This article was consulted by Lê Thị My, Specialist Level II, MD - Director of the Thyroid Disease Center, Department of Diagnostic Imaging and Nuclear Medicine, Vinmec Times City International General Hospital.
Nowadays, due to various factors, the infertility rate is increasing. One of the contributing causes is thyroid disease. So how does thyroid disease affect female fertility? Can women with thyroid nodules get pregnant? Let’s explore this topic in the article below.
1. Understanding Thyroid Nodules
Thyroid nodules, or nodular goiters, are abnormal growths of thyroid cells that form lumps in the thyroid gland, altering its structure and endocrine function. Although most thyroid nodules are benign (non-cancerous), diagnosing and treating thyroid cancer at the earliest stage requires an accurate evaluation by a specialist. Below are some key points patients should know about thyroid nodules.
Thyroid nodules are classified based on the type of proliferating tissue in the thyroid gland. They can be either benign or malignant (thyroid cancer) and may appear as a solitary nodule or multiple nodules.
Due to the diverse pathological characteristics of thyroid nodules, determining their severity requires a thorough examination and classification by a specialist.
Are nodular goiter dangerous?
Benign thyroid nodules do not pose a life-threatening risk but can cause discomfort and affect daily activities.
According to many studies, the incidence of thyroid cancer is relatively low, with only about 4-5% of thyroid nodules being malignant.
If a thyroid nodule is cancerous, prompt treatment by a specialist is crucial. With proper treatment, thyroid cancer can be cured.
For benign thyroid nodules, patients can rest assured that proper treatment will not significantly affect their ability to become pregnant. However, if the nodule grows larger, it may cause swelling in the neck area, compressing surrounding structures and leading to discomfort.
2. How Do Thyroid Diseases Affect Female Fertility?
The thyroid gland produces two essential hormones - triiodothyronine (T3) and thyroxine (T4) - which play a crucial role in body growth and development. Thyroid disorders can impact female fertility before, during, and after pregnancy.
This has been documented in The Obstetrician & Gynaecologist journal, where researchers highlight that thyroid diseases significantly affect reproductive function in women, potentially leading to stillbirth, preterm birth, miscarriage, and other complications.
Among the causes of female infertility, thyroid diseases are considered a serious risk factor. Since thyroid hormones regulate growth and development, they also influence a woman's ability to become pregnant. The thyroid gland affects fertility in the following ways:
Effects on Pregnancy:
Can women with thyroid nodules get pregnant? The thyroid gland plays a role in regulating the menstrual cycle. When thyroid hormone levels are too high (hyperthyroidism) or too low (hypothyroidism), menstrual cycles can become irregular - ranging from mild to severe abnormalities.
In some cases, thyroid diseases can also lead to prolonged amenorrhea. Irregular menstrual cycles are another reason that makes conception more difficult. Additionally, when immune system disorders cause thyroid disease, they can also affect other glands, including the ovaries. This is the reason why some women experience early menopause.
In summary, when thyroid disease disrupts menstrual cycles, it directly impacts ovulation, making conception significantly more challenging.
Effects During Pregnancy:
Pregnant women with thyroid diseases face various health risks for themselves and their babies. During the first 10–12 weeks of pregnancy, while the fetus begins to produce its thyroid hormones, it is still entirely dependent on the mother's thyroid function. Therefore:
- Hyperthyroidism in the first trimester increases the risk of preeclampsia, preterm birth, thyroid storm, and heart failure. If poorly managed, hyperthyroidism can cause fetal growth restriction, neonatal hyperthyroidism, congenital heart diseases, preterm birth, stillbirth, or birth defects.
- Untreated hypothyroidism in pregnancy may lead to complications such as muscle disorders, anemia, preeclampsia, congestive heart failure, and postpartum hemorrhage. In the fetus, it increases the risk of placental abnormalities, low birth weight, congenital hypothyroidism, and developmental delays in the nervous system and cognitive function.
Overall, thyroid disorders primarily impact fertility by making conception more difficult. This occurs because thyroid hormone imbalances disrupt endocrine hormone regulation and ovulation. In particular, hypothyroidism can elevate prolactin levels, which inhibits ovulation, leading to amenorrhea or oligomenorrhea, thus increasing the risk of infertility in women.
3. Can women with thyroid nodules get pregnant?
3.1. The ability to become pregnant when having thyroid disease.
Although thyroid disease affects fertility, women with well-managed thyroid disorders can still get pregnant and have a healthy pregnancy. In many cases, women can even get pregnant and give birth while undergoing treatment, provided they are closely monitored by an endocrinologist and adhere to the doctor's instructions.
Most medications used to treat thyroid disorders are safe for the fetus, allowing pregnant women with thyroid diseases to continue their treatment. However, women with thyroid diseases must undergo a medical check-up before pregnancy. This helps detect and manage potential complications caused by thyroid diseases.
3.2. Preventive Measures for Thyroid Diseases
- Avoid sudden weight gain or loss.
- Avoid prolonged stress.
- Seek medical evaluation if experiencing symptoms suggestive of thyroid diseases.
- Maintain a regular and sufficient sleep schedule.
- Maintain a balanced diet with essential nutrients and stay active through regular exercise.
Vinmec International General Hospital is a reputable facility for diagnosing, treating, and preventing various conditions, including endocrine disorders. Patients at Vinmec receive care in a modern medical environment equipped with advanced diagnostic and treatment technologies, guided by highly qualified doctors trained both domestically and abroad.
One of the advanced techniques used at Vinmec is radiofrequency ablation (RFA) for benign thyroid nodules, which has shown excellent results, with studies demonstrating a 30–50% reduction in nodule volume within one month, 60–70% within three months, and over 90% within 12 months after treatment, while leaving no surgical scars on the neck and preserving as much healthy thyroid tissue as possible, thereby eliminating the need for lifelong thyroid hormone replacement therapy.
Due to its effectiveness, radiofrequency ablation (RFA) for thyroid tumors is not only applied in the treatment of benign thyroid nodules but has also been updated for use in treating malignant thyroid lesions, including papillary thyroid microcarcinoma (tumors <1 cm in size without regional lymph node metastasis) and locally recurrent lesions or metastatic lymph nodes in the neck from thyroid cancer that have already undergone surgery and radiotherapy.
To achieve the highest diagnostic and treatment efficiency, Vinmec has equipped itself with the most advanced imaging diagnostic systems available today. Notably, the GE Healthcare E9 ultrasound machine features a flat probe, high frequency, and HD resolution, providing clear and detailed images. The radiofrequency ablation (RFA) technique for thyroid tumors, performed under ultrasound guidance, allows doctors to fully control the procedure, ensuring optimal ablation while minimizing damage to blood vessels, nerves, the trachea, and the esophagus. This makes the procedure highly safe while also maximizing tumor size reduction.
Patients will undergo regular follow-ups at 1, 3, 6, and 12 months after the procedure with an endocrinologist and a radiologist to ensure accurate and objective evaluations of their recovery and treatment success.
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