Thyroid dysfunction and semen quality

This review summarizes the normal thyroid hormone regulation of semen quality, provides an update on human and animal studies on thyroid disorders and altered semen quality and also elucidates the possible mechanism of hypothyroidism and hyperthyroidism-induced alterations in semen quality. This review also intends to highlight the necessity of large-scale cohort studies using human subjects, as the available reports used only limited number of subjects, which confines to obtain a valid conclusion. Animal studies are also required to find out the proper molecular events occur during thyroidal disorders leading to altered semen quality. Untreated hyperthyroidism can also lead to complications of high blood pressure in pregnancy, poor growth of the baby and premature delivery.

You should have regular blood tests throughout your pregnancy so that your dose can be adjusted if necessary.

Antithyroid drugs alert card

Sexual dysfunction affects a large portion of the male and female population and has an incompletely defined etiology. In this review we explore the impact of thyroid dysfunction on female and male sexual function. We discuss the impact of correcting thyroid derangements and the pathophysiologic basis of thyroid hormone on the genitalia, and suggest future directions for research into the impact of thyroid disease on sexual functioning. The good news for men facing thyroid dysfunction is that thyroid-related fertility issues are often reversible with proper treatment. Men with hypothyroidism may benefit from hormone replacement therapy to regulate thyroid levels and restore normal semen quality. Those with hyperthyroidism can undergo treatments like antithyroid medications, radioactive iodine therapy, or surgery to control excess hormone production, resulting in improved semen analysis outcomes and fertility potential.

• Moreover, alterations in thyroid hormones signaling could also have detrimental effects on the placenta, possibly even causing abortion; however, the molecular mechanisms involved have not been completely understood 21.
• Around 1 in 1,000 men experience hyperthyroidism, and hypothyroidism affects about 1 in 100.
• Proper thyroid function ensures optimal sperm production and sperm quality, while imbalances in thyroid hormone levels—whether too high or too low—can lead to fertility issues.
• As explained earlier thyroid hormones are important regulator of male reproductive function so any alterations in their serum levels have profound effects on male reproduction.
• Thankfully, with the right thyroid medication and management, these thyroid problems can often be corrected, improving semen quality.

Subclinical Hypothyroidism in Women

The most frequent causes of hypothyroidism in pregnancy are the endemic iodine deficiency and the chronic autoimmune thyroiditis in iodine-repleted areas 32, 33. If evidence linking overt hypothyroidism with infertility and poor pregnancy outcomes is straightforward, that regarding subclinical hypothyroidism is more controversial, and the reference range of TSH in fertility, pregnancy, as well as in ART has recently become a matter of debate. Thyrotoxicosis results in increased serum levels of sex hormone binding globulin (SHBG) due to increase in estradiol levels, and a reduction of the metabolic clearance rate of estradiol. In women with hyperthyroidism, testosterone and androstenedione levels increase due to a higher production rate.

Women may have longer or heavier periods, which can cause anaemia, or your periods may stop completely. Men’s fertility may also be affected and they may be less likely to father a child if their thyroid hormone levels are low. However, once you are taking medication (levothyroxine tablets) and your thyroid hormone levels are back to normal your chances of becoming pregnant, or fathering a child, should improve dramatically.

Post-partum thyroiditis

In our studies, we too report a similar positive feedback effect of raised estradiol levels on LH secretion; suggesting a key role of estrogen in regulating serum gonadotropin levels. The rise in synthroid 5mg LH was not as high as seen in cycling females which could result due to high testosterone levels Figure 3.66 Boucekkine and Semrouni (1990)69 examined the effect of estradiol on basal and GnRH – stimulated gonadotropin secretion in patients with Klinefelter’s syndrome. Injections of estradiol to these patients for five days, induced an initial decline in the serum revels of FSH and LH, followed by a 6.6-fold rise in estradiol levels on day three and 1.7- fold increase in LH levels on day four of the injection. Their results also demonstrated the establishment of a positive feedback of estradiol on LH secretion in patients with Klinefelter’s syndrome. If it is untreated you may have lighter, irregular periods and find it difficult to conceive.

Hyperthyroidism in Men

In these patients, hypothyroidism was induced by stopping or by decreasing the dose of T4 over at least one spermatogenic cycle. It is observed that there was a decrease in seminal volume, and progressive forward motility compared to the controls. During euthyroid state, induction of hypothyroidism did not lead to seminal changes as compared with the same patients.52Therefore, it appears, short-term post-pubertal hypothyroidism does not cause sufficient seminal alterations to impair male fertility. Jaya Kumar et al. investigated the reproductive and endocrine functions of eight male patients with primary hypothyroidism. They conducted the investigation during the hypothyroid state and after the euthyroid state was achieved with T4 substitution therapy.

In multiple pregnancies, it is expected that TSH level is even more suppressed due to higher hCG concentration 13. When population- and trimester-specific reference ranges for TSH are not available, an upper reference of approximately 4 mU/mL may be used 9. If you have an untreated (or undertreated) underactive thyroid gland (hypothyroidism) you are likely to find it more difficult to conceive.

SPERM FUNCTION AND SEMEN

Nutrients such as iodine, zinc and selenium can benefit thyroid function, but it’s important to consult a doctor before starting supplements. Including iodine-rich foods like eggs, milk and seaweed can naturally support thyroid function, which in turn, promotes better sperm count and semen parameters. Taken together, these studies demonstrate the lack of consensus in the association of hyperthyroidism and ED.

You will require regular thyroid function tests in pregnancy to ensure you are on an appropriate dose. If you have been treated for Graves’ disease with radioactive iodine or surgery in the past, or need antithyroid drugs during pregnancy, you may have Graves’ antibodies (also known as TSH receptor antibodies (TRAb)), which can cross the placenta. On rare occasions these can cause temporary hyperthyroidism in the baby during pregnancy and after birth, but this is treatable.