Ideal TSH for pregnancy?

[OhPeanuts]

Hi, I have started wondering about all sorts ahead of a frozen transfer. I looked at some blood results of mine from a few months ago and noticed my TSH is 2.6. I am sure I have read it should be less than 2.5 for pregnancy to be successful. Does anyone have any knowledge or experience on this? I tried asking my GP and she just replied with “ask your gynaecologist” so that’s not too helpful. I’ll definitely ask my clinic but I am sure I asked this at the initial consultation and they said ask your gp which was why I got the blood test done in the first place! Feel like nobody will help me interpret it and it’s too complex for me to know on my own.

I’m worried about transferring embryos and them failing/miscarrying for a reason like this. Any advice would be appreciated! Thank you x

@OhPeanuts definitely ask your clinic - my NHS doctor (and endocrinology consultant) both quote under 4 being ok which it is for all other times but my IVF consultant insists on under 2.5. You're not wildly out but definitely worth asking!

Ps private blood test is about £40 for this

Hi- not sure how useful this is but just wanted to share with you in case it helps. My TSH was 2.6 back in May when I had it tested by my GP. My naturopath asked me to get it tested again in September as she thought it was a little high so I paid for an at home check with Medichecks (really easy) and it had gone up to almost 3 (this was after 3 months of being super healthy and starting supplements etc). I was concerned about it going the wrong direction. My clinic tested it 2 weeks ago as part of the blood tests before I started IVF and I asked what it was and it had gone up to 3.6! I was really surprised it was going up so much in such a short time and asked if it was an issue (my naturopath said it should ideally be closer to 1) and they said anything under 4.5 was fine. If you go online pretty much everywhere says under 2.5 for fertility so I am not really sure what to think. Starting my first injections on day 2 tomorrow so if this round is not successful it is definitely something I will be looking into.
I wouldn't worry too much about being marginally over 2.5 xx

Mine also says under 2.5 is best. They've put me on Thyroxine to reduce it to that level. However my previous clinic (an NHS one) didnt even question my TSH level @ 4.1! I think a lot of these tests are belt-and-braces, but I for one am very happy to take all the help I can get! So definitely a good question to ask your consultant👍

Thank you everyone! Glad to know it’s not just me wondering about this.

@Jane1284 thanks for recommending medichecks, I think I’ll go ahead and retest mine now so I have it to show my clinic dr at our call in a few weeks...it’s nhs so I don’t think they’re going to do anything about it if it’s higher as I’m technically in range but it’s worth asking.

@PineappleC can I ask how long you’ll be taking the thyroxine for? Is it just before and during ivf or will you need to take it forever now that you’ve started? Is it something bodies kind of get used to so you can’t stop taking it later?

@PineappleC that's very useful to know. My clinic is both private and NHS. After this round on the NHS I will probably stay with them for my private round. Will be interesting to see if I can push them to look into my TSH levels once i am private. I guess they may be more keen if I am payment for the tests. Can always change clinics too if I don't feel like I am getting anywhere with them.

@OhPeanuts I've found Medichecks very easy to use. I tested my FSH with them as well as my GP and fertility clinic weren't bothered about testing it which I found odd considering my low AMH/AFC. Good luck! x

@ohpeanuts I've only been taking it for 2 weeks as we've just moved to our new clinic. No one's mentioned having to take it forever, and I was only given enough for a month, so not sure but seems unlikely that it'll be chronic otherwise I'd imagine (hope!) they'd have warned me! It's worked well though - it's gone from 4.1 to 2.9 in two weeks 😊

@jane1284 yes I think if it's a private one that accepts NHS patients it's more likely to offer additional tests for a payment. We moved because ours was an NHS clinic within an NHS hospital (albeit they would have carried on privately too) and it seemed any extra request we made for tests (which in some cases were vital to a success) were met with resistance! We are now at ARGC and they love doing additional tests 😅 Good luck and I hope you get some peace of mind 😊

@PineappleC thanks- that is really good to know. Will see how this round goes and then start looking at additional tests.

