Hello XXXXXX
Thanks for your query.

Uncorrected thyroid dysfunction in pregnancy has adverse effects on fetal and maternal well-being. The deleterious effects of thyroid dysfunction can also extend beyond pregnancy and delivery to affect neurointellectual development in the early life of the child. Demand for thyroid hormones is increased during pregnancy which may cause a previously unnoticed thyroid disorder to worsen.

Hypothyroidism is diagnosed by noting a high TSH associated with a subnormal T4 concentration. Subclinical hypothyroidism is present when the TSH is high but the T4 level is in the normal range but usually low normal. This is the condition you are suffering from.

Several studies, mostly retrospective, have shown an association between overt hypothyroidism and adverse fetal and obstetric outcomes . Maternal complications such as miscarriages, anaemia in pregnancy, pre-eclampsia, abruptio placenta and postpartum haemorrhage can occur in pregnant women with hypothyroidism. Also, the offspring of these mothers can have complications such as premature birth, low birth weight and increased neonatal respiratory distress. Treatment of hypothyroidism reduces the risks of these adverse obstetric and fetal outcomes

Levothyroxine is the treatment of choice for hypothyroidism in pregnancy. Thyroid function should be normalised prior to conception in women with pre-existing thyroid disease. Once pregnancy is confirmed the thyroxine dose should be increased by about 30-50% and subsequent titrations should be guided by thyroid function tests (FT4 and TSH) that should be monitored 4-6 weekly until euthyroidism is achieved. It is recommended that TSH levels are maintained below 2.5 mU/l in the first trimester of pregnancy and below 3 mU/l in later pregnancy.

Hence, please consult your gynecologist and normalize your thyroid levels before planning a pregnancy.
Take regular folic acid supplements meanwhile.
Get yourself tested for thyroid antibodies , as if present, they can further worsen the picture while pregnant and even while trying to conceive.
All the best, and feel free to discuss further.

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For women, there's sometimes a link between hypothyroidism and infertility. Low levels of thyroid hormone can interfere with the release of an egg from your ovary (ovulation), which impairs fertility. In addition, some of the underlying causes of hypothyroidism — such as certain autoimmune or pituitary disorders — may impair fertility.

For women, treating hypothyroidism is an important part of any effort to correct infertility. If infertility remains after hypothyroidism has been corrected, other interventions to treat infertility may be needed.

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