Schilddrüse und Kinderwunsch
Thyroid hormones are important for the maturation of egg cells. Without sufficient maturation, ovulation might not take place. Both hyper- and hypofunction can result in cycle disturbance and in that way limit fertility. Thyroid gland examination and thyroid hormone analysis, such as fT3, fT4, and TSH, are absolutely necessary when there is cycle disturbance and a desire to have children. If there is known thyroid gland dysfunction, rapid treatment and close supervision during pregnancy are necessary.
When there is known hypofunction and a wish to have children, substitution therapy with the thyroid hormone (Levothyroxine) should be initiated. The aim is normalization of thyroid gland function and ideally a TSH level of approximately 1 µU/l.
With existing hyperfunction and a small thyroid gland, drug therapy using tablets is recommended. However if there is hyperfunction and a very large struma, surgical removal of the thyroid gland is the first option. Then the missing thyroid hormone can be replaced by lifelong medication (Levothyroxine).
The third treatment option with hyperfunction and a desire to have children is radioiodine therapy. Here the thyroid gland is disabled by the administration of radioactive iodine and its hyperfunction thus eliminated. However a pregnancy must be postponed for 6 months after radioiodine therapy.