How Autoimmune Thyroiditis Can Influence Fertility

BySamradni Pradhan
Updated: 2 Jun 2025, 5:03 pm

Autoimmune thyroiditis, also referred to as Hashimoto’s thyroiditis, is a leading contributor to thyroid issues that may disrupt fertility health. It triggers an immune attack on the thyroid gland, causing hormonal imbalances that disrupt ovulation and affect pregnancy health. Understanding this link helps you manage your reproductive health and work with your doctor to achieve the best results.

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A variety of factors can influence fertility, and one that deserves more attention is thyroid health, specifically, autoimmune thyroiditis. This condition occurs when the immune system targets the thyroid gland, potentially disrupting hormone levels that play a key role in reproductive function. In this blog, we’ll help you understand what autoimmune thyroiditis is, how it can affect your ability to conceive, and what proactive steps you can take if you’re planning to start a family.
In this article:

What Is Autoimmune Thyroiditis?

In autoimmune thyroiditis, your immune system mistakenly attacks your thyroid gland. This leads to inflammation and, over time, may damage the gland, reducing the production of essential thyroid hormones.The primary hormones involved, thyroxine (T4) and triiodothyronine (T3), play crucial roles in regulating metabolism and supporting other bodily functions, including reproductive health. When the thyroid gland fails to produce the necessary hormones, it can result in hypothyroidism.Key Points to Know:
  • The immune system produces antibodies that target the thyroid gland, causing inflammation.
  • Chronic inflammation can lead to the gradual destruction of thyroid tissue.
  • Reduced thyroid hormone production affects metabolism and hormonal balance.
  • Thyroid hormones have a direct influence on menstrual cycles, ovulation, and pregnancy.
  • In the early stages, normal hormone levels may be observed, but the presence of thyroid antibodies is also noted.
  • Over time, insufficient hormone production can cause symptoms of hypothyroidism.

Why Does Autoimmune Thyroiditis Affect Fertility?

Thyroid hormones play a crucial role in regulating your reproductive system. They influence your menstrual cycle, ovulation, and the health of your uterus. When thyroid hormone levels are unstable owing to autoimmune thyroiditis, they can interfere with this balance in many ways:
  • Irregular periods: You may find that your periods are irregular, and either the flow is heavier or lighter than usual.
  • Anovulation: Hormonal imbalance can prevent your ovaries from releasing eggs on a regular basis.
  • Poor egg quality: Inadequate thyroid hormones might affect your egg development negatively, making it challenging to conceive.
  • Luteal phase defects: The second half of your menstrual cycle may be weak to support early pregnancy.
  • Increased miscarriage risk: Research suggests that autoimmune thyroiditis and associated thyroid issues increase the risk of early pregnancy loss.

The Link Between Thyroid Antibodies and Fertility

Even if your thyroid hormone levels appear to be normal, the presence of thyroid antibodies means your immune system is affecting your thyroid gland. These antibodies can also impact your fertility independently by causing inflammation or subtly altering hormone function.Tests for thyroid peroxidase antibodies (TPOAb) or thyroglobulin antibodies (TgAb) might come back positive. A study shows that there is a higher chance of miscarriage and other issues related to reproductive health in women with these antibodies, even when thyroid hormone levels seem healthy.Important Points to Consider:
  • Thyroid antibodies signal an ongoing autoimmune attack on your thyroid gland.
  • Antibodies can cause inflammation that impacts fertility beyond hormone levels.
  • The presence of TPOAb and TgAb is linked to an increased risk of miscarriage.
  • Women with thyroid antibodies may experience implantation issues and reduced ovarian function.
  • Testing for thyroid antibodies is important even if thyroid hormone levels appear normal.
  • Managing thyroid antibodies may improve fertility outcomes and pregnancy success.

Symptoms You Might Experience

Autoimmune thyroiditis is difficult to detect as its symptoms include everyday stress or other common health issues, which makes the condition hard to spot. Nonetheless, recognising potential symptoms at an early stage can provide support to begin treatment sooner, especially when you are trying to get pregnant.While symptoms may vary, some common signs of autoimmune thyroiditis include:
  • Experiencing low energy
  • Changes in weight with no clear reason.
  • Feeling cold quickly
  • You may also experience symptoms like dry skin or hair thinning.
  • Anxiety or depression are common kinds of mood changes.
  • Problems such as muscle weakness and joint pain
  • Tenderness or swelling on your neck
Autoimmune thyroiditis is often unnoticed by many women and is discovered during fertility-related blood tests.

How is Autoimmune Thyroiditis Diagnosed?

If your doctor suspects that thyroid issues are affecting your fertility, they may request specific blood tests to assess thyroid function and immune activity. Getting an accurate diagnosis at the early stages may improve your chances of conception.Tests for autoimmune thyroiditis, such as running these blood tests, are suggestive:
  • Doctors measure TSH to discover if your thyroid gland is functioning properly by comparing it to normal reference ranges.
  • Free T4 and Free T3: These tests directly measure the levels of active thyroid hormones circulating in your bloodstream.
  • TPOAb and TgAb: Damage to your thyroid can be confirmed with these antibodies if your immune system is targeting it.
Together, these tests give your doctor a clearer picture of your thyroid function. Your doctor will look at the test results to check if your thyroid disease plays a role in your reproductive problems. Early detection of thyroid issues helps to support thyroid function, restore hormonal balance, and improve reproductive health.

How to Promote Better Fertility Through Managing Autoimmune Thyroiditis

If the doctor finds that you have autoimmune thyroiditis, especially with hormone problems, your fertility can be improved with treatment.
  1. Using Levothyroxine for thyroid care:
Most doctors prescribe levothyroxine, a manufactured hormone, to fill in for what your thyroid doesn’t produce. After starting this medication, your hormones are balanced, your periods return, and your ovulation improves. To maintain optimal hormone levels, your doctor will regularly monitor your blood and adjust the medication as needed.
  1. Checking for thyroid antibodies
The primary aim of treatment is to administer hormones, but some doctors also assess antibody levels. Although antibodies can’t be treated directly, stabilising thyroid function and managing inflammation can improve outcomes.
  1. Lifestyle and Nutritional Support
Supporting your immune system and thyroid health can complement medical treatment:
  • Eat a nutrient-rich diet of iodine, selenium, and zinc to support thyroid and immune function.
  • Manage stress with yoga, meditation, or therapy, as stress can worsen autoimmune conditions.
  • Avoid smoking and limit alcohol to protect thyroid health.
  • Prioritise sleep and physical activity for overall well-being.

When To Get Tested

Consult your doctor about thyroid antibody testing if you notice any of these symptoms:
  • If miscarriages occur frequently without a clear reason
  • After 6 to 12 months of trying, finding it hard to conceive
  • Irregular periods
  • Signs of thyroid imbalance
  • Genetic history of thyroid problems or autoimmune disease
Recognising these signs at an early stage can have a significant impact on your fertility journey.Thyroid issues, such as autoimmune thyroiditis, are often overlooked but can affect fertility. With the right guidance, proper treatment, and care, you can manage your thyroid health and increase your chances of a successful pregnancy. If autoimmune thyroiditis comes to mind, be sure to discuss it with your doctor. The right care and changes in your habits may support you along your journey to starting a family.

FAQs on How Autoimmune Thyroiditis Can Influence Fertility

  1. Does a normal thyroid hormone level in my blood prevent infertility brought on by autoimmune thyroiditis?Having thyroid antibodies can still negatively impact a person’s fertility, as these antibodies generate inflammation and small hormonal changes, even if hormone levels are normal.
  2. Can you use levothyroxine if you are pregnant?Taking levothyroxine ensures your thyroid hormones are healthy during pregnancy and supports your baby’s growth.
  3. Should everyone with autoimmune thyroiditis who is trying to conceive have their thyroid function tested regularly?While you’re pregnant, your thyroid hormone indicator will likely be tested every 6 to 8 weeks, as your body’s hormone balance might change.
Disclaimer: Medically approved by Dr Pallavi Vasal, Clinical Director - Obstetrics and Gynaecology Marengo Asia Hospital, Gurugram