The question
Hi there,
I have high TPO antibodies (around 300) and now about to embark on our IVF journey in a few weeks. It seems that I have POI and I'm 27 years old.
I am currently on 100mg of Levothyroxine and I'm keen to explore all options to inform my clinic to manage IVF AND my thyroid to achieve a successful pregnancy. As I have POI, embryo numbers are likely to be small, so I'm concerned that my antibodies and autoimmune condition are going to attack our precious embryos.
What would you recommend in terms of treatment plan for management of the antibodies. Would a series of intralipid infusions be beneficial in improving implantation rate? My partner and I are paying for 2 rounds of IVF (which is financially breaking us) and we want to make sure that we can do everything correctly, as managing a thyroid issue alongside IVF are very difficult and two separate challenges to face at the same time.
Thank you so much!
Georgie
Answer from Dr. Geoffrey Sher
Between 2% and 5% of women in their childbearing years deal with hypothyroidism, a condition that affects women more than men. This issue with the thyroid often leads to difficulties in getting pregnant or maintaining a pregnancy.
Hypothyroidism in women often happens because the immune system attacks the thyroid gland. The condition is known as Autoimmune Hypothyroidism or Hashimoto’s disease. Specific antibodies, like antithyroglobulin and thyroid peroxidase (TPO) antibodies, slowly reduce thyroid hormone production. Genetics, estrogen effects, and X chromosome abnormalities also contribute to its prevalence among women.
Here's a surprising fact: Even women who don't show obvious thyroid problems might have thyroid antibodies linked to trouble conceiving or experiencing recurrent pregnancy loss (RPL). These sneaky antibodies can linger without clear signs of hypothyroidism in clinical or lab tests. And commonly, even after treating hypothyroidism with hormone supplements, these antibodies stick around.
More than two decades ago, I performed a study and reported on the fact that almost 50% of women with thyroid antibodies, regardless of thyroid function, had overactive uterine natural killer cells (NKa) and activated cytotoxic lymphocytes (CTLa) that are capable of attacking the embryo’s “root system” (trophoblast) and compromising implantation. The result was often total implantation failure (often erroneously diagnosed as infertility) or early pregnancy loss. Testing for NKa and CTLa requires access to few highly specialized Reproductive Immunology Reference laboratories. We demonstrated that treating these women with immune therapies like Intralipid or immunoglobulin-G, along with a sprinkle of low-dose steroids, significantly boosted their chances of successful reproduction.
For example, let's take a peek at the journey of a one of my patients, a 42-year-old Australian physician. She faced a whopping 23 unsuccessful IVF attempts due to Hashimoto's disease. We rapidly identified underlying NKa/CTLa and after a single cycle of tailored immune therapy ( as above) she conceived and gave birth to a healthy baby boy—an incredible glimmer of hope in her life.
It's important to note that not every woman with thyroid antibodies experiences an immune cell party in her body. However, understanding this unique relationship and providing the right treatments can reverse immunologic implantation dysfunction (IID) caused by NKa/CTLa. This knowledge offers renewed hope, making the journey to successful reproduction a brighter and more achievable adventure.
In the end, remember this: Even when your body throws a curveball like autoimmune thyroid IID the game isn't over. With the right strategies, a sprinkle of hope, and a dash of persistence, victory is within reach. So, chin up and keep moving forward.
Geoff Sher
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ADDITIONAL INFORMATION:
I am attaching online links to two E-books which I recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure:
1.From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) “
http://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf
- “Recurrent Pregnancy Loss and Unexplained IