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[knitknat]

Knitspouse and I have been trying to conceive for about 6 months, to no avail. Thanks to the wonders of the inter-nets, I have discovered that I display the classic symptoms of hypothyroidism, including depression, lethargy, and some of the characteristics of my menstrual cycles. Talked to my Mom and apparently this runs in our family.

Went to my GP and asked for the TSH test, which his office said came back "normal" at 3.52. He said our recent move to small, university town may be the cuplrit for my problems, that I am too young (at 32) and within normal range of TSH to have thyroid-related infertility. I say BS. Stupid rural doctors.

Questions for the fora: in your experience, is it even worth fighting with GP on this, or is it time to find a new doc and start all over again? Should I try to get a referral straight to the endocrinologist, or will an OBGYN be more open-minded?

Have others experienced hypothyroid-related infertility? If so, how long after starting therapy were you able to conceive?

Yes, I sound anxious about this for only being 32, but time is not my friend. Every women in my family has a hysterectomy for uterine fibroids by the time she is 35. So please don't say I have lots of time.

[inthelab]

How were your T3 and T4 levels, and how were your other hormone levels?
Yes, it's worth fighting over.  Labs make mistakes.

[knitknat]

T3 and T4 aren't reported on my lab results, either they didn't test them or didn't report, despite my specific request for assessment of thyroid function.

Another sign of incompetence?

[sweetcider]

OP, it seems like you've already decided that this doctor is incompetent.  For that reason alone, find a new doctor.  It sounds like your primary concern is conception, so find an OBGYN.  Bring up your concerns about thyroid function and relate your family history with the new doctor.  But, please be willing to consider the possibility that your thyroid function is fine.  Self diagnoses via the internet can be useful starting place, but don't let it blind you to other concerns/ideas/whatever your doctor might have.

[inthelab]

Agree with sweetcider.
Go to an OB-GYN to address your fertility issues and discuss family history of thyroid trouble.  The OB may redo the tests or else send you to an endocrinologist for a consult.  You might find a new internist/family practitioner (= GP) via your OB.

[barred_owl]

OP, it seems like you've already decided that this doctor is incompetent.  For that reason alone, find a new doctor.  It sounds like your primary concern is conception, so find an OBGYN.  Bring up your concerns about thyroid function and relate your family history with the new doctor.  But, please be willing to consider the possibility that your thyroid function is fine.  Self diagnoses via the internet can be useful starting place, but don't let it blind you to other concerns/ideas/whatever your doctor might have.

Exactly!  Well-stated, sweetcider.  A more thorough, comprehensive evaluation seems to be called for here--one that includes assessing thyroid function, but isn't limited to just that.

[msparticularity]

I thought I'd chime in here, since your story sounds rather similar to mine. My former spouse and I struggled with infertility for almost three years before I managed to get pregnant. I, too, had classic symptoms of hypothyroidism and a family history to back it up. In fact, my family practitioner (who was also my mom's doctor), was sure something would show up on my thyroid panel pretty much every time I went in to see him about a range of things for literally a couple of decades. Still hasn't happened.

In my case, there was a complex of issues, including lack of ovulation and a probable damaged ovary/Fallopian tube on one side, along with possible motility issues for ex's sperm. Things did turn out fine, but it took awhile and involved a variety of experiments (speaking very honestly). And yeah, I'm another cliche--I finally got pregnant after we quit trying and began working on adoption.   

[wiley]

Go to an OB/GYN or reproductive endocrinologist. Irregular periods could be PCOS, too, so you might check that out. Go for a specialist and not your GP. It's worth it.

I'm surprised your relatives had hysterectomies because of fibroids. My wife had a fibroid removed from interior to the wall of her uterus, and now she's pregnant (thanks to IVF).

[inthelab]

Go to an OB/GYN or reproductive endocrinologist. Irregular periods could be PCOS, too, so you might check that out. Go for a specialist and not your GP. It's worth it.

