TTC with Elevated FSH and Thyroditis

Hello, who can answer this? Preferably a doctor please? I have been TTC for 5 years now and had 2 unsuccessful IVFs in 2007. I also had one miscarriage in 2004 as well as one clinical pregnancy.  My Endocrinologist said that I'm still young and should try with FSH at 13 (in 2007). However, I went to get second opinion this year and another OB/GYN -who practices endocrinology did some tests and my FSH was still a little elevated, but also discovered that my TSH  T 3 T4 were off. So I went for ultrasound and had radiologist do a radioactive thyroid uptake scan/test and it came out that I have hyperthyroid and now hypothyroid with thyroid antibodies. Another endocrinologist put me on Synthroid. Can anyone tell me if there is a connection between TSH, FSH and what are my chances to conceive? Im 29.

[Elaine Brown, MD]

Hi!
MOST REs like to see an FSH of less than 10 as a predictor of a good response to hyperstimulation of the ovaries with medications.  SO, an FSH of 13 would suggest that your ovaries would NOT respond well.  Your past experience with IVF would probably be a better guide though--if you produced several eggs that fertilized, you would probably be able to do so again.  At 29 a higher percentage of the eggs that you do produce are going to be normal than would be for a 39 year old, so you have the advantage of good egg quality if not a huge quantity.
Anti-thyroid antibodies are related ( at least some researchers believe) to IVF failure.
So, I expect that if you went through another cycle, the team would  put you on some sort of steriod such as solumedrol to suppress antibody formation.  (This is commonly done anyway).  Abnormal thyroid functions are also related to miscarriage.  Correcting your thyroid levels would definitely be advantageous.  If you were my patient, I would repeat an FSH and also do an antral follicle count once your thyroid levels have normalized.  If you DO conceive--CONTINUE your synthroid.
I hope this is useful information!
Good luck!
Dr B

[malgoskag]

Dear Dr. Brown,

Thank you very much for such kind words and hope. I do appreciate it.I will continue and let you know about the progress.