August 11, 2017

TSH Should Be Part Of The Evaluation For Infertility

Thyroid and Infertility

TSH or Thyroid Stimulating Hormone should be part of the routine evaluation of recurrent pregnancy loss and infertility. TSH should be part of the evaluation for infertility. Here is why: A TSH level of 5mU/l or greater is indicative of hypothyroidism. A TSH level less than 5 mUl but greater than 2.5mU/l is associated with implantation failure and early pregnancy loss. A recent study published in the European Journal of Obstetrics and Gynecology and Reproductive Biology in 4,643 women who had thyroid function tests performed when pregnant found a TSH level in the hypothyroid range in 1.5% of women and 10.3% had a TSH between 2.5 mU/l and 5mU/l. Approximately 19% of women with a TSH higher than 2.5 mU/l but less than 5mU/l went on to develop clinical hypothyroidism. Women with a TSH greater than 5 mU/l delivered infants of low birth weight.

TSH should be determined and treated if found to be over 2.5 mU/l. The TSH level should be reassessed in early pregnancy since there is increased utilization and demand for thyroid hormone in early pregnancy. The dosage usually needs to be adjusted by as much as 20% to keep the TSH level less than 2.5 mU/l.

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Joseph A. Hill, III, M.D.

Joseph A. Hill, III, M.D. Board-Certified in Reproductive Endocrinology and Infertility