I'm surprised your relatives had hysterectomies because of fibroids. My wife had a fibroid removed from interior to the wall of her uterus, and now she's pregnant (thanks to IVF).

Absolutely. Fibroids are NO reason to have a hysterectomy; there are several treatment options ranging from partial myomectomey (surgery) to thermal ablation to uterine arterial ablation (this procedure I had for bleeding fibroids).

[janedoh]

I have autoimmune thyroid disease (diagnosed at age 10) and I feel sick at at TSH above 2 (most labs say "normal" is up to 5). Since my thyroid no longer produces hormone, I need to change doses when that happens. Most endos want their patients at 2 or under these days. However, patients on full replacement are not the same as patients with functioning or semi-functioning thyroids. 3.5 seems a bit low to be the primary cause of infertility, but everyone's body is different.

There are lots of things that can cause the symptoms you describe. FWIW, I have a pretty large fibroid (a little larger than a softball) that doubles or triples in size when I am pregnant, plus another in my uterine wall that comes and goes with pregnancy. Neither my thyroid disease or my fibroids were major issues in my fertility.

It sounds like you don't trust your doc, so get a new one. If you are really concerned about thyroid disease, get yourself checked (TSH, T3, and T4) again in a few months. If all is well, your TSH should be where you are now or lower, and your T3 and T4 levels should be within normal range as well. As a previous poster suggested, I would also get evaluated for PCOS. A good endo could check both issues for you.

Although 6 months seems like a long time trying, it is not out of the normal range for healthy, fertile couples. But since you are concerned, I would definitely get a more detailed workup. Good luck!

[lemonbar]

I don't really understand the focus on thyroid issues and the self-diagnosis via the internet. Nevertheless, it is true what others say here: there could be many causes of infertility. You do need to see an OBGYN, and if s/he thinks there is a problem, they will refer you to a reproductive endocrinologist. Do not let an OBGYN try to treat you for infertility. Nothing against OBGYNs, but REs are the ones trained to deal with the issue. If you are in a rural area, it might be tough to find an RE. I was in this predicament, and ended up having to drive over an hour to receive infertility treatments.

Having said that, I doubt you'll get referred if you've only been trying for 6 months and you are under 40 years of age. I think the general rule is, most REs will only see you if you're under 40 and have been trying for a year. If you're over 40, it's 6 months. So, be prepared to have to wait a bit longer.

Have you been using ovulation predictor tests and timing sex? The science is of course not exact, but I would suggest trying that if you have not been doing so up until now. Look at the book Taking Charge of Your Fertility: it will explain not only the benefits and how to's of timing sex and using OPs, but also, if you're interested in temping (and using other signs) to help predict ovulation.

[oseph]

Chime with all the answers - I had temporary infertility possibly due to - thyroid, vague hormonal imbalance causing irregular menstruation, PCOS, pre-diabetes, ovarian cysts and fibroids, weight issues, high cortisol levels, problems with my body readjusting to life off the pill, depression, anxiety, migraines, chronic fatigue, etc., etc., etc.  Family history of:  hysterectomy, endometriosis, depression, chronic fatigue, anxiety, migraine, diabetes, ovarian cysts and fibroids, miscarriage, irregular menstruation, and thyroid problems.  Don't be surprised also if you go see the reproductive endocrinologist and all or one of these issues are raised because of suggestive but inconclusive lab results.  They're all part of the Great Demon that is the female endocrine system.

Best thing you can do is find an OBGYN willing to coordinate with a reproductive endocrinologist AND a psychiatrist.  Stress levels must be managed throughout this whole process, whether through meds, exercise, massage, or whatever.  This is hard to do when you're stressing out about what is going on with your body, but the old adage about getting pregnant when you've stopped trying happens pretty frequently.  Also if your weight is too high or too low you should work on fixing that.

I remember being there and it was no fun, but it is a chance to deal with lots of other nagging health issues regardless of the outcome.  If you get your endocrine system under control, you will feel much much better on a daily basis.  And of course I send baby wishes also.