Thyroid and ivf - thyroid check before transfer?

[PenguinBlue]

Hi everyone, hope everyone is doing well.

Just a quick one from me. I have hypothyroidism and have been on 50mcg Levothyroxine since Jan. I am on my second cycle and requested they check my thyroid again and FSH is currently 2.9 which is above the 0.4-2.5 mUi it should be when TTC.

The doctor today prescribed me to increase my meds and take 75mcg. I asked whether I can have another test just before transfer and she said they wouldn’t recommend as it’s unlikely to have made a difference by that point (currently I think around 9-10 days away from transfer). Just wanted to get perspective if anyone had done something similar and checked their thyroid before transfer itself and were able to see a difference? Or if increasing dosage now will support and help my transfer?

Thank you xxxx

[PenguinBlue]

Just a small update, I had my afternoon update from my clinic and they want me to alternate between 50 and 75 mcg each day 🤷🏽‍♀️

Also if anyone is also interested in answers for this post, I have posted this question on the Thyroid U.K. network and had a lot of information sent from the administrator on the responses section. I’d still be interested to know anyone else’s thoughts from an ivf perspective too xx

[ToughCOOKIE78]

Hi Penguin, do you know what you TSH hormone levels are?

My transfer is on Thursday, I’ve been on levothyroxine for just over 2 weeks now, first week taking 25mg and now 50mg every other day.

My TSH has gone down from 2.59 (they say 2 should be the maximum for IVF/ early pregnancy) to 0.9 so quite quickly.

This med works quite quickly- why don’t you ask them to check your TSH levels?

I wouldn’t worry too much though as if they would be worried trust me they would check!

Hope this is helpful ❤️

When is your transfer? Xx

[PenguinBlue in reply to ToughCOOKIE78]

Hi tough cookie! Thank you for your response! It’s really helpful! Oh wow, that’s great that they’ve changed and upped your meds so quickly over 2 weeks! Will you need to reduce your dose or are they quite happy with the levels you’re at right now? I’m quite jealous yours have gone down so quickly! Did your clinic test your thyroid each week?

Sorry my TSH was 2.92 when it was checked on Friday. Back in Jan it was 5.3 and then after being on meds for 6 weeks it came down to 2.0 in late Feb.

Yes, I do trust my docs but am a little apprehensive as they didn’t really ask to check it for this cycle and I had to request it myself. I will speak to my Gp and see if I can get retested next week or will look to get an online one with medichecks maybe!

Lots of luck for your transfer on Thursday 🧡🤞🏽🧡🤞🏽🧡 is it your first cycle?

I’m hoping for egg collection over the weekend and transfer should be late next week I think! Xx

[ToughCOOKIE78 in reply to PenguinBlue]

No they’re keeping me on 50mg every other day for now and will test me in a months time (and if I’m pregnant every month after that to adjust doses in case needed). No it’s my 4th cycle 😱and my 4th transfer 🙈I had a mmc at the end of March at 11wks 💔 I’m still recovering psychologically but time is ticking so better get back on the saddle sooner rather than later!

You still have a week to go so if they don’t want to test your TSH book a private test in another clinic it’s about £45 but totally worth it! So you can then shove the report under their noses and will have to make a decision! 😉xx

[PenguinBlue in reply to ToughCOOKIE78]

Ah ok, it makes me feel better to know you’re alternating dosage also which is what my clinic have now said to do too.

Oh I’m so so sorry to hear about your miscarriage- I can’t imagine what that feels like and not surprised you are still healing. Hope your fourth transfer will bring you the positive you deserve!

Haha that would be great if I could shove the results at them! Apologies for being unknowledgeable but how would you book a private test at another clinic? Do most fertility clinics test if you called and asked them? Or do you mean a private medical centre or hospital? Xxx

[ToughCOOKIE78 in reply to PenguinBlue]

Yes like a private gynaecology clinic or one of those medical centres where they do all sorts of blood tests...xx

[PenguinBlue in reply to ToughCOOKIE78]

Got it! Found 2 quite close to my clinic so am investigating now - thanks so much tough cookie! Keep me posted on your upcoming transfer xxx

[ToughCOOKIE78 in reply to PenguinBlue]

No worries! Thanks, will do! X

[sazzle2680]

Hi PenguinBlue

Taking progynova can effect the potency of your Levothyroxine. If you can, try and avoid taking progynova and Levothyroxine at the same time, ideally 4 hours apart. This is possibly why you’ve a slightly increased TSH from previous result. In terms of testing, it should be 6-8 weeks after having a dose change that you retest. Only 20% of Levo is absorbed quickly. The remaining 80% takes quite some time to absorb into the body which is why it doesn’t show in blood tests for a number of weeks.xx

[PenguinBlue in reply to sazzle2680]

Hi sazzle! Thanks for letting me know - I didn’t know that re levo and progynova - it’s crazy what we learn on this forum and what our docs tell us. If I hadn’t been on this forum I would have no idea on checking my thyroid or anything!! Will definitely space them out once I start taking progynova - thank you!

Good to know re the absorption of levo - as my TSH was 2.9, I’m hoping the 20% which absorb brings it into the normal range for fertility 🤞🏽 Xxx

[sazzle2680]

Sorry, I should have said, the full impact of the dose change won’t be apparent for 6-8 weeks. Essentially when you up your dose of Levothyroxine you know your TSH will reduce and T4 increase, but you won’t know properly by how much until 6-8 weeks later. Testing before that will show TSH has reduced but you’d still need to test again at 6-8 weeks to know where your plateau point is (if that makes sense). What your resting level of TSH is with that dose change. A low TSH isn’t a problem in pregnancy, it can create issues with bone strength if it’s left really low for a long time...but you would pick that up very quickly if testing at 6-8 weeks, so don’t worry about that.

When your little embie sticks, your thyroid will be closely monitored throughout (as toughcookie describes) but it is usual for clinics to up your Levothyroxine by 25mg as soon as you get your positive test. This is because there is always an increased demand for thyroid hormone when you’re pregnant which causes the TSH to rise again and clinics want to stop that happening.xx

[PenguinBlue in reply to sazzle2680]

Hi Sazzle, thank you so much for your additional explanation - all makes sense!! I’ve ordered a medichecks thyroid profile test so I can check my levels before transfer and hopefully will see that they have reduced but completely get that it won’t be the final picture until I have my blood test in 6 weeks time. I think it’s just more for my piece of mind that the levels reduce at least a little before transfer or if not I know I can definitely flag it back to my clinic. Xxx