyroid is not functioning properly several different disorders can arise such as hypothyroidism, where the thyroid is not producing enough active thyroid hormone, or hyperthyroidism, where the thyroid is producing too much active thyroid hormone.

How does the thyroid impact my fertility?

Thyroid disorders, such as hypothyroidism and hyperthyroidism, can impact your fertility by disrupting the delicate hormonal pathways that are essential for successful conception. For women, if your thyroid is not functioning properly it can result in irregular menstrual cycles, lack of ovulation, and challenges with implantation. For men, having abnormal thyroid hormones can negatively impact their semen parameters. It is important for both partners, but especially women, to have their thyroid checked once you have planned to start growing your family.  

How can I check my thyroid?

Checking thyroid function typically involves blood tests that measure the levels of specific hormones produced by the thyroid gland. Thyroid function tests can be typically done at any time of day and do not require you to be fasting, but always confirm this with your healthcare provider. At a minimum, a TSH (Thyroid Stimulating Hormone) test will be ordered. TSH is produced by the pituitary gland which is located at the base of the brain and stimulates the thyroid to produce T4 (thyroxine). Elevated or reduced TSH levels can indicate an underactive or overactive thyroid.

Additionally, your healthcare provider may order T4 (Thyroxine) and T3 (Triiodothyronine). T4 is the main hormone produced by the thyroid, and it gets converted into the more active T3. Measuring these hormones helps further evaluate thyroid function. Typically, if there are abnormalities with these tests your healthcare provider will recommend screening for thyroid antibodies to rule out autoimmune causes of thyroid disorders. This is especially important for those who are trying to get pregnant or have a history of recurrent pregnancy loss.

Navigating Recurrent Pregnancy Loss

If you are someone who has experienced two or more pregnancy losses, first off, I am so sorry that you have experienced this. My heart goes out to you during this difficult time! After multiple pregnancy losses, it is important to meet you’re your healthcare provider for further testing to see if there are conditions that could be causing or contributing to these losses.

When talking with your healthcare provider be sure your thyroid is evaluated as part of your workup. Recent research has shown that hypothyroidism and hyperthyroidism, as well as autoimmune conditions like Hashimoto's thyroiditis and Graves' disease, can contribute to challenges in implantation, fetal development, and impact the overall stability of pregnancy. If your thyroid testing is abnormal, your healthcare provider can develop a personalized treatment plan which typically involves prescribing an oral tablet of thyroid hormone to help support the thyroid and will continue to manage your thyroid levels closely during the trying-to-conceive period and pregnancy.

Thyroid's Impact on Pregnancy

As pregnancy progresses, the thyroid's role becomes even more important. Thyroid hormones play a pivotal role in the development of the fetal brain and nervous system. Maintaining optimal thyroid function is important for preventing complications during pregnancy such as preeclampsia, gestational diabetes, and preterm birth. Regular monitoring through blood tests, especially measuring TSH, helps healthcare providers assess and manage thyroid health throughout pregnancy. If thyroid disorders are identified, a medication can be started and thyroid levels can be monitored closely to ensure a healthy pregnancy and the well-being of both the mother and the baby.

Having your thyroid checked periodically is important for your overall health, but is an essential step on the trying-to-conceive journey for both partners. Screening for thyroid disorders in the preconception period optimizes the fertility status for both men and women and can decrease your risk of miscarriage. For women, having optimal thyroid levels can minimize the risk of complications during pregnancy and help with fetal development. By working closely you’re your healthcare provider and adopting a proactive approach to thyroid health, you can improve your chances of a healthy and successful pregnancy.