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In LVoe
Joined: Sep 2007
Location: USA
Posts: 1,210
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Re: Thyroid and TTC, sad news.
champagne clara,
Having Graves' Disease does NOT mean you can't be pregnant. I have Graves', too, although in my case it has never been the reason for my infertility problems (I also have severe endometriosis that prevents my eggs from getting where they need to go. Ovulation has never been the problem for me, which is usually the problem with Graves'.)
I'll try to give you a short version of my story, which is unfortunately still pretty long. When I was diagnosed with Graves', I went on medication and my endocrinologist told me absolutely not to get pregnant until the disease was stabilized for at least a year and preferably two! I followed this advice, not knowing I would then be unable to get pregnant for other reasons. At any rate, I took the medicine for about 2 years, then was off it with normal thyroid levels for about 2 years, and then started dealing with all the infertility stuff. I finally had my daughter through IVF, and my hyperthyroidism came back a few months after she was born and I went back on PTU (propylthiouracil). The thyroid got better, I came off meds, and then got pregnant with a frozen embryo but miscarried. The miscarriage likely had absolutely nothing to do with my thyroid levels, which were completely normal at the time.
Then this past December, getting ready to start another IVF cycle, my thyroid levels started creeping up again and I went back on PTU. We proceeded with the cycle after a lot of discussion, since the levels weren't too bad and I wasn't really symptomatic, and I am now in the very early stages of another IVF pregnancy, this time on PTU.
I have read tons about this and seen two endocrinologists and a high-risk OB _before_ getting pregnant to decide the safest course of action. From what I have read, there are a few big issues during pregnancy with this disease. 1 - You do not want to be hyper or hypo thyroid during pregnancy, because of the risk to the baby. Uncontrolled hyper or hypothyroidism during pregnancy is a bad, bad thing. So you want the disease to be as stable as possible when you get pregnant. 2 - PTU (and Tapazole) do cross to the baby, so the goal is to be on the lowest dose of medicine possible that keeps your levels on the high (hyper) end of the normal range. From everything I have read, the issues with the baby are very dose-related, so the lower the dose the better. 3 - Thyroid levels fluctuate throughout pregnancy, and your body often really starts chewing up thyroid hormone during the first trimester, so your dose may need to be decreased and you may be able to come off the medicine altogether, although you will probably have to go back on again or up on the dose after delivery. In my current situation, we have been able to back off quite a bit on my dose and I am hopeful I will be able to stop it altogether in a couple of weeks. 4 - You will need to be monitored closely during pregnancy, both in terms of lab levels and how the baby is doing. In my case, I am seeing both my endocrinologist and a high-risk OB. 5 - and this may or may not be an issue for you, but you can breastfeed on PTU.
That may all sound a little scary, but the point is that you still can have a pregnancy with hyperthyroidism, you just have to be very careful with it. Also remember that a lot of women first get diagnosed with hyperthyroidism _during_ pregnancy - think how much riskier that is, since they don't have the chance to get things under control before getting pregnant. At least you're in a situation where you can address it before the pregancy starts.
Another option is to do radioactive iodine, which makes you hypOthyroid so you have to take thyroid replacement hormone (but not PTU or Tapazole). The advantage there is that thyroid hormone does _not_ cross to the baby, so there are fewer worries during pregnancy. The disadvantage is that most recommend that you wait at least six months, and probably at least a year, after having radioactive iodine because of any effects that may have on the fetus, and it can take a while to get your thyroid levels regulated as well. We never really considered that option, because with my other problems I was not willing to wait a year. But depending on your age and your situation, it might be something to think about.
Sorry for the long post. This post is definitely not meant to be medical advice, but I would just urge you to talk to other doctors before accepting someone telling you that you can't get pregnant with this disease. I dealt with a conservative doctor telling me similar things at first (although not that I could _never_ get pregnant, just that I should wait a long time), but I have done a lot of research and read probably 50 journal articles about this and about the management of the disease, and worked with my doctors on it, and it can be done safely. In comparison to other diseases that you could have while pregnant, it is definitely not the worst. I would just make sure you work with doctors who are familiar with treating hyperthyroidism during pregnancy. If you have someone who hasn't done much of that, keep looking, because this is common enough that there are people out there who know how to deal with it.
Please post back to this thread or PM me if you want any more information. I would be happy to talk about this with you.
Good luck to you!
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