Thyroid/IVF

[Jacqueline73]

Good afternoon everyone,

I am looking for some info please regarding what my TSH levels should be before starting my next round of IVF as I have previously had 2 miscarridges. 1st one 5 weeks 2nd one 11 weeks. I had my thyroid removes 12 years ago and have been on leverthyroxine ever since I get checked yearly and I am currently on 75mg daily. I had this checked before my 1st transfer in 2016 and both doctor and consultant advised everything one fine TSH was 4.7. I have recently found out from other ladies that this was way too high. I just want to make sure it at the correct levels for my next transfer. Thank you in advance. X

[jimh111]

Your TSH should be below 2.5 during pregnancy. However, with your history I would target a TSH around 1.0 as it will increase a bit during pregnancy. Aim to keep it below 2.5 during the first six months and below 3.0 for the last three months. (If I were in your shoes - not possible - I would keep it around 1.0).

[Jacqueline73 in reply to jimh111]

Hi Jimh111 thank you so much for your reply. Can you please advise what T4 and T3 should be and should I ask to be tested for thyroid anti bodies at the same time? Sorry for all of the questions I'm just trying to tick all boxes if that makes sense.

[jimh111 in reply to Jacqueline73]

As far as baby's health is concerned the TSH should be below 2.5. There is no research that I know of that recommends fT3 or fT4 targets but as reallyfedup123 notes most patients will do well with a TSH around 1.0, fT4 high in interval and fT3 around mid-interval. These are rough targets. TSH 2.5 is the cut off where they have found low thyroid might start to affect the pregnancy but a lower TSH may be needed for the mother to be well herself.

[Jacqueline73 in reply to jimh111]

Thank you Jim I'm just confused as to why my doctor and consultant do not know this and have let me do 3 rounds of IVF the emotional and financial strain it has put on us its so frustrating. Fingers crossed if I can get this sorted and I can help me have a successful pregnancy 😊

[jimh111 in reply to Jacqueline73]

If you get aggro regarding your thyroid treatment mention the 'N' word, negligence. It has legal meaning and so will gather attention.

[Jacqueline73 in reply to jimh111]

Totally agree Jim there is 2 words I always keep up my sleeve negligence and discrimination 😊

[Hidden in reply to jimh111]

Amazing that in this day and age OB docs don't think to order a thyroid workup by an endo part of early prenantal care or even do it before someone who is trying to get pregnant actually does-esp with a miscarriage history. If it were me I would demand this from my OB/GYN. And bringing some written professional info to him/her would be something else I would consider. If they are not receptive I would consider another doctor.

[Jacqueline73]

Thank you very much for your reply reallyfedup123 I am going to delay I'm IVF and take this up with my doctor on Thursday until they get the levels correct. IVF has been a roller coaster both emotionally and finacially for my partner and I we have done it now 3 times now without success and my next round will be my last so I want to give it my best shot. I have learnt so much about my thyroid in the last 2 days and I am amazed both my doctor and ivf consultant did not know this. Again thank you so much 😊

[Hidden in reply to Jacqueline73]

Hi Jacqueline. I sent a post a few minutes ago meant for you but accidentally replied to Jim. Please check this thread and sorry for my poor computer skills. I hope you get this straightened out very soon and have a very easy successful pregnancy. Take care xx irina

[Jacqueline73 in reply to Hidden]

Thank you Irina xx

[Hidden in reply to Jacqueline73]

You're welcome.🐱

[helvella]

I continue - despite having read so many stories - to be shocked that ANY clinic dealing with fertility, pregnancy and all that goes along with them, can fail to properly check thyroid hormone levels as a part of the absolutely fundamental assessment before any "treatment" can be commenced. Along with iron, folic acid/folates, B12, etc.

That anyone can remain inadequately assessed and treated when running up to their fourth round is downright iniquitous.

[Jacqueline73 in reply to helvella]

Hi Helvella the more I am finding out the more angry and annoyed I am getting. My doctor has known me since I was a kid she knows my history that's one of the reasons I have stayed with her. She is well aware of my thyroid being removed and I have also been diagnosed with thyroid eye disease over ten years ago. Hopefully I will get some answers on Thursday if not I will be looking for a new doctor this forum has been really helpful and I'm so glad it was recommended to me. 😊

[Jacqueline73]

It's crazy I trusted them to be the experts 😂

[Saya85]

Hi Jacqueline

As others have mentioned tsh below 2.5 is what is recommended.

In terms of support - this is actually recommended by NICE guidelines - you can print it off and show ur GP and consultant. I’m very sorry it’s taken them this long to sort it out.

T4 And t3 should be mid/upper third of ranges as suggested and once pregnant the t4 is normally increased by 25/50mcg immediately as baby relies solely on mothers thyroid in first 12 weeks.

I would get thyroid antibodies tested also - why was ur thyroid removed? Had u been diag hyperthyroid? Or was it cancer?

Although thyroid is a hot topic for clinics atm and many are very proactive - it is still shocking how so many are ignorant. However ignorance is not the same as (deliberate) negligence. If ur GP is supportive but unaware u will hopefully be able to educate her and get the right support u need.

Definitely have your vitamins checked also! Iron ferritin vitD Vit B12 And folate as minimum.

Also you may want to push for immunological fertility treating such as clotting (factor V Leiden ) and antibodies etc (pls check fertility UK forum on healthnunlocked if you haven’t already- they will have a wealth of information on this too)

Good luck- you are definitely on the right path to investigate and manage your own health. You have more than enough right to demand testing so be confident in doing so and I’m sure you will get lots of support on here ☺️