Graves Disease and trying to conceive

[Mamasturge]

Hello, we just finished our first round of IVF and the beta came back negative. We were actually surprised since everything was like textbook, ending with a 2 embryo transfer on day 5, with intralipid infusion as well.  I do have a son already who was conceived naturally so we thought that helped our chances, although on the flip side I do have Graves disease (diagnosed after my son was born) and I am now 42.  We increased my Synthroid once just when we transferred the embryos, and then again when I was still feeling bad (to 150 mg), but that was right before we got a negative test result.  My T3 is on the lower side and I am getting feedback from thyroid forums that this was causing me to feel so bad all through my IVF cycle, but my doc does not test for T3 (not sure why!) so at the start of my cycle it was at 2.02 and at the end was at 2.30 (range being 2.0-4.4).  Could a low T3 cause the loss?  Or possibly my antibodies?  I need to get this resolved asap so I can get it fixed and retry the IVF as I don't have much time left.  We live out of the country so I am having to do phone consults and email my labs back to the States for my doc to see.  If you have any advice I would greatly appreciate it!

[Mamasturge]

Ok, going to get my antibodies checked today, so we know if that was involved or we can exclude that.  But just one thing, if I am on T4 only meds and my T3 is low and I am feeling really bad, what would you advise to your patients?  How do we know if I am converting T4 to T3 properly?  Thanks!

[Mark Lupo, M.D.]

TSH and T4 are much more important in this case than T3 (not necessary to measure and we don't treat w/T3 when pregnant or trying to conceive).  Antibodies are associated w/ infertility/miscarriage.  If you had Graves' and become pregnant, test TSI levels about week 24-26.  TSH goal for now is low-normal range.

[Mark Lupo, M.D.]

TSH and T4 are much more important in this case than T3 (not necessary to measure and we don't treat w/T3 when pregnant or trying to conceive).  Antibodies are associated w/ infertility/miscarriage.  If you had Graves' and become pregnant, test TSI levels about week 24-26.  TSH goal for now is low-normal range.