TSH high level before transfer :(

[ValaI]

Hi everyone,

I have just discovered this group and decided to join as I need help to understand how thyroid levels work for IVF.

I am on my two week wait after a frozen transfer (11 March) in Spain and asked for the clinic to test progesterone and thyroid levels two days before transfer (09 March) as RI wanted to check levels of Thyroid. This was once we increased intake of Levythoroxine from 50 mg to 75mg for every other day because 2 weeks ago results showed increased level of TSH again.

I was fuming to understand that I would need to wait 6 days for the results and no one in the clinic explained this when I asked initially for the timeframe.

The results are as per below and I had my regular dose that morning:

*THYROPEROXIDASE ANTIBODIES (ANTI-TPO) result is 289.400 Ul/ml and TSH result is 3.420 mcU/ml

Shared this with RI and he recommended to increase the dose to 100 mg for 2 days of the week and the rest 5 days take 75mg.

Now my questions for you my dear ones are:

1. Knowing that TSH needs to be 2.5 at least on day of transfer, is there a chance that the increased dose during 2 week wait can help reduce the level?

2. Do I keep taking the recommended dose from RI or keep taking 100mg in this two week wait and test in a week again?

I have incorporated Brazilian nuts to help with this but I am devastated that clinics are completely ignorant and careless on this matter. It’s heartbreaking after all the money and time we put in this to make things happen they dont take responsibility. ☹️😢

We have to become our own doctors and nurses and nutritionist after all the money we throw for their advice and guidance.

Please please can someone advice and let me know your thoughts on this?

Thank you so so much for your time

Xoxoxo

Val

[greygoose]

1. Knowing that TSH needs to be 2.5 at least on day of transfer, is there a chance that the increased dose during 2 week wait can help reduce the level?

No. But that's irrelevant, because it's not the TSH itself that is going to help or hinder.

TSH - Thyroid Stimulating Hormone - is a pituitary hormone that tells the thyroid to make more hormone when the pituitary senses the there is not enough in the blood. So the TSH is seen as an indicator of thyroid hormone levels - T4 and T3. And that's about all it does.

When talking about conception and pregnancy, it's not the TSH that is the important bit - especially as it's not always reliable. It's the FT4 and FT3. During the first trimestre of your pregnancy, the baby will be living off your thyroid hormones, until it develops a thyroid of its own. And, it's mainly the T4 that passes the blood/placenta barrier. So, you need your FT4 as high as possible, and forget the TSH.

In any case, a TSH of over 2 is far too high for anyone. When on thyroid hormone replacement, it should come down to 1 or under.

2. Do I keep taking the recommended dose from RI or keep taking 100mg in this two week wait and test in a week again?

Not sure what your asking there. I thought you were on 75 mcg and told to increase it to 75/100 alternating. But, with a TSH as high as yours, I would have thought you needed at least 100 mcg daily. If not more.

But, testing just one week after an increase is not going to give you any reliable information. It takes at least six weeks for the dose to settle and give you reliable results.

The results are as per below and I had my regular dose that morning:

*THYROPEROXIDASE ANTIBODIES (ANTI-TPO) result is 289.400 Ul/ml and TSH result is 3.420 mcU/ml

Taking your levo on the morning of the test will not have any effect on either the antibodies nor the TSH. It will only affect the FT4, and it seems they didn't test that! I don't think any of them really know what they're doing, or why.

[ValaI in reply to greygoose]

Hi @greygoose, before doing the blood tests I have obtained the list of endocrinologists shared here in the forum but I am reading that not all endocrinologists have enough information about thyroid impact in IVF. I was wondering is there a recommendation or a post where we can identify few of endocrinology specialists with focus on IVF? Or how is this best done? I know its not allowed to share names of clinics and consultants but would be nice to know who do we approach. Thank you in advance for your help and guidance. This is much appreciated…. Val xoxo

[greygoose in reply to ValaI]

I'm afraid I can't help you, there, I just don't know. Perhaps you should write a new post asking just that. Then those that do know can reply.

[Buddy195 Administrator]

… just a word of caution Brazil nuts Valal. As 400ug selenium supplements have been shown to be toxic, ensure that you only have 1-2 Brazils per day (as each contains 50-90ug selenium dependent on soil type).

[ValaI in reply to Buddy195]

Thanks Buddy, well noted on this info, I was usually taking 3 nuts per day but reduced to two now. Wasn’t aware of the potency they have 🤔. Thank you so much, I really appreciate it.

[ValaI in reply to Buddy195]

hi Buddy, it’s again me Val. As mentioned to greygoose, before doing the blood tests I have obtained the list of endocrinologists shared here in the forum but I am reading that not all endocrinologists have enough information about thyroid impact in IVF. I was wondering is there a recommendation or a post where we can identify few of endocrinology specialists with focus on IVF? Or how is this best done? I know its not allowed to share names of clinics and consultants but would be nice to know who do we approach. Thank you in advance for your help and guidance. This is much appreciated…. Val xoxo

[Buddy195 Administrator in reply to ValaI]

I would start a new post asking for ‘Endo recommendation knowledgable in IVF’. Replies will need to be via private message only, so your post will be closed by the admin team. It may also be worth stating the region you live in/ would be willing to travel to/ if you would consider an online appointment.

[ValaI in reply to Buddy195]

I just posted in both Fertility and Thyroid forums but worth adding the detail about the location which ai didn’t think before. Thank you ever so much

[radd]

Valal,

Welcome to our forum,

I myself have no experience of IVF but know that TSH needs to be kept low to prevent an increase in prolactin that is disruptive to conception and retaining the pregnancy.

Many GP’s (and possibly IVF clinics 🤷‍♀️) don’t understand that when testing levels it is not the usual 6 week protocol waiting for cells to saturate but immediate thyroid hormone levels that are prudent as these will be influencing conception and the developing embryo.

TSH changes lag behind thyroid hormone changes but I would keep taking the 100mcg Levo as if IVF is successful you will need to up the dose anyway to have sufficient thyroid hormone levels to support both yourself and the baby.

I also notice your thyroid hormone antibodies are high. There is research showing thyroid antibodies to pass over to baby, and even suggestions that they can disrupt conception as equate to an unnatural high inflammation. A good read is 'Your Healthy Pregnancy With Thyroid Disease' by Dana Trentini and Mary Shomon who offer information on how to mange autoimmune issues during conception and pregnancy.

If you are you supplementing folic acid, many Hashi sufferers prefer the methyl version that can be more easily utilised by the body. Also I would suggest a selenium supplement to ensure adequate levels as opposed to relying on brazil nuts. Selenium not only helps thyroid hormones to work better (as part of the production and conversion process) but research shows selenium to help reduce thyroid antibodies.

[ValaI in reply to radd]

Hi @radd, it’s again me Val. As mentioned above, before doing the blood tests I have obtained the list of endocrinologists shared here in the forum but I am reading that not all endocrinologists have enough information about thyroid impact in IVF. I was wondering is there a recommendation or a post where we can identify few of endocrinology specialists with focus on IVF? Or how is this best done? I know its not allowed to share names of clinics and consultants but would be nice to know who do we approach. Thank you in advance for your help and guidance. This is much appreciated…. Val xoxo

[radd in reply to ValaI]

Valal,

You could start a new post with a title such as ' Looking For IVF Experienced Endo' or similar. Then write a little paragraph inviting others to share their experiences with certain endos by PM only.

[ValaI in reply to radd]

Thanks so much radd, will do that now immediately. Hugs