THYROID & FERTILITY: Part 2 – Trying to Conceive, Fertility, Pregnancy and Miscarriage

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Board certified OBGYN and REI, fertility doctor Natalie Crawford, MD discusses thyroid disease, screening, and treatment for people who are trying to conceive, undergoing fertility treatments, or having recurrent miscarriages. Listen as she reviews latest guidelines and updates – hitting on information that is controversial or uncertain.

Reviewed in this video:
Should you screen for thyroid disease in pregnancy?
What is a normal TSH in pregnancy?
Should you test for thyroid in infertility?
What are thyroid antibodies?
When should you treat if you have positive thyroid antibodies?
Does thyroid disease cause recurrent miscarriage?
Is it safe to take thyroid hormone?
When should you test your thyroid?

*PART 1 video reviews the basics of thyroid physiology, TSH and hypothyroidism and hyperthyroidism

*This is not medical advice but education. Please ask your doctor your general medical questions.

Resources:

Dosiou C. Thyroid and Fertility: Recent Advances. Thyroid. 2020 Apr;30(4):479-486. doi: 10.1089/thy.2019.0382. Epub 2020 Feb 4.

Chen LM, et al. Associations between thyroid autoantibody status and abnormal pregnancy outcomes in euthyroid women. Endocrine 2015;48:924-8.

Lee SY, et al. Monitoring, and Treatment of Thyroid Dysfunction in Pregnancy. J Clin Endocrinol Metab. 2021 Mar 8;106(3):883-892. doi: 10.1210/clinem/dgaa945.

Negro R, Thyroid antibody positivity in the first trimester of pregnancy is associated with negative pregnancy outcomes. The Journal of clinical endocrinology and metabolism 2011;96:E920-4

Cleary-Goldman J, et al. Maternal thyroid hypofunction and pregnancy outcome. Obstetrics and gynecology 2008;112:85-92.

Karakosta P, et al. Thyroid dysfunction and autoantibodies in early pregnancy are associated with increased risk of gestational diabetes and adverse birth outcomes. The Journal of clinical endocrinology and metabolism 2012;97:4464-72

Abbassi-Ghanavati M, et al. Pregnancy outcomes in women with thyroid peroxidase antibodies. Obstetrics and gynecology 2010;116:381-6.

Abalovich M, et al. Overt and subclinical hypothyroidism complicating pregnancy. Thyroid : official journal of the American Thyroid Association 2002;12:63-8.

Vissenberg R, et al. Effect of levothyroxine on live birth rate in euthyroid women with recurrent miscarriage and TPO antibodies (T4-LIFE study). Contemporary clinical trials 2015.

Vissenberg R, et al. Live-birth rate in euthyroid women with recurrent miscarriage and thyroid peroxidase antibodies. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology 2015:1-4.

Yan J, et al. Thyroid peroxidase antibody in women with unexplained recurrent miscarriage: prevalence, prognostic value, and response to empirical thyroxine therapy. Fertility and sterility 2012;98:378-82.

Negro R, , et al. Euthyroid women with autoimmune disease undergoing assisted reproduction technologies: the role of autoimmunity and thyroid function. Journal of endocrinological investigation 2007;30:3-8.

Velkeniers B, et al. Levothyroxine treatment and pregnancy outcome in women with subclinical hypothyroidism undergoing assisted reproduction technologies: systematic review and meta-analysis of RCTs. Human reproduction update 2013;19:251-8.

Lepoutre T, et al. Reduction of miscarriages through universal screening and treatment of thyroid autoimmune diseases. Gynecologic and obstetric investigation 2012;74:265-73

Thyroid Disease in Pregnancy: ACOG Practice Bulletin, Number 223. Obstet Gynecol. 2020 Jun;135(6):e261-e274.

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Fertility doctor, Natalie Crawford, MD is a double board certified OBGYN and REI, and co-founder of Fora Fertility, a boutique fertility practice in Austin, Texas.

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Sharing fertility facts to educate women about trying to conceive, getting pregnant, ovulation, fertility treatments, IUI, IVF, becoming a doctor, life as a woman in medicine, and more.