Hi all, this is such an interesting thread and something that's been on my mind for a long time.
My TSH was at 3.6 a couple of years ago and my friend who is a gynecologist in Germany (where I'm from) said this was too high, and to definitely see my GP and try to reduce it.
My GP here in the UK agreed to prescribe me Levothyroxine after much discussion and a chat with the assisted conception unit I had been referred to. They all said because 3.6 is still "subclinical" (under the 4.5 cut off for treatment) it shouldn't stop me from getting pregnant.
However following the prescription, I felt like no one monitored the success, I was not given any more blood tests, etc. I ended up stopping to take levothyroxine as I was having an argument with my GP's reception every time I asked for a prescription. They would just check the blood results they had on file for me and basically say I didn't need it.
Now I've gotten to the point where we've had a round of IVF (freeze all) and just had a FET last week. I am thinking that if I do get a BFP I'll raise the TSH issue with my clinic and hopefully they'll monitor it.
I really feel like this issue is completely disregarded and doctors are dismissive about it, even though my friend said it's so important for conception and being able to sustain a pregnancy. I feel let down by the NHS, but also just feel defeated and like I don't want to keep fighting them.
Sorry for the long message, but I'm just so glad I'm not the only one worrying about this!

@WaitingToExpect20 thanks for sharing! I totally agree, surely they’d want to do everything they can not just for their patients but also for their success rates. You’d think they’d try and monitor this a bit more even just out of interest to see if it makes a difference to outcomes but like you i just get told “ask your gp” by the clinic and “ask your ivf clinic” by the gp so it’s like they’re just washing their hands of it. Very frustrating and I’ll be livid if in a few years someone does tests and tells me this was a problem!

Do let us know how you get on and I hope your get a BFP 😊.

@PineappleC thank you! Good to know it’s a monthly thing and not a lifetime thing.

I’m yet to get my retest with medichecks...must organise myself better

I know this thread is a bit old now. I'm on levothyroxine because my level was something like 2.8. My private ivf clinic wrote to my gp and I've been on it ever since. They said I only need it while ttc and during pregnancy. So will stop if I do ever have a baby!

@seven201 thank you, so interesting that you will take it and then can stop. Also great that your clinic has been so proactive and written to the gp. Without this it seems like a battle.

An update from me - I had my levels rechecked via medichecks and the tsh came down to 2.3 in Dec (from 2.6 in aug) and all the rest looked ok, no antibodies etc. So I am feeling a bit more reassured. I think if one of my frozen transfers in the new year is successful though I’ll be keeping an eye on this in case it goes up again.

My doctor also asked for thyroid test through my GP this week before FET. She said it needs to be under 2.5. I had one done through GP last year and it was 1.99 and the reference range is 0.3-4.3 in the wider population. I don't know if the test has a validity and am asking my GP to make a referral again.

@OhPeanuts, @Jane1284, what is the process and how fast is medichecks? Is it as official? I am thinking of using a private one if GP is too slow. I have a medical insurance that can claim this back anyway.

That’s interesting @Jo99999. Medichecks you order the blood test you want online and you either have a kit delivered to your house which you post back or you can do into a clinic and have your blood taken which costs more. I presume it is valid but may be worth checking if your doctor would accept it.
I had my first cycle of IVF this month with transfer on the 5th Dec. Unfortunately it didn’t stick. I have a follow up with the doctor on Monday so will be querying the fact my TSH went from 2.6 in May to around 3.6 before treatment. They didn’t seem bothered at the time but everyone else says below 2.5 for pregnancy which has made me wonder why they don’t seem to care.

@Jo99999 medichecks has been explained already by @Jane1284 so I’ll just add that yes it’s super fast! I ordered my kit, realised I bought the wrong thing and called them 2 hours later to cancel 🙄 and reordered it. It arrived on the day after. I did my sample and sent it off on a Thursday and the result and a written review by a dr was in my emails on Monday by 10am. Super fast and great that you can ask a question to the reviewing dr and they will interpret your results with that in mind for you. As far as I can tell it seems legit and widely used. I think the ref ranges are the same as the nhs ranges. Have a look at the website 😊

The only down side was having to finger prick - the lancet left a huge (exaggerating a bit) hole in my finger and I had to work so kept bleeding all day because I was typing and hitting the area. But you can always pay extra and go to a clinic and have blood taken normally to get around that.

