Thyroid and Getting Pregnant: Why You Should Look Beyond Just TSH

When trying to conceive, only TSH is often measured, but that doesn’t always provide a complete picture of thyroid function. Thyroid antibodies such as anti-TPO and anti-Tg can affect fertility and early pregnancy, even when other levels are normal. Testing for these markers provides greater insight and allows you to take timely, targeted steps toward a healthy pregnancy.

If you’re trying to get pregnant, you want to leave as little as possible to chance. You pay attention to what you eat, how you live, and maybe you’re already taking folic acid. More and more women are also checking their blood test results. That makes sense, because your hormones play an important role in your fertility and a healthy pregnancy.

Your thyroid is an organ that is often overlooked in this context. And when it is tested, the focus is usually only on TSH. In this blog post, you’ll learn why it can be helpful to look beyond TSH when you’re trying to conceive.

Why TSH alone isn’t always enough

A standard blood test usually measures only TSH, sometimes along with free T4. This tells you whether your thyroid is underactive or overactive. What it doesn’t show is whether your body is producing antibodies against your thyroid.

Those thyroid antibodies may already be present even while your TSH and free T4 levels are still normal. And they can be particularly important if you’re trying to conceive.

What Are Thyroid Antibodies?

With thyroid antibodies, your immune system produces antibodies against your own thyroid gland. This is called an autoimmune reaction. The two most common types are:

• Anti-TPO, antibodies against the enzyme thyroperoxidase.
• Anti-Tg, antibodies against thyroglobulin.

You can have these antibodies without noticing any symptoms. Your thyroid levels may still be normal. Elevated antibody levels are often seen in Hashimoto’s disease. You can read more about this in our blog post on Hashimoto’s disease.

Thyroid Antibodies and Getting Pregnant

Research shows that women with elevated thyroid antibodies may have a higher risk of difficulty getting pregnant, early miscarriage, and thyroid problems during pregnancy. This is true even if their TSH and free T4 levels are normal.

An elevated result doesn’t mean you can’t get pregnant. It does, however, provide insight. If you know about it early enough, your doctor can monitor your thyroid before and during your pregnancy and make adjustments if necessary.

Which blood tests should you get when you’re trying to conceive?

If you want to get a clear picture of your thyroid function, you can have these values tested in addition to TSH:

• Free T4, and possibly free T3, to see how your thyroid is functioning.
• Anti-TPO, the most important antibody to test for.
• Anti-Tg, as a supplement.

You can have the antibodies tested separately— anti-TPO and anti-Tg—or just anti-TPO. Want everything in one test? Then check out the comprehensive thyroid blood test, which includes TSH, free T4, free T3, anti-TPO, and anti-Tg.

You can also get tested in stages. Start with TSH and, if necessary, the antibodies. If a value is abnormal, we can perform additional tests on the same blood sample within five business days. You won’t need to have your blood drawn again.

When is additional testing recommended?

Ask yourself these questions:

• Have you been trying to get pregnant for a while?
• Have you had a miscarriage before?
• Do you have a family history of thyroid problems or autoimmune diseases?
• Do you have symptoms such as fatigue, weight fluctuations, or hair loss?

Do you recognize several of these points? If so, it may be a good idea to have your thyroid tested more thoroughly and discuss the results with your doctor. If you’ve been trying to get pregnant for a while, check out our blog post “Having Trouble Getting Pregnant” to learn about other tests that can provide insight. Your AMH level can also tell you more about your fertility.

How Testing Works at Bloedwaardentest

You can order the thyroid antibody test on its own, without a referral from your primary care physician. You can have your blood drawn at one of more than 1,000 blood draw locations in the Netherlands. If your results are abnormal, a doctor or medical expert will always call you first. Would you like to discuss your results in more detail? Then you can book a consultation with our lifestyle doctor.

Conclusion

If you’re trying to conceive, TSH alone doesn’t always tell you enough about your thyroid. Thyroid antibodies, such as anti-TPO, may already be present even while your other levels are still normal. By having them tested, you’ll know where you stand and can work with your doctor to make adjustments in a timely manner.

Frequently Asked Questions About the Thyroid and Getting Pregnant

Can you get pregnant with elevated anti-TPO levels?

Yes. An elevated anti-TPO level doesn’t mean it’s impossible to get pregnant. It is, however, a reason to monitor your thyroid in consultation with your doctor.

Is a normal TSH level enough if you’re trying to conceive?

Not always. A TSH test shows how your thyroid is functioning, but it doesn’t indicate whether you have thyroid antibodies. To check for those, you’ll need to get tested for anti-TPO and, if necessary, anti-Tg.

What is the difference between anti-TPO and anti-Tg?

Both are antibodies against your own thyroid gland. Anti-TPO targets the enzyme thyroperoxidase and is the most important test to perform. Anti-Tg targets thyroglobulin and is a supplementary test.

Medical disclaimer: This information is general in nature and is not intended to replace personal medical advice, diagnosis, or treatment. If you have any symptoms, receive an abnormal test result, or have any concerns, please contact your primary care physician or treating physician.

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