Thyroid disorders are increasingly prevalent, impacting reproductive health by causing infertility and miscarriages due to their crucial role in conception and fetal development. While routine pre-pregnancy screening isn't standard, it's vital as thyroid imbalances can disrupt hormonal regulation and create a hostile uterine environment. Misconceptions about lifelong medication management often lead to these disorders being overlooked, particularly in working women. Prioritizing adequate sleep and stress reduction are essential lifestyle adjustments for supporting optimal reproductive outcomes and managing thyroid health.

Thyroid disorders are increasingly prevalent, impacting reproductive health by causing infertility and miscarriages due to their crucial role in conception and fetal development. While routine pre-pregnancy screening isn't standard, it's vital as thyroid imbalances can disrupt hormonal regulation and create a hostile uterine environment. Misconceptions about lifelong medication management often lead to these disorders being overlooked, particularly in working women. Prioritizing adequate sleep and stress reduction are essential lifestyle adjustments for supporting optimal reproductive outcomes and managing thyroid health.

Thyroid disorders are increasingly prevalent, impacting reproductive health by causing infertility and miscarriages due to their crucial role in conception and fetal development. While routine pre-pregnancy screening isn't standard, it's vital as thyroid imbalances can disrupt hormonal regulation and create a hostile uterine environment. Misconceptions about lifelong medication management often lead to these disorders being overlooked, particularly in working women. Prioritizing adequate sleep and stress reduction are essential lifestyle adjustments for supporting optimal reproductive outcomes and managing thyroid health.

With the increase in chronic stress and endocrine disruptor chemicals everywhere, thyroid disorders, both immune-related and non-immune-related, have increased. Both together or independently can contribute to conception-related difficulties as well as miscarriages.

Pre-pregnancy thyroid screening

As part of the routine, we do thyroid screening before pregnancy, but the majority of the guidelines do not suggest or support the routine use of thyroid screening. So, this is something where maybe more studies have to be done and we should start doing more thyroid screening before pregnancy in the preconception period itself.

Thyroid, infertility & miscarriages

Thyroid hormone has a crucial role right from the development of eggs to implantation, to placentation, to continuation of the pregnancy, as well as adequate foetal growth and development. So silent thyroid disorders can go unnoticed, only to present as infertility or miscarriage.

When thyroid hormone production is low, in response to that, the pituitary gland in the brain releases more thyroid-stimulating hormone or TSH. Now, when this TSH increases, prolactin also increases along with it. And when the prolactin increases, the menstrual cycle becomes irregular and egg development or ovulation is inhibited.

Abnormal thyroid levels can also decrease something called SHBG or sex hormone-binding globulin, which is responsible for binding the estrogen and progesterone hormones. So their levels keep fluctuating. As a result, egg production and endometrial development do not happen properly.

Also, if hyperthyroidism or hypothyroidism is present, there will be an abnormal molecular environment of the endometrium or the uterus lining, and conception will be difficult.

Fifteen per cent of thyroid disorders are autoimmune thyroid disorders and autoimmunity can damage egg development and the follicles. Not only that, it can damage an embryo which is coming into the uterus, creating a very hostile environment for implantation.

Why working women miss recognising thyroid disorders

Thyroid disorders often remain undiagnosed in working women mainly because of the common myths surrounding thyroid disorders and conception.

The most common myth is that if a person has had a thyroid disorder, has taken medicine, and it has come down to normal, they do not need thyroid medication anymore. This is a misconception, because once you start taking the thyroid tablet, you have to continue it lifelong.

Or if you think you want to stop it, it has to be checked every six weeks, and if it can be maintained without the thyroid medication, then only can it be stopped.

Lifestyle tips to support reproductive health

The most important lifestyle change that can be made is sleep. Sleep is the most important. People should sleep on time, wake up on time, and manage their stress levels.

(The author is a Consultant - IVF & Reproductive Medicine, Manipal Hospital Whitefield and Varthur)

The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.

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