Infertility is a significant global health concern, affecting around 15 percent of couples worldwide. Among the 60–80 million infertile couples globally, 15–20 million reside in India alone.
While the causes of infertility are multifaceted, thyroid disorders are a notable yet often overlooked factor contributing to this issue. Importantly, infertility is not solely a female problem; both male and female factors can play a role. Dr Amita Jain, Delhi NCRs top laparoscopic and thyroid specialist doctor explains how thyroid disorders can impact fertility in both genders.
The thyroid is a butterfly-shaped gland in the neck that produces hormones like T3 and T4, essential for regulating metabolism, heart rate, and body temperature. It also secretes calcitonin, which helps bones absorb calcium.
Disorders such as hyperthyroidism and hypothyroidism disrupt hormone levels, impacting various bodily functions and potentially leading to infertility. Thus, the thyroid is vital for maintaining overall health and hormonal balance.
What are the types of thyroids?
Hypothyroidism is when the thyroid gland produces less thyroid hormone.
Hyperthyroidism is when the thyroid produces too much thyroid hormone.
What is the Impact of Thyroid Disorders on Fertility?
Hyperthyroidism and hypothyroidism
Thyroid imbalances such as hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid), can disrupt fertility. Hyperthyroidism leads to an excess of thyroid hormones, while hypothyroidism results in a deficiency.
Both conditions are linked to difficulties with conception due to their impact on reproductive hormones. In women, thyroid imbalances can disrupt menstrual cycles and ovulation, while in men, abnormal thyroid hormone levels can affect sperm production and quality.
Disrupted Ovulation and Pregnancy Complications
Low levels of thyroid hormones can interfere with ovulation, the process where an egg is released for fertilization.
Without ovulation, conception becomes challenging. Moreover, an underactive thyroid increases the risk of miscarriage, making it harder to carry a pregnancy to term.
Overlooked Thyroid Disorders
Thyroid disorders are sometimes missed in cases of unexplained infertility. It’s crucial for doctors to conduct thorough evaluations and tests to identify any potential thyroid issues that could be affecting fertility.
What about the Impact of Thyroid Disorder on Female Fertility?
Some of the impacts could be:
Hypothyroidism
Hypothyroidism occurs when the thyroid gland is underactive, resulting in low thyroid hormone levels.
This condition can disrupt the menstrual cycle, leading to irregular periods, infrequent menstruation, or even no menstruation at all. It can also impair ovulation, making it harder for women to conceive.
Hormonal imbalances caused by hypothyroidism can affect key reproductive hormones like FSH, LH, estrogen, and progesterone, further reducing fertility.
Hyperthyroidism
Hyperthyroidism, marked by excessive thyroid hormone production, can also disturb the menstrual cycle. Women may experience shorter cycles, irregular periods, or infrequent menstruation.
Ovulation might be disrupted, which can lower fertility. In severe cases of Hyperthyroidism, a condition called thyroid storm can occur, posing significant risks to reproductive health.
Autoimmune Thyroid Disorders
Autoimmune conditions like Hashimoto’s thyroiditis and Graves’ disease involve the immune system attacking the thyroid gland, leading to hormonal imbalances.
These disorders can affect reproductive health and increase the risk of complications during pregnancy, such as miscarriage or preterm birth. Proper medical management is crucial for women with these conditions to ensure both maternal and fetal health.
What is the Impact of Thyroid Disorder on Male Fertility?
Impact on men would be:
Thyroid Imbalance: Hypothyroidism (underactive thyroid) decreases testosterone levels, leading to low sperm count, poor semen quality, and erectile dysfunction. Hyperthyroidism (overactive thyroid) may increase testosterone but can cause infertility due to abnormal semen analysis, like reduced semen volume and motility.
SHBG Imbalance: Hypothyroidism lowers sex hormone-binding globulin (SHBG) levels, while hyperthyroidism raises them. High SHBG can affect sexual function, causing decreased libido, erectile dysfunction, and premature ejaculation, complicating conception efforts.
How to Diagnose Thyroid Disorders?
To diagnose thyroid disorders, the first step is a blood test to measure thyroid-stimulating hormone (TSH) levels. Elevated TSH levels may indicate hypothyroidism (an underactive thyroid), while low TSH levels suggest hyperthyroidism (an overactive thyroid). The normal TSH range is generally between 0.5 to 5.5 µIU/mL, though individual evaluations may vary based on symptoms.
If TSH levels are abnormal, further testing may be conducted, including a full thyroid panel. This panel assesses levels of thyroxine (T4) and triiodothyronine (T3), and checks for thyroid antibodies.
The T4 test measures the inactive form of thyroxine, while the free T3 test evaluates the active form. Additionally, the TPO test can detect thyroid peroxidase antibodies, which are indicative of autoimmune thyroid conditions like Hashimoto’s thyroiditis or Graves’ disease.
What is the Treatment?
Treating infertility linked to thyroid disorders involves normalizing thyroid hormone levels with medication. For men, this can improve sperm quality, while for women, it helps correct menstrual and ovarian issues.
Hypothyroidism can be managed with hormone replacement therapy, and Hyperthyroidism may require antithyroid medication, radioactive iodine, or surgery. Nutrient-rich foods like iodine, Vitamin B, Zinc, Selenium, and Vitamin D support thyroid health. Lifestyle changes, such as a healthy diet and regular exercise, also contribute to effective treatment and prevention.
Conclusion
Thus, it is evident that thyroid disorders significantly impact fertility in both men and women. From disrupting menstrual cycles and ovulation to affecting sperm quality and hormone balance, managing thyroid health is crucial for successful conception. Early diagnosis and treatment can improve fertility outcomes and support overall reproductive health.
Dr Amita Jain is a surgeon with highest degree of professional competence, precision and surgical craftsmanship. Performed all complicated general surgery procedures with in depth knowledge of invasive and few minimal invasive and onco surgical techniques. Underwent special training in trauma, executed various trauma-related complex life-saving neurosurgical procedures, reconstructed injured mangled limbs and performed vascular and reconstructive procedures with critical care.
Dr Amita Jain holds 28 plus years of rich experience in Trauma and General Laparoscopic Surgeries (including Gallbladder stone removal, appendix removal, hernia repair surgery, piles and fissure surgeries). She was the Professor Surgery of at the Army College of Medical Sciences and Base Hospital Delhi Cantt. In 1994 she was commissioned as Surgeon under the United Nations Mission in Congo. From 2020 to 2022, she worked with Bansals Hospital. Currently, Dr Amita Jain is the Senior Consultant, (Speciality: General and Laparoscopic Surgeon) at Artemis Lite Hospital, New Delhi