Low TSH and Infertility: Exploring the Connection

Question
Since my daughter was born 21 months ago, we've been trying to get pregnant with no luck.  My period hasn't gotten back to normal since I had her (I have have very short cycles 22-26 days, often don't ovulate, and I have a VERY light flow) and I've just about given up trying excpet I went to my endocronologist today and he suggested that my thyroid could have something to do with the infertility.  I've been on various doses of thryoid medicine for over a year but my TSH hasn't gotten above 0.04.  He suggested I have surgery to remove my thyroid because that could "fix" the problem, but I'm not sure he knows much about infertility.  Could a low TSH be causing this and could removing my thyroid "fix" me?  I'm 37 years old and running out of time and options so any advice you can give me would be VERY much appreciated!!!
Thank you!
Melyssa Scott

Answer
Hello Melyssa from the U.S.,

Thyroid stimulating hormone is produced in the Pituitary along with many other hormone precursors, such as FSH and LH which stimulate the ovary.  A low TSH level, means your are not producing TSH because the thyroid is over-producing hormones and so the brain/pituitary hold production back.  This is referred to as "hyperthyroidism".  There are various causes for this disorder, and explanation of each would be overwhelming for this forum.  The cause needs to be found and treated.  Abnormal thyroid hormone can definitely affect your fertility.  I cannot say whether removing the thyroid is appropriate or not, but I would recommend that you consider a second opinion with another Endocrinologist if you need advice regarding this issue.  One question I would ask is what is causing your thyroid to be over-active, then ask what the appropriate treatment is.  From a fertility point of view, this is certainly something that you want to take care of before attempting to become pregnant, and soon because of your age.

Good Luck,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf