When couples begin planning for a pregnancy, the spotlight often falls on ovulation tracking, prenatal vitamins, and optimising diet and lifestyle. Yet one crucial factor frequently overlooked is thyroid health. Even subtle imbalances can quietly disrupt hormones and fertility, which is why a thyroid profile – particularly the TSH test – should be among the first investigations to consider before trying to conceive.
HT Lifestyle reached out to Dr Shobha Gupta, medical director, gynaecologist and IVF specialist at Mother’s Lap IVF Centre, New Delhi and founder of Mumma’s Blessing IVF and Birthing Paradise in Vrindavan for her expert insights regarding this matter. She highlights, “Many patients ask me, ‘Doctor, my periods are regular, so why do I need a thyroid test?’ The reason is simple – conception depends not only on ovulation but also on hormonal harmony inside the body. Even a mild thyroid imbalance can silently delay pregnancy.”
What is TSH and why does it matter?
According to Dr Gupta, Thyroid Stimulating Hormone (TSH) is produced by the brain and controls how much thyroid hormone the body makes. These hormones influence metabolism, but they also regulate the ovaries and menstrual cycle.
The gynaecologist explains, “When TSH rises, it usually indicates an underactive thyroid (hypothyroidism). Ovulation may become irregular, and egg quality can be affected. Many women continue to menstruate every month, yet the ovulation is not optimal. Regular periods do not always mean regular ovulation. Hormones work more subtly than we think.”
Ideal TSH range for conception
While laboratory reports often cite a normal TSH range of 4 to 5 mIU/L, Dr Gupta emphasises that for those trying to conceive, the ideal level should be closer to 2.5 mIU/L or lower. Maintaining TSH within this narrower range helps create a more stable hormonal environment, allowing a healthy pregnancy to progress optimally.
She explains, “Why so strict? Because early pregnancy depends completely on the mother’s thyroid hormone. During the first trimester, the baby cannot produce its own hormone and relies entirely on the mother. Even a borderline rise can disturb implantation and increase the risk of early pregnancy loss. We aim not just for a normal report, but for an optimal hormonal environment where pregnancy can naturally progress.”
Effects of high TSH on fertility
According to the gynaecologist, elevated levels of TSH can lead to several subtle changes in the body. These include:
- Irregular ovulation: Eggs may not be released at the right time.
- Poor egg quality: Reduces chances of fertilisation.
- Hormonal imbalance: Progesterone support becomes weak.
- Implantation difficulty: Embryo attachment may fail.
Dr Gupta highlights, “Patients often come after months of trying naturally without success, and sometimes the only abnormality we find is a slightly high TSH. This is one of the most correctable causes of delayed conception.”
Risk during early pregnancy
The gynaecologist points out that even after conception, uncontrolled TSH can create problems. It can increase the chances of:
- Chemical pregnancy
- Early miscarriage
- Fatigue and complications in the mother
She stresses, “This is why I repeat thyroid testing as soon as pregnancy is confirmed and adjust medication promptly.”
How to correct TSH levels?
TSH treatment is simple but must be consistent, according to Dr Gupta. She outlines the following ways:
- Daily thyroid medication on an empty stomach.
- Regular monitoring every four to six weeks.
- Adequate iron and iodine intake.
- Proper sleep and stress control.
Many couples feel relieved when pregnancy occurs naturally after thyroid correction. Planning a pregnancy is not only about timed intercourse or advanced fertility treatment. It is about ensuring the body’s internal environment is supportive. Thyroid hormone plays a quiet but powerful role in fertility. Testing TSH early can prevent months of anxiety and unnecessary procedures.
Dr Gupta concludes, “When the thyroid is balanced, the reproductive system functions more smoothly. Sometimes the path to pregnancy is not complicated treatment, but simply correcting a small hormone at the right time.”
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
