Miss Chen, 28 years old, has been married for two years but has been unsuccessful in getting pregnant. A few years ago, she was diagnosed with hyperthyroidism and has been receiving intermittent treatment in the internal medicine department. Over the past six months, her menstrual cycles have become irregular, which has caused her great concern. She visited the obstetrics and gynecology department seeking advice and requested the doctor to investigate why she has been unable to conceive.

 

Is there a relationship between thyroid and infertility? The answer to this question is affirmative. The human body is a complex system, especially the intricate interplay among various endocrine glands. Many mechanisms and interactions are still being researched in the field of medicine. However, it is a well-established fact that thyroid dysfunction, whether it is hyperthyroidism or hypothyroidism, can affect ovulation and lead to infertility.

 

The thyroid gland regulates a person's metabolic rate. Therefore, individuals with hyperthyroidism often experience symptoms such as nervousness, rapid heartbeat, palpitations, heat intolerance, weight loss, tremors in the fingers, fatigue, weakness, diarrhea, enlarged thyroid, exophthalmos (bulging eyes), and reduced menstrual flow or oligomenorrhea. On the other hand, individuals with hypothyroidism may experience symptoms such as excessive menstrual flow, general weakness, fatigue, dry and cold skin, sleepiness, hair loss, cold intolerance, and weight gain. Of course, not all symptoms mentioned above will occur in a single individual. However, if 2-3 of these symptoms occur together, it is important to consult a doctor for a thorough examination and not overlook these warning signs from the body.

 

When the thyroid is hyperactive, not only does thyroid hormone increase, but it also leads to an increase in sex hormone-binding globulin. This can indirectly or directly affect the hypothalamus and pituitary gland's hormone secretion, ultimately resulting in anovulation (lack of ovulation). The absence of ovulation affects menstrual patterns, and without ovulation, pregnancy is not possible.

 

Long-term hypothyroidism can stimulate an increase in thyroid-stimulating hormone (TSH) secretion as well as prolactin secretion. This can ultimately lead to anovulation. Therefore, individuals with thyroid dysfunction should also have their prolactin levels checked. However, regardless of whether it is hyperthyroidism or hypothyroidism, appropriate treatment can lead to recovery. It not only restores normal menstrual patterns but also increases the chances of getting pregnant. Additionally, it can help prevent miscarriages caused by thyroid dysfunction during pregnancy.