Infertility is defined as the inability to conceive after one year of regular intercourse without contraception. It is one of the medical, social and psychological burdens in the world. About 18–20% of couples in reproductive age are infertile.

The thyroid hormone regulates cellular function; abnormal thyroid function can affect your fertility. Undiagnosed and untreated thyroid disease can be a cause for infertility or frequent miscarriage.

According to the Indian Thyroid Society about 70 per cent of women with PMS have low thyroid levels, which make the ovaries less able to produce progesterone leading to PMS symptoms. 25.6 per cent of the Indian population have thyroid dysfunction and possibly resulted in infertility.

Having trouble getting pregnant? Your thyroid could be the problem - and your doctor may not even know it. Standard blood tests miss up to 80 percent of cases in which low tissue thyroid levels are causing or contributing to infertility.

Underactive thyroid (hypothyroidism) is a condition in which the thyroid gland doesn't produce enough of certain important hormones. For women, there is a link between hypothyroidism and infertility. Low levels of thyroid hormone can interfere with ovulation, which impairs fertility. In addition, some of the underlying causes of hypothyroidism — such as certain autoimmune or pituitary disorders — impair fertility.

Seema Arora (name changed on request), 29, a working professional, her world came to an end when she got to know that she can’t be pregnant. As thyroid is very much common in today’s lifestyle, Seema was diagnosed with thyroid but she ignored it and did not go for regular maintenance check ups. After 1 year when she underwent TSH blood test she got to know that she is suffering from hypothyroidism due to which she is now unable to conceive.

Since standard thyroid blood tests are not sensitive enough to detect low ovarian tissue levels the majority of the time, women must find a knowledgeable physician who understands that standard tests will often not be useful in detecting low ovarian thyroid levels.

Symptoms:

The symptoms of hypothyroidism can be of many types. Some patients show no symptoms, while others show some marked symptoms. The symptoms usually depend on the severity of the hormone deficiency and the rate at which it develops in the patient. The symptoms are usually milder at the beginning but develop gradually as the condition deteriorates.

The general symptoms are weight gain, fatigue, constipation, muscle and joint aches, sluggishness, and intolerance towards cold weather, abnormal and irregular periods, fatigue, and sleeplessness. The skin may turn dry and thick. The hair may become coarse or thin. At times eyebrows disappear and nails become brittle.

Diagnosis:

If you feel the above mentioned symptoms immediately go for a TSH (thyroid stimulating hormone) test, Chest X-ray, T4 or thyroxine test.

Treatment:

Hyperthyroidism can be treated in many ways. However, a doctor chooses the line of treatment on the basis of a number of variables like the underlying cause of hyperthyroidism, the age of the patient, the size of the thyroid gland and the presence of coexisting medical illnesses.

If you are found to have hypothyroidism, thyroid hormone replacement is very effective in restoring fertility. It may take 1-2 months to normalize your thyroid hormone levels with medication; and once you start medication, you must check your TSH levels to confirm they are in the normal range. You will usually need to continue the medicines for the rest of your life and recheck your thyroid function every 6 months or so.

Millions of people have an undiagnosed thyroid problem, and don’t realize that it is the source of the other health challenges they face. Infertility is a major health threat due to thyroid and many other conditions that are often the direct result of undiagnosed and untreated thyroid conditions.  In order to lead a healthy life I would recommend that all patients who recognise any of these symptoms should go for a TSH test.

The writer is Dr Shobha Gupta , Medical Director and Infertility Specialist at Mother’s Lap IVF Centre – Pitampura, New Delhi