IVF and TSH

[Lfhbm]

Hi,

I am hoping that someone out there can give me some advice. I'm doing a frozen cycle. I found myself in hospital about a week and a half ago; my TSH was tested and found to be 4.8. This was a shock to me as it had been 2.3 only two weeks before. The only thing that had changed was my starting IVF treatment. I'd started estrogen medication and been taking it a week or so at this point. I've since read that this can affect the uptake of Levo. I contacted my Endo and she advised that I up my Levo by 12.5 mcg.

So I had my transfer on Monday. And I am more relaxed and relatively more positive than I was with my first IVF cycle. But I am concerned about my TSH and how this might impact a growing embryo. This morning I upped my Levo by another 12.5. Now I am taking 100 mcg - I'd originally been on 75 mcg for ages.

I tend to think my Endo is a bit rubbish, and this process is highlighting this to me. Could anyone please give me some advice? Have you been through this and noticed your thyroid levels were affected by the IVF meds? How have you managed?

Thank you for your help and advice. And thank you for listening!

[misswinky34]

Hmm. I'm surprised at the minute increase to be honest. Ideally tsh needs to be surpressed, my endo keeps mine under 1, I could never get pregnant when my tsh was around the 4 Mark. To get mine from 4 to between 0-1 I was in 100mcg then increases to 125 then increased to 150 during pregnancy. Which took 5 years. I know there are lots of things that can block absorption of Levo, it may well be down to the IVF meds. But I know some clinics vary the ranges they are willing to work with, the fertility clinic we were with wanted tsh under 2 and some were unwilling to do treatment until it was under control because of the risks to a successful pregnancy.

Not trying to be negative- just realistic. I would say you need a bigger nudge to get your Tsh between 0-2 than 12mcg Levo. I don't think that will touch you.

When pregnancy is confirmed they usually increase in 25mcg increments, to give the embryo the best chance of survival. Technically when you have your embi on board, you will need that increase to support it straight away.. as it will deplete maternal thyroid until it can self sustain at 12 weeks. You need enough for the both of you. I would be questioning the endo about this.

I know there's advice on leaving certain time distances between meds. And some people take Levo 12 hours between other meds to prevent lack of absorption.

The other possibility is, are you sub clinical or hashimotos? As you may have had a Hashi flare up, which could only be temporary. Either way, in my opinion your TsH needs to be as low as possible. Lower than what it is now to support any pregnancy.

I would be having a discussion with your endo and fertility team about this for sure.

Another thing you could do is ask this question in thyroid UK on this site too, there's plenty of experts on there who I'm sure can help 😊

Xxxxx

[Lfhbm in reply to misswinky34]

Thank you! I've posted to the thyroid UK too. What you've said further highlights that my endo is rubbish. My tsh was stable before this process but I do believe she's not hearing my concerns.

The hospital doing my IVF tend to leave the thyroid up to the endos. I wish they'd work together! I'm going to see about changing endo.

I do have Hashis. For my last IVF my tsh went to 0.03 during treatment. And it was 1.something before I started. I must be extra sensitive!

I'm going to stick with 100 mcg as opposed to the 87.5 that was advised by my endo.

[misswinky34 in reply to Lfhbm]

Yes your TSH was much better in them earlier treatments. My fertility consultant wa happy at it Being suppressed at .16 as t4 had lowered too. Plus I was very symptomatic when the TSH was over 2

Same here! Fertility consultant and endo from different planets! Feels like we're really having to fight, almost persuade them for help! But your exactly right with your concerns, something's caused a fluctuation like that and TSH abnormalities can be the difference carrying and losing. I'm 32 weeks and still having to push for function tests every 6 weeks 😐 It needs proper management. Hashis is a disease that deserves treatment like any other would.

Not to be rude but your endo doesn't sound the best 😐 I think I only fell lucky with endo because she's also a qualified OB and she's only taken over since I've been pregnant. The fight I've had up that point 🙄 GPs especially 😡

Did they test your antibodies at the same time? That might have given a clue of when the spiked occurred. and you can prove it.

Your concerns are sound, proper management is critical when your TTC and its a brutal enough process without barriers like this that could jeopardise it all.

You sound headstrong so I'm sure you will get the results you need 😊

Good luck with it 🍀🙏❤️Xxxx