hashimoto and infertility

Hello I am 42 years old woman with unexplained infertility , never been pregnant I had all sorts of tests and diagnostic laparoscopy  done I have excellent FSH and prolactin had twice insemination and once INVITRO fertilization, but with no luck! I have Hashimoto.  My antibodies are very very high it was diagnosed 5 years ago. I am taking my Thyroxin regularly and I have low Ft3. I need to ask you how come I never got pregnant before my diagnosis, is it possible that I had thyroid problem before but I did not know it, I used to check my THS regularly. What could be the chances of successful In Vitro for me, or keeping the pregnancy and so on?? Do you think that getting a surrogate mother will be a much wiser idea? I live in Europe and we can do it here easily. Thanks.

[Elaine Brown, MD]

Hi!
I think it is possible that your thyroid condition prevented you from conceiving.  Abnormal antibodies of any sort, but especially antibodies to thyroid or phospholipids can attack an embryo and prevent implantion.  It might be possible to suppress your antibodies with some sort of steroid medication such as Prednisone or dexamethasone.  I don't know if they tried that in your other cycles.  A surrogate might be a good answer.  Depending upon how well your ovaries respond to stimulation, you might want to transfer 2-3 embryos to a surrogate, and 2-3 into your own uterus.  You of course run the risk of a multiple birth with that procedure.  I also would encourage you to consider PGD if it is available.  Pre-implantation genetic diagnosis would assure that only the healthy embryos were transferred.  At 42, even if you produce multiple embryos, a high percentage of them will be genetically abnormal, and won't implant or develop.
I hope this helps!
I wish you the best luck!
Dr B