Let us know how you get on.

@Jane1284 sorry to hear that, I hope they seriously consider your question and give a bit more guidance if you’re going to try again.

I had a TSH that jumped around from 2.7-4.5. My original ivf doctor didn't mention a problem. We were doing IVF due to low sperm count. After 3 failed full IVF rounds we met with a senior consultant who said while I was 32 it appeared I had bad eggs (embryos didn't develop properly) and may need donor eggs. She then spotted my slightly elevated TSH and said it should be under 2.5. She prescribed thyroxin and said to come back once it was under 2.5 for 3 consecutive months. 3 months after I started it I was pregnant naturally and had a beautiful baby girl. Fairly certain my previous ivf rounds were doomed due to high TSH (2 were self funded). I would never do ivf again without TSH sunder 2.5.

Ideally, you want it to be under 2, not even 2.5. The acceptable range is 0.5-2. When mine was 2.2, my gp increased my dose of levothyroxine. Be aware of what can increase the levels, such as some combination birth control pills.

Thanks @bluebird3 and @KatBeCool - really helpful info. Will be speaking to my doctor tomorrow about organising our FET. Really hope they are willing to discuss my elevated TSH. Appreciate both your detailed responses xx

@OhPeanuts @Jane1284,Trying to get a thyroid test via medicheck but there are many types. I just wonder which one you bought. I am also trying to ask my doctor as she only mentioned thyroid test without specifics. I assume it is just TSH.
medichecks.com/products/thyroid-stimulating-hormone-blood-test
medichecks.com/products/thyroid-function-blood-test
I don't understand why the single TSH test costs more than the 3 marker one TSG, T3 and T4 test.
Thanks!

@Jo99999 the one I went for is this one because I wanted to know if I had antibodies medichecks.com/products/thyroid-function-antibodies-blood-test

The one with three things costs more because they are testing for the extra 2 tests which are important to understand along with the TSH. It’s really complicated but I think all together having more of the tests gives a better picture of what is going on.

Also if you google for a voucher code you may find one - I did and saved a bit 😊

@OhPeanuts, thanks for quick reply. It makes sense to go for the 5 biomarker one.

This is such an interesting thread, thank you! Been Ttc for 18 months and no bfps.

I had my bloods done by NHS and my TSH was 3.7, the GP didn't think there was anything wrong with this and they that level did not indicate Hypothyroidism. I had had another test in the summer which was 2.1, so guessing it fluates a lot.

I am hopefully starting IVF in February, and the clinic was able to write a note to my doctor to request that I be prescribed it. I have two month prescription and have been taking for a week, but so much better and wonder if actually this could help me get pregnant naturally.

I am 38, no issues apart from the TSH. Partner healthy and normal SA.

I spoke with my clinic yesterday about my rising TSH level and they said that the head of the clinic has set the required level as below 4. I queried why most other clinics say below 2 for fertility but they said their research said 4 (it is Kings Fertility- both NSH & private). They are going to test my level again before I start my next round of IVF but they did not seem keen to prescribe anything unless it was over 4 and were pretty adamant it would not affect IVF success. I guess I need to have another test and go from there. Seems so odd that they were so adamant it wouldn’t affect results when everyone else seems to say how important a low TSH is for fertility

Hi everyone!

Just a little update from me. I’ve found the same as you, @Jane1284

They said a recent international study showed that a TSH under 4 is fine, especially if T3 and T4 are alright and no antibodies present (which could indicate Hashimoto’s for example). It’s important those all get tested, as TSH alone doesn’t give the full picture.
They did say that TSH may rise when pregnant though, so women like us who are near the threshold should be monitored during pregnancy.

Good luck everyone! 😊

Relived to read that your clinic is saying something similar @WaitingToExpect20 - makes me feel a bit better when I’ve just paid for 3 rounds of IVF privately to start in Jan!
Good luck to us all. I hope 2021 is a positive and successful year for everyone on this tough journey xx