Fertility and Pregnancy: The Impact of Thyroid Disorders in Women

Thyroid disorders are among the most common endocrine conditions affecting women, significantly influencing fertility and pregnancy. The thyroid gland regulates metabolism, hormone production, and reproductive health. An imbalance in thyroid hormones—either hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid)—can disrupt ovulation, menstrual cycles, and overall reproductive function.

Thyroid Disorders and Fertility Hypothyroidism and Infertility

Hypothyroidism occurs when the thyroid gland produces insufficient hormones, leading to fatigue, weight gain, depression, and irregular periods. This deficiency can impact ovulation, reducing conception chances. In some cases, it causes anovulation (absence of ovulation), making pregnancy difficult. Hypothyroidism is also linked to polycystic ovary syndrome (PCOS), a condition that further affects fertility.

In India, around 10-12% of the population has hypothyroidism, with women being more vulnerable. A study by the Indian Thyroid Society found that nearly 22% of women in Hyderabad suffer from thyroid disorders, affecting their reproductive health significantly.

Hyperthyroidism and Fertility Issues

Hyperthyroidism results from excessive thyroid hormone production and causes weight loss, rapid heartbeat, anxiety, and irregular cycles. Women with untreated hyperthyroidism may struggle with conception due to hormonal imbalances and increased metabolic activity. Graves’ disease, an autoimmune disorder, is a common cause of hyperthyroidism.

Though less prevalent than hypothyroidism, hyperthyroidism still affects 1-2% of the Indian population. In Hyderabad, hospital records show that 15% of thyroid-related cases in women are due to hyperthyroidism.

Thyroid Antibodies and Autoimmune Infertility

Autoimmune thyroid conditions like Hashimoto’s thyroiditis produce thyroid antibodies that interfere with ovarian function and embryo implantation. Elevated thyroid peroxidase (TPO) antibodies are linked to an increased risk of miscarriage and infertility.

Thyroid Disorders and Pregnancy Complications

If left untreated, thyroid disorders can lead to serious maternal and fetal complications, including:

• Miscarriage and Preterm Birth: Uncontrolled thyroid conditions can increase the risk of pregnancy loss and preterm labor. In India, thyroid disorders contribute to 8-12% of pregnancy complications, with Hyderabad recording a higher prevalence of 14%.

• Preeclampsia: Hypothyroidism is linked to high blood pressure and proteinuria, raising the risk of preeclampsia.

• Low Birth Weight and Developmental Issues: Poor thyroid function can impact fetal brain development, leading to cognitive impairments. Studies indicate that nearly 20% of infants born to mothers with untreated hypothyroidism have low birth weight.

• Gestational Hypertension: Abnormal thyroid hormone levels can lead to high blood pressure, posing risks to both mother and baby.

Managing Thyroid Disorders for Healthy Fertility and Pregnancy

• Thyroid Function Tests: Women planning to conceive should undergo TSH, T3, and T4 tests to detect imbalances early. Fertility centers in Hyderabad report that nearly 30% of infertility cases are linked to thyroid dysfunction.

• Medication and Treatment: Hypothyroidism is treated with levothyroxine, while hyperthyroidism may require anti-thyroid medications, beta-blockers, or, in severe cases, radioiodine therapy or surgery.

• Diet and Lifestyle Changes: A balanced diet rich in iodine, selenium, and zinc supports thyroid function. Managing stress, reducing caffeine intake, and maintaining a healthy weight also improve reproductive health. Over 42 million people in India suffer from iodine deficiency, a major cause of thyroid disorders.

• Monitoring During Pregnancy: Pregnant women with thyroid disorders require regular monitoring and medication adjustments for optimal hormone levels.

Conclusion

Thyroid disorders significantly impact female fertility and pregnancy outcomes. Early diagnosis, proper treatment, and lifestyle modifications can help women conceive and have a healthy pregnancy. Women facing difficulty in conception or recurrent miscarriages should seek a thyroid evaluation. With rising thyroid disorder cases in Hyderabad and across India, awareness and timely intervention are crucial for better reproductive health outcomes.

(The writer is a MBBS, MS(OBG), FRM, Consultant Fertility Specialist Ankura Hospital for Women and Children)