If you’re struggling to conceive and have been diagnosed with hypothyroidism—or suspect you might have it—you’re not alone.
Many couples face fertility challenges linked to thyroid health. As a fertility specialist, I want to help you understand how your thyroid impacts fertility, what symptoms to watch for, and how effective treatments can restore your chances of building a family.
The positive part is that with proper treatment, most individuals with hypothyroidism can have healthy pregnancies.
Can Hypothyroidism Cause Infertility?
Yes, untreated hypothyroidism can cause infertility in both women and men. In women, low thyroid hormone levels interfere with the release of an egg (ovulation), making it harder to conceive.
In men, hypothyroidism can reduce sperm production, motility, and overall sexual health.
The good news is that treating hypothyroidism can often restore fertility or greatly improve your chances of conceiving.
How Hypothyroidism Affects Female Fertility?
Hypothyroidism disrupts female fertility in several ways:
- Reduced ovulation: Without enough thyroid hormone, your body may not release an egg each month, leading to irregular or absent periods.
- Irregular menstrual cycles: Thyroid hormone imbalances can cause cycles to become unpredictable, making it difficult to time conception.
- Luteal phase defects: The second half of the menstrual cycle after ovulation may be shortened or disrupted, reducing the chance of successful embryo implantation.
- Autoimmune factors: Some women with hypothyroidism have autoimmune thyroid disease like Hashimoto’s, which is linked to higher rates of miscarriage and pregnancy complications.
Restoring thyroid hormone levels with medication often normalizes menstrual cycles and improves fertility outcomes.
How Hypothyroidism Affects Male Fertility?
While hypothyroidism is less common in men, it can still have a significant impact on reproductive health:
- Lower testosterone levels: This can decrease sex drive and sperm production.
- Reduced semen volume and sperm motility: Sperm may be less able to swim and fertilize an egg.
- Abnormal sperm morphology: Sperm shape and structure may be affected, further reducing fertility.
- Erectile dysfunction and delayed ejaculation: These symptoms can make conception more difficult.
If you or your partner have unexplained fertility issues, thyroid testing is an important step in the evaluation process.
Symptoms of Hypothyroidism:
If you’re trying to conceive, be aware of these common symptoms of hypothyroidism:
- Fatigue and sluggishness
- Irregular or heavy menstrual periods
- Unexplained weight gain
- Cold intolerance
- Dry skin and hair loss
- Depression or low mood
For some, especially those with autoimmune thyroid disease, the presence of thyroid peroxidase (TPO) antibodies may be a risk factor for miscarriage and lower live birth rates, even if thyroid hormone levels are normal.
Diagnosis: What Tests to Run
To check for hypothyroidism, your doctor will typically order:
- Thyroid-stimulating hormone (TSH): The main screening test for thyroid function. For women trying to conceive, a TSH level below 2.5 mIU/L is often recommended for optimal fertility.
- Free T4: This measures the active thyroid hormone in your blood.
- TPO antibodies: These indicate autoimmune thyroid disease, which may require closer monitoring even if hormone levels are normal.
Regular monitoring is essential, particularly during fertility treatment and pregnancy
Treatment Path Before IVF/IUI
The primary treatment for hypothyroidism is hormone replacement therapy using levothyroxine, a synthetic form of thyroid hormone
Most people take this medication daily, and it’s safe to continue during fertility treatment and pregnancy.
Lifestyle adjustments, like a balanced diet, regular exercise, and managing stress—can also support thyroid health and overall fertility. It’s essential to stabilize your thyroid hormone levels before starting fertility treatments like IVF or IUI
When IVF or IUI Becomes Necessary
After your thyroid levels are stable, your fertility specialist can help you decide the best next steps:
- IUI (Intrauterine Insemination): Suitable for mild cases of infertility, especially if ovulation improves with thyroid treatment.
- IVF (In Vitro Fertilization): Recommended for more severe or prolonged infertility, or if other treatments haven’t worked.
Your fertility clinic will monitor your thyroid levels throughout treatment to ensure optimal conditions for conception and pregnancy.
ART Outcomes in Hypothyroid Patients
With proper treatment, women with hypothyroidism can achieve similar pregnancy and live birth rates as those without thyroid disease.
Studies show that once thyroid hormone levels are normalized, there is little difference in IVF outcomes between treated hypothyroid patients and their peers.
However, untreated hypothyroidism can lead to lower implantation rates, higher miscarriage rates, and other complications.
Risks of Untreated Hypothyroidism in IVF/IUI
If hypothyroidism is not treated before or during fertility treatment, you may face:
- Cycle cancellation or poor response to ovarian stimulation: Your ovaries may not respond well to fertility drugs, resulting in fewer eggs retrieved.
- Higher miscarriage rates: Untreated hypothyroidism increases the risk of pregnancy loss, even after successful conception.
- Preterm delivery and other pregnancy complications: Proper thyroid function is crucial for healthy placental development and fetal growth.
Close monitoring and treatment are key to minimizing these risks.
When to Consult a Fertility Specialist
You should consider seeing a fertility specialist if:
- You’ve been trying to get pregnant for 6–12 months with no success.
- You have irregular menstrual cycles or a history of miscarriage.
- You’ve been diagnosed with hypothyroidism or have symptoms suggestive of thyroid dysfunction.
Early consultation can help identify and treat underlying issues, improving your chances of a healthy pregnancy.
Conclusion
Hypothyroidism is a common but treatable cause of infertility. Early recognition, thorough evaluation, and individualized treatment can dramatically improve the chances of conception and a healthy pregnancy. If you are trying to conceive and have concerns about your thyroid health, speak with your healthcare provider about comprehensive testing and tailored treatment options. With proper care, most individuals with hypothyroidism can look forward to successful pregnancies and healthy families.
Frequently Asked Questions(FAQs)
Yes, untreated hypothyroidism can interfere with ovulation in women and sperm production in men, leading to infertility.
Look for fatigue, irregular periods, weight gain, cold intolerance, dry skin, and low mood.
Diagnosis is made with blood tests for TSH, free T4, and sometimes TPO antibodies.
Levothyroxine is the standard treatment. Lifestyle changes and close monitoring are also important.
Yes, with proper treatment and monitoring, most women with hypothyroidism can have healthy pregnancies and babies.
