Hashimotos - does this affect TTC?

Hi ladies,

I am asking this question on behalf of my dear computer illiterate girlfriend! She has been TTC for several years, and has fallen pregnant twice via IVF, but unfortunately lost one baby at 7 weeks, and the other was classed as a chemical pregnancy.

She has been told that she has normal thyroid, but high antibodies - a condition known as Hashimotos. She has been unable to get the antibodies down, and is concerned that it may hamper her chances of pregnancy, or elevate her chance of miscarrying once pregnant.

Does anyone have any experience with a similar situation? If so, can you offer any advice?

I am currently 34 weeks along, and it is so hard to see my dear friend struggling to start her family. She is 42, and her partner is 35, both in excellent health and have been doing everything in their power to make a miracle happen.

Hi lct76 so sorry to hear your friend is having trouble. Yes I think there is a treatment option which I think includes prednisone to lower immune/anti bodies and maybe clexane, but I am not experienced in this and just seem to remember this as a treatment for the same. Though I would be surprised if your friends FS is not considering this if she is doing ivf. Best of luck to you too for your coming birth xx

I have Hashimotos - diagnosed a few months before I fell pregnant with DD but not treated as thyroid levels not considered low enough. I expected it to take longer to get pregnant as thyroid was low but got pregnant first month of TTC - then it began being managed via taking Thyroxine seeing an endocrinologist. My antibody levels have never been measured again, and I have never been told anything about it making it more difficult to conceive (low thyroid can yes but have never had antibodies mentioned) - I conceived my DS second month of TTC - so has certainly not been an issue for me and my antibody levels are not measured they just measure the thyroid level. I see my endocrinologist in March I will ask her then about it.

Has she seen an endocrinologist at all? The range that is considered 'normal' thyroid function is very wide in Australia, and having lower thyroid levels is meant to sometimes cause issues conceiving (although didn't in my case). The problem with Hashimotos is that it causes thyroid levels to fluctuate significantly. My thyroid level was within normal ranges but very low until I became pregnant and then at 5 weeks the tests showed thyroid levels extremely low and treatment became at this point.

Not sure if that helps or not.

Endocrinologists want to see thyroid levels between a certain range when TTC and when pregnant - it's a much narrower range than is what is usually considered "normal". My endo worked with when I started TTC to make sure my levels were in that range and then had me go for fairly frequent blood tests throughout my pregnancy. Thyroid antibodies can indicate other things as well (although I don't remember specifics) - for this reason, I think that it may be worthwhile to get a referral to see and endo.

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Endocrinologists want to see thyroid levels between a certain range when TTC and when pregnant - it's a much narrower range than is what is usually considered "normal".

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Do you know an indicative range of what this might be or where I could find some info on it? I have just asked my GP to check into my thyroid function (in light of my recent m/c) and would like to know what she might consider normal that could actually indicate a problem (ie under what circumstances I might need to be a little argumentative). Thanks.

I don't remember off hand, but if you google a bit, you will find the info - that's how I first found it before seeing an endo.

Juniper I was so sorry to see your news. From what I remember ideal tsh level is between 2 and 2.5 when TTC, but you also need to get free T3 and T4 tested as well as just tsh is not enough. I hope you get some answers x

Thanks BDT. She did request T3, T4 and antibodies in addition to the TSH. In the past I've only had TSH tested. The thing that concerned me was that she said if the TSH was normal she wouldn't care if the others were off. Made me think I need to educate myself about it before we discuss the results.

buliej, thanks. I'll do that.

Just found this on another board that I belong too - coincidentally someone is dealing with the same thing -

She prefers to see TSH between .35 - 2.5. Being HYPOthyroid negatively impacts fetal development and it now appears that being HYPERthyroid impacts getting pregnant.

Thanks buliej. That's similar to some I found last night (after following your advice).

I don't know anything about Hashimotos, but I would say your friend's age is probably her biggest issue - both in terms of getting, and staying Pregnant.

At 42, around 95% of your eggs are chromosomally abnormal, and you don't have a lot left anyway :(

That's why it's so hard to get a sticky bub and why statistically, women that age only have a 2-3 % chance of IVF success.

It totally sucks :(

Good luck to your friend. I hope she is successful :)

Our ex Admin Sarah has Hashimitos. I'll get her to post.

Hashimotos absolutely definitely affects your ability to become & also to stay pregnant.

Your thyroid is responsible for a lot of hormones & can greatly affect ovulation & periods, so your friend might be having ovulation issues or period issues in the first place, perhaps why she is needing IVF? Hashimotos can lead to an increased level or the breastfeeding hormone (lactin something, ugh can't think of the name) which restricts ovulation.

Once you fall pregnant the baby is reliant on your thyroid for the first trimester particularly, but also for the entire pregnancy. In the first trimester if you thyroid is underactive (which is the case with Hashimotos), your baby is not getting enough thyroxine & it can cause miscarriage. After first trimester baby's thyroid starts to work but s/he still relies heavily on mum's thyroid. This might be where things are coming unstuck. If her antibodies are too high then her bub isn't getting enough thyroxine which could be causing her issues.

That said, if you have your levels under control with medication there are no problems with falling pregnant & staying pregnant. In between my DS & DD, we believe I had two very early miscarriages, once I was diagnosed I had a healthy IVF pregnancy, now my 3yo DD. Since then we have had two more pregnancies, one m/c but unrelated to the Hashimotos & another bub due in a few weeks.

Why has she had trouble getting her levels under control. Is she not on Thyroxine to correct them? I have had it since I was 22 and pretty much been monitored every 3-6 months for 13 years. Pregnancies and anything hormonal (like IVF) seem to send my hormones all over the place and in those periods needed to have it monitored more closely. I have had 2 m/c, 1 when my levels were fine and 1 when they weren't. But I have also had 2 healthy normal pregnancies. 1 through IVF and the other naturally. My levels fluctuated badly in pregnancy though and it was a battle to keep the at the right level.

Hashimots can have an effect on TTC and then on the babies brain development in the early part of pregnancy. It is important that her levels are kept under control. Also, I found it contributes in other ways, being tired all the time, low mood, stressed more easily. All symptoms you experience if the levels are not right.

Maybe I misread the original post - I thought was talking about the levels of the Hashimotos antibodies in particular? and my experience was these have never been rechecked is only the T3, T4 and TSH levels that are checked. So in essence I have been treated the same as others who have low thyroid but don't have Hashimotos. Isn't it the low or high thyroid levels that are the issue in pregnancy rather than the antibodies?

From my very limited understanding of Hashimoto's the antibodies produced attack the thyroid glad which is what causes low thyroid. So therefore, you treat the symptom (low thyroid) by having synthetic thyroxine that your body is not producing. I have not herd of anything that would treat the antibodies as that is the auto-immune disease and as far as I am aware there is no cure for. It is the low thyroxine levels that causes the issues with infertility and abnormal fetal brain development.

If you have this condition then it needs to be treated with Thyroxine for the rest of your life to keep the levels stable.

As I said though, I am not a doctor and this is just my personal understanding of the disease.

I remember my fear about finding out about Hashimotos and this increasing as I googled and read more about it.

I'm by no means an expert but I have Hashimotos. I didn't fall pregnant until I had IVF and had many months of natural treatments prior to undergoing IVF. My endocrinologist wanted by TSH to be between 1-2 and the closer to 1 the better. Normal according to GPs can be as high as about 5 so it's always good to get the actual result and not just go by what the medical professional says is normal. My antibodies were never retested as I was told there isn't much point as the only thing they can treat is the TSH level. So, they can only treat the symptom rather than the cause. When pregnant it is the TSH that is important to fetal development.

I took Selenium from the naturopath and this is supposed to help treat antibodies. I also had acupuncture

There is a lot of mixed information about Hashimotos and fertility. For some people it doesn't seem to be a problem and for others there is a real struggle to get pregnant. My FS wasn't concerned about the antibody levels but just wanted my TSH to be in the right place. My endocrinologist on the other hand told me that antibodies can make it hard to fall pregnant. My FS was surprised that this was the endocrinologist view and said that she hadn't seen that in her practice.

The other thing to consider is that where someone has one autoimmune disease they are more likely to have a second condition and the second condition can impact on fertility. For me, I have coeliac disease which if untreated can also impact on fertility. Exploring other potential autoimmune diseases could be worth it.