The health of the couple preparing for pregnancy is the primary requirement for a healthy pregnancy, but how should you prepare for pregnancy when you have hypothyroidism or hyperthyroidism? Should you continue to take your medication or stop taking it before you have a baby? What are the precautions to take? Let’s find out together.
Thyroid function measurement is very important. Both hypothyroidism (hypothyroidism) and hyperthyroidism (hyperthyroidism) can cause infertility and sterility, and hypothyroidism may also affect the IQ of the offspring. In addition, even if you do not have hypothyroidism before pregnancy and do not have relatives with thyroid disease in your family, it is important to be screened for thyroid disease. This is because patients with occult thyroid disease who had normal thyroid function before pregnancy can become significantly hypothyroid or hyperthyroid after pregnancy. Currently, screening for pre-pregnancy thyroid disease has been carried out in many cities by family planning departments.
Get your thyroid function checked before you get pregnant
Thyroid disease is the second most common disease in the field of endocrinology, in which female patients are 6 to 10 times more common than male patients. There are about 100 million patients with thyroid disease in China, but its treatment rate is less than 2%, we really pay too little attention to thyroid!
Effects of abnormal thyroid function on mother and fetus
If you don’t know you have thyroid disease before you get pregnant, the impact on the mother and the fetus can be very significant. Due to the insidious nature of the onset of hypothyroidism, many pregnant mothers do not realize that they have a thyroid disorder. The adverse effects of uncontrolled hypo- or hyperthyroidism on pregnancy and obstetric complications include infertility, infertility, miscarriage, preterm delivery, pre-eclampsia, congestive heart failure, thyroid crisis, placental abruption, and infection.
From the perspective of eugenics, comprehensive screening for thyroid disease in women who are planning to become pregnant or are already pregnant is essential to avoid fetal brain development disorders and many obstetric complications in hypothyroid pregnant women. The best time to be screened is when planning a pregnancy, or within 6 weeks of gestation, the earlier the better. Of course, it is better to be screened throughout pregnancy than to detect congenital hypothyroidism after the birth of the child, and the incidence of hypothyroidism is higher in the second trimester.
Women who are planning to have IVF should also have their nail function checked in advance
Many hospital fertility centers do not check the thyroid function of their patients. Some people have done IVF several times at a cost of $20,000 to $30,000 each time, but they have failed. It may be caused by subclinical hypothyroidism or positive thyroid antibodies. Some hospitals do check the thyroid function, but they do not judge the results according to the criteria for pregnant women, which still causes many patients to delay treatment.
Thyroid hormones not only affect egg development, but also the intrauterine environment. Abnormalities in egg development and the uterine environment can cause infertility and sterility. Some patients think that IVF will solve the problem. In fact, if the uterine environment is abnormal, IVF will not survive after transplantation. It is like the relationship between the seed and the land, neither the seed nor the land can produce good healthy seedlings.
Effects of abnormal thyroid function on men preparing for pregnancy
Decreased or increased thyroid hormones can also affect sperm quality and thus cause male infertility. In men with hypothyroidism, subclinical hypothyroidism and hyperthyroidism, various indicators such as sperm viability, A-grade sperm count, sperm motility, sperm malformation rate and liquefaction time can be abnormal, which can cause azoospermia in severe cases.
What thyroid tests should be done for women preparing for pregnancy?
Thyroid function is a customary name, but it is actually the measurement of thyroid function, which is the level of thyroid hormones. T3 (triiodothyronine), T4 (thyroxine), TSH (thyrotropin), FT3 (free triiodothyronine), FT4 (free thyroxine), TgAb (thyroglobulin antibody) and TPOAb (thyroid peroxidase antibody) are the seven most valuable tests for the first time. TPOAb is an independent risk factor, which means that an elevated TPOAb may cause miscarriage.
Why is it important to check for thyroid peroxidase antibodies?
A patient who is positive for thyroid antibodies means that he or she has occult thyroiditis. If the patient is not pregnant, the thyroid hormone is barely enough for the mother to use and will not show hypothyroidism, and the serum TSH level is often less than 2.5 mIU/L but more than 1.0 mIU/L. In this case, the doctor will tell the patient that the result is normal and no treatment is needed. However, once the patient becomes pregnant, especially after a twin pregnancy, the thyroid hormone level will drop rapidly and the TSH level will rise significantly, resulting in significant hypothyroidism.
Scientific approach to pregnancy preparation for hypothyroid patients
Hormonal characteristics of hypothyroidism patients
For pregnant women preparing for pregnancy, the first step should be to check thyroid hormone levels and be sure to check thyroid antibody levels at the same time. The most common test results in hypothyroid patients generally show normal or mildly elevated serum TSH levels and normal or elevated levels of thyroid antibodies. Only a small number of patients also have reduced thyroid hormone levels.
Treatment in preparation for pregnancy
Currently, the treatment for hypothyroidism is to take thyroxine. There are generally two types of thyroxine that we get in hospitals or pharmacies, three types. The first type is levothyroxine, a synthetic thyroxine, which is imported and produced in Germany, called “Eugenol”. The domestically produced one is called “Raitis”. There are generally two types of dosage forms, namely 100 micrograms and 50 micrograms per tablet. The second type is thyroid tablets, which are tablets made from the thyroid gland of cattle, pigs or sheep after drying and pressing, with a content of 40 mg per tablet. Its dosage form is poorly stable and the dose is not easy to control. It is not recommended for women who are preparing for pregnancy or who are pregnant. The drug does not have any side effects and is not only free of side effects for the fetus, but essential. This is because the fetus does not produce thyroxine in the early stages of pregnancy (within 20 weeks) and must consume the mother’s thyroxine.
Goal of thyroid function control in pregnancy preparation
Pregnant women with normal thyroid antibody levels should have a TSH level of less than 1.0 mIU/l, and those with elevated antibody levels should control their TSH level to about 0.5
The TSH level should be controlled to about 0.5 mIU/l for those with elevated antibody levels.
TipsWomen with hypothyroidism who are preparing for pregnancy should pay attention to contraception during the treatment phase. This is because the decrease in serum thyroid hormone levels during hypothyroidism can affect the development of primordial oocytes. During the treatment process, after the serum TSH level is completely normal, it is best to wait for 2 to 3 menstrual cycles so as to ensure that the quality of the eggs ovulated is completely normal. Otherwise, the rush to get pregnant may be affected by the quality of the eggs, resulting in a decrease in fetal quality. In fact, in the case of men with hypothyroidism, they should also wait for three months after their TSH levels are normal before getting pregnant, otherwise, the quality of the fertilized eggs may also be affected by the poorer sperm quality in hypothyroidism.
What doctors say to women preparing for IVF.
For women who are preparing for IVF, it is recommended to have their thyroid function checked before ovulation promotion. This is because ovulation promotion can increase the thyroid burden and cause mild hypothyroidism. It is important to keep the TSH level below 1.0mIU/L before transplantation. If elevated thyroid antibody levels are also present, it is best to control the TSH level below 0.5mIU/L. Otherwise, after successful transfer, especially when more than two embryos are transferred, the maternal thyroxine level will drop rapidly and embryonic arrest may have occurred by the time it is discovered. Review thyroid function immediately after successful transplantation and adjust the dosage of Eugenol in time.