Introduction
The thyroid gland is a vital butterfly-shaped gland of the endocrine system located in the front portion of the neck. The thyroid gland gets stimulated by the stimulating thyroid hormone (TSH) secreted by the anterior part of the pituitary gland, thereby producing three hormones: triiodothyronine (T3), tetraiodothyronine (T4 or thyroxine), and calcitonin. The thyroxine (T4) hormone and triiodothyronine (T3), together, are known as thyroid hormones. The T3 hormone influences the body's vital function regulates the body's metabolism, and is mainly active compared to the T4 hormone, which is comparatively inactive. When the thyroid gland releases thyroid hormones, some organs in the body transform the T4 hormone into the T3 hormone to impact the body's metabolism and the cells. On the other hand, calcitonin regulates the calcium levels in the body and does not affect the body's metabolism or the cells.
A normal functioning thyroid gland is essential for conception and healthy pregnancy. Any imbalance in T3, T4, and TSH production levels can cause weight fluctuations, mood changes, menstrual irregularity, and infertility. Conception means the ability of a couple to conceive or get pregnant.
What Are the Common Thyroid Disorders?
Thyroid disorders are the most commonly occurring endocrine disorders in women. A thyroid disease or disorder occurs when the thyroid gland produces the thyroid hormones (T3 or T4) in an unbalanced manner (insufficient or excessive). Two main thyroid disorders include hyperthyroidism and hypothyroidism. In addition, autoimmune conditions like Hashimoto's thyroiditis cause hypothyroidism, and Graves's disease causes hyperthyroidism.
What Is the Link Between Thyroid Hormones and Conception?
The disorders caused by thyroid hormones (hyperthyroidism and hypothyroidism) can negatively affect conception. An unregulated thyroid disorder disrupts the luteal phase (the last half of the menstrual cycle after the ovulation process), moderated by the progesterone hormone leading to difficulties in the implantation process; therefore, leading to difficulties in getting pregnant or early miscarriages to occur. Some signs of malfunctioning or low levels of progesterone hormone due to the thyroid hormones are irregularities in the menstrual cycle (longer or shorter cycle) and atypically abnormal bleeding levels, either heavier or lighter bleeding, and shorter or longer window periods of bleeding.
How Does Hypothyroidism Affect Conception?
Hypothyroidism is marked by elevated TSH levels and decreased thyroid gland hormone production. This condition is more prevalent in the female population than in the male population. Reduced thyroid hormones affect conception in women in the following ways.
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It disrupts the menstrual cycle making conception hard. Heavy menstrual bleeding is also noted.
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It interferes with the ovulation (egg releasing from the ovary) process.
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It increases the risks of miscarriages, premature birth, and intrauterine death of the fetus.
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Some underlying reasons behind hypothyroidism, like pituitary disorders or autoimmune conditions like Hashimoto's thyroiditis, can be an underlying reason for infertility.
Hypothyroidism affects conception in men as the condition changes their sperm morphology.
How Does Hyperthyroidism Affect Conception?
Decreased levels of TSH and overproduction of thyroid hormones or an overactive thyroid mark hyperthyroidism. An autoimmune condition called Graves disease is another one of the leading causes of hyperthyroidism. An increase in thyroid hormone production affects conception in the following ways.
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It disrupts the menstruation cycle. Menstrual cycles are either lighter or fewer.
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It increases the chances of an early miscarriage or premature birth.
Hyperthyroidism can affect conception in men in the following ways.
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It leads to a decrease in the volume of semen; ejaculation contains less volume of semen.
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The sperm morphology changes along with a decrease in sperm density.
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It also decreases sperm motility (the ability of sperm to move well and efficiently).
Do Autoimmune Conditions Affect Conception?
Autoimmune antibodies in the body with or without hypo or hyperthyroidism can also affect the ability to conceive. Autoimmune conditions (Hashimoto's thyroiditis and Graves disease) cause an immune imbalance affecting the thyroid hormones and the conception process. This imbalance causes difficulty in the implantation and fertilization process. It can also increase the possibility of a miscarriage.
What Tests Are Done to Rule Out Thyroid Disease Affecting Conception?
A thyroid function test (TFT) is done to check the level of TSH (stimulating thyroid hormone), T3, and T4 hormones. Further tests are suggested to rule out autoimmune thyroid conditions if abnormalities are detected in the thyroid function test (TFT). Those tests include thyroid peroxidase antibodies (TPO), thyroid stimulating immunoglobulin (TSO), and thyroglobulin/antithyroglobulin antibodies.
How to Manage Thyroid Disorders to Help With Conception?
Thyroid disorders caused by the thyroid hormone must be treated adequately to conceive quickly and to correct infertility. Therefore, when a pregnancy is planned, consult a doctor and regulate the condition. Treatment methods for conceiving a thyroid disease include lifestyle modifications and medical intervention.
Lifestyle Modifications:
Lifestyle modifications are recommended to conceive easily and for a healthy and successful pregnancy.
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Patients are advised to stay physically active and maintain a healthy diet.
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Patients are advised to avoid food containing goitrogens (a substance found in food that affects the functioning of the thyroid gland). Some foods include cabbage, spinach, turnip, peaches, and peanuts.
Thyroid Function Tests:
If you find difficulty conceiving or have had repetitive miscarriages, a thyroid evaluation study is recommended. One can also undergo a thyroid study in case of an irregular menstrual cycle or if you have a familial history of thyroid diseases or disorders.
Medical Intervention:
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For hypothyroidism patients, treatment choice includes hormone therapy with thyroxine. This treatment helps normalize the menstrual cycle and also improves fertility.
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For hyperthyroidism patients, treatment choice includes antithyroid drugs.
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In the case of hyperthyroidism, pregnant patients are usually given the lowest dose of their medication as there are chances of the medication crossing the placental barrier.
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Vitamin D plays an essential role in a healthy thyroid. Supplements are recommended if sufficient vitamin D isn't received from the sun.
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For people with thyroid conditions, even after conception, the thyroid hormone should be closely monitored by the physician and managed to reduce the chances of miscarriage and also for the regular and adequate development of the fetus.
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If infertility issues persist even after treating thyroid disorders, additional fertility interventions are required, so consult a fertility specialist and take help.
Conclusion
The relationship or link between the thyroid hormone and conception is quite essential. A normal thyroid gland is of utmost importance for a normal and healthy pregnancy. Conversely, abnormal thyroid hormones can affect women's and men's fertility. Therefore, it is always essential to regulate abnormal thyroid hormone levels before planning to conceive. The abnormalities can be normalized and improved with adequate lifestyle changes and medical intervention, thereby helping to restore a normal healthy reproductive ability.
