What role does the thyroid gland play in the desire to have children?

Univ. Doz. Dr. Georg Zettinig in an interview on thyroid diseases and the desire to have children


The desire to have children is often associated with high hopes and expectations and, if not fulfilled, can represent an enormous burden for those affected. When searching for the cause, an examination of the thyroid gland should be carried out in any case, because the function of the thyroid gland influences not only the metabolism but also the cycle and thus the fertility of the woman. Our editor Lisa Türk visited the thyroid specialist Univ. Doz. Dr. Georg Zettinig in an interview about the thyroid gland in connection with the desire to have children.

The thyroid gland and thyroid hormones

The thyroid gland is a hormone-producing glandular organ. It stores iodine and produces the vital thyroid hormones thyroxine (T4) and triiodothyronine (T3). Among other things, these hormones regulate metabolism and influence growth. The C cells of the thyroid gland also produce the hormone calcitonin, which is involved in calcium and bone metabolism.

In order to form the thyroid hormones, the body needs iodine. Since the human organism cannot produce the mineral itself, it is dependent on the supply via food. From the intestine via the blood, the iodine reaches the thyroid gland, where it is incorporated into the hormones in several steps. To improve the iodine supply and prevent deficiency symptoms, iodine has been added to table salt in Austria since 1963.

Diagram of the thyroid gland and the hormones T3 and T4 Dr_Microbe / iStock

The thyroid gland itself is controlled by the pituitary gland, which releases the hormone TSH (Thyroid Stimulating Hormone). This stimulates the thyroid gland to produce T3 and T4 and thus regulates the thyroid hormone level in the blood as needed. In cold weather, during growth or during pregnancy, the metabolism requires more energy. T3 and T4 increase the basal metabolic rate of the body, as all body cells work more intensively under their effect and thus consume more energy.

Thyroid dysfunction can cause overproduction or underproduction of thyroid hormones and lead to various health problems, including effects on fertility.

How does the thyroid gland influence fertility?

In addition to the cardiovascular, nervous and digestive systems, thyroid hormones also exert influence on the reproductive functions of the body. The hormones T3 and T4 influence the sex hormones and thereby also the maturation of the egg and ovulation. Because of this, hypothyroidism or hyperthyroidism can cause cycle disorders, which manifests itself, for example, in irregular or absent menstruation and reduces the likelihood of conception.

In the case of an unfulfilled desire to have a child, an examination of the thyroid gland and clarification of the thyroid function is therefore necessary.

In hyperthyroidism, too many thyroid hormones are produced. The dysfunction can be recognized by a too low TSH value in the blood. If the cause of hyperthyroidism is an enlargement of the thyroid gland or a so-called hot nodule, this must be treated before pregnancy. A hot nodule in the thyroid gland consists of thyroid cells and releases thyroid hormones uncontrollably. In Graves' disease, the cause of hyperthyroidism, the immune system forms antibodies against the TSH receptors on the thyroid gland as an autoimmune reaction. These mimic the TSH effects and cause increased stimulation of the thyroid gland, resulting in increased production of thyroid hormones. The autoimmune disease is usually treated with thyrostatic drugs. This therapy complicates the desire to have children, as pregnancy is not recommended while taking thyreostatics due to the increased miscarriage rate, among other reasons. In this case, a desire to have children should be explicitly discussed with a thyroid specialist.

In the case of hypothyroidism, which is associated with an insufficient production of thyroid hormones and is diagnosed on the basis of an elevated TSH level, the fulfillment of the desire to have a child is somewhat less complicated. The cause of hypothyroidism may be chronic immune thyroiditis or Hashimoto's thyroiditis, in which the immune system produces antibodies against the thyroid gland, causing it to become inflamed and produce too little thyroid hormone despite increased stimulation by TSH. Treatment is by administration of thyroid hormone tablets.

In the case of an unfulfilled desire to have a child, the patient is usually advised to take thyroid hormones if the TSH value is 2.5 mU/l or higher. In this case, it is important that the underactive thyroid gland is sufficiently compensated before conception and that the hormone dose is increased in early pregnancy. This happens for the reason that in normal cases the pregnancy hormone beta-HCG stimulates the thyroid gland, whereby in early pregnancy (approx. 10th-12th week of pregnancy) more hormones are produced and a slight hyperfunction occurs. The increased energy demand is needed for the unborn child to develop and grow sufficiently. If the thyroid gland has been removed or does not produce enough hormones, this control loop with the increased basal metabolic rate cannot function (sufficiently), resulting in an increased abortion rate. Thus, hormone dosage in early pregnancy must be adjusted in most cases of hypothyroidism.

Significance of thyroid hormones for the unborn child

Thyroid hormones play a crucial role in the physical and mental development of the unborn child. At the beginning of pregnancy, the child's organism cannot yet produce thyroid hormones itself, which is why it is dependent on an adequate supply from the mother. Thyroid hormones are particularly essential for brain development, which is why physical and mental growth may be impaired, especially in the case of manifest thyroid insufficiency. To avoid any developmental damage, the mother must have an adequate supply of thyroid hormones. Serious consequences usually only occur in the case of (rarer) manifest hypothyroidism. Slight increases in TSH levels are usually easy to treat and therefore less dangerous for the unborn child.

Thyroid dysfunction and pregnancy.

Before pregnancy:

Ideally, thyroid function should be monitored regularly during the period of childbearing, for example at six-month intervals, so that therapy is adjusted accordingly to ensure well-controlled thyroid function.

At the beginning of pregnancy:

In early pregnancy, thyroid function should be checked promptly (around the 8th week of pregnancy) to adjust the hormone dose accordingly.

During pregnancy:

In the following months of pregnancy, regular checks of the thyroid gland should take place to ensure an adequate supply of thyroid hormones so that the mother can pass them on to the child, especially in the first three months.

Pregnant woman holding her belly Daniel Reche / Pixabay

At the end and after pregnancy:

It is useful to check the thyroid gland again already towards the end of pregnancy and to consider how to tackle the thyroid dysfunction after pregnancy. Pregnancy suppresses all autoimmune reactions, which is why after delivery the immune system changes again and many autoimmune diseases increase or appear anew. Accordingly, the thyroid gland may become inflamed again by the antibodies after pregnancy. Usually, thyroid patients experience a mild temporary hyperfunction two to three months after delivery due to the destruction of thyroid tissue and the release of stored thyroid hormones. This returns to normal after the hormone store has been used up and then changes to a more pronounced hypothyroidism, as the damaged thyroid tissue is no longer able to produce sufficient hormones.

A moderate reduction of the hormone dose in the first two months after delivery can be useful in this case and should be discussed in the context of a thyroid check-up, as should a subsequent increase in the dose.


A common cause of infertility in women is thyroid dysfunction. Thyroid dysfunction can lead to cycle irregularities and decrease the chances of pregnancy. The hormones produced in the thyroid gland are essential for the physical growth and mental development of the unborn child, who is dependent on the mother's thyroid hormones, especially at the beginning of pregnancy. Treatment of the dysfunction is the main focus in thyroid patients with a desire to have children. Although the thyroid gland is usually not the central parameter in an unfulfilled desire to have children, its function should be well adjusted, regularly checked before and during pregnancy, and the time after birth should be planned in order to continue to treat the thyroid gland adequately afterwards.

Editorial principles

All information used for the content comes from verified sources (recognised institutions, experts, studies by renowned universities). We attach great importance to the qualification of the authors and the scientific background of the information. Thus, we ensure that our research is based on scientific findings.
Olivia Malvani, BSc

Olivia Malvani, BSc

As a student of nutritional sciences, she writes magazine articles on current medical and pharmaceutical topics, combining them with her personal interest in preventive nutrition and health promotion.

Dr. med. univ. Bernhard Peuker, MSc

Dr. med. univ. Bernhard Peuker, MSc

Bernhard Peuker is a lecturer and medical advisor at Medikamio and works as a physician in Vienna. In his work, he incorporates his clinical knowledge, practical experience and scientific passion.

The content of this page is an automated and high-quality translation from DeepL. You can find the original content in German here.

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