Hypoactive Thyroid: Associated with Miscarriage?

I have been diagnosed with Hashimoto's (hypoactive) thryoid. My doctor believes that my two miscarriages could be related to this. Does this diagnosis that I will never be able to carry a child to term?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Hashimoto's thyroiditis is the most common cause of hypothyroidism during pregnancy in the U.S. It may occur in 8 to 10 percent of women of reproductive age. This disease occurs in patients who have a predilection for other autoimmune disorders, including Addison's disease, diabetes, pernicious anemia and myasthenia gravis. Hashimoto's often presents with a goiter (a painless swelling on the neck). As in Graves' disease, pregnancy has a beneficial effect on the course of Hashimoto's thyroiditis, with a relapse frequently seen after delivery.

A study published in the November 2000 issue of the Journal of Medical Screening, a publication of the British Medical Journal reported that pregnant women with hypothyroidism (underactive thyroid) have a four-times greater risk for miscarriage during the second trimester.

Researchers recommend looking at a change in pregnancy screening practices. "Perhaps expectant mothers should get a TSH test before pregnancy or as part of the initial standard prenatal blood work."

Other studies among pregnant women with an underactive thyroid have suggested a link between miscarriage, premature birth, low birthweight, placental abruption and pregnancy-induced hypertension, though these studies were limited to women attending high-risk clinics and might not reflect the findings in the general population.

The following is a summary of what was said in Williams Obstetrics (1993) and Maternal-Fetal Medicine (1994):
-- Rates of recurrent miscarriage are reported to be higher in hypothyroid women than in those with normal thyroid studies.
-- Early replacement with thyroxine improves fetal outcome.
-- Because of the association between autoimmune thyroid disease and recurrent miscarriage, thryoid antibodies should be obtained in women with recurrent miscarriages.
-- There is no documented benefit from treating low-thyroid women with recurrent miscarriage with L-thyroxine.

It sounds very likely that you will be able to carry a child to term, but I think it is wise to see the endocrinologist and wait the recommended time before attempting pregnancy again. You need time to build up energy, as well as nutrient, iron and calcium stores again.

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