High TSH just before embryo transfer day - clinic said it’s fine…

[PaulaDag]

Hi All,

I take 50 / 75 mcg of levothyroxine on alternate days and had it checked at my GP on Thursday, before embryo transfer on Monday. It’s been around 1.07 and 1.32 miu/l the last 2 months which was great but after taking oestrogen for 15 days it’s pushed it over to 2.76 miu/l. I had it checked again just before transfer and it’s 2.56 miu/l (after upping does to 75 Friday, Saturday and Sunday). The fertility clinic says it’s fine as oestrogen is known to elevate it. and they have an accepted range. See below what consultant said:-

“I wouldn’t change doses at this late stage – they won’t have an impact in time for transfer (it takes 6 weeks for dose change to take effect). Your TSH is in range for transfer (we account for the fact that E2 will push up TSH when we set ranges)”.

Just wanted some opinions on this as I’m a little worried? I’ve always been under the impression it needs to be under 2.0 for pregnancy etc, but I don’t have a true hypo thyroid problem per se it’s more just controlling it to rule things out.

Is it true oestrogen pushed TSH up and it’s not to be included in the range?

I’ve upped my dose to 75 mcg everyday anyway as I assumed it can’t do any harm during the tww as I’m day 3 now but a bit concerned it might cause issues with success xx

[Skittles11]

Hi

A really similar thing happened to me on a frozen cycle - here is the link, I received some really useful responses from people

healthunlocked.com/fertilit...

I would say you have done the right thing to increase it by 25mcg and that should help counteract the increase. Your levels are not wildly high so don't worry too much.

Take care xx

[PaulaDag in reply to Skittles11]

Hi Skittles,

Thanks for this. It makes me feel a lot better that it didn’t seem to impact your FET cycle. What was your last level before the transfer? Mine was 2.53 on transfer day :(. It’s so worrying as I’m day 4 now. No symptoms aside from some period like pains this morning 🤔

It almost seems as if the clinics don’t like it if it is higher than 2 or 2.5 before starting the FET (not that they’d check if I didn’t push it!), but if the oestrogen elevates it during the FET cycle that is ok (to a certain level of course). Tbh I’ve tested via my gp monthly as my clinic don’t seem to want to monitor TSH that much.

I don’t understand why oestrogen elevates TSH but I guess I can expect this to happen for each FET when I start oestrogen then if this one is unsuccessful. Maybe I need to increase my thyroxine once I start oestrogen - is that what you have done since to counter it?

Xx

[Skittles11 in reply to PaulaDag]

Hi

My level the day before the transfer was 2.32 so it had come down in just a few days. I was taking 75mcg of Thyroxine upped from 50mcg which I think is what you're doing.

I have only had one frozen cycle which very sadly ended traumatically but the Thyroid levels on this cycle were absolutely fine. Yes ideally I would have wanted them lower but they had no impact on my result which at the the time was positive (as I say it did later end traumatically but this had no connection to the thyroid). If I were having another FET I will now be aware my Thyroxine could do with an increase maybe just before I start the oestrodial or in the early stages of taking it.

If it comes to it you will also now possess this useful knowledge...BUT do not despair as your levels I really believe won't prevent you becoming pregnant this time. They are just within the limits and that is okay xx

[PaulaDag in reply to Skittles11]

Thanks for your guidance on this skittles, really appreciate it and sorry to hear about your loss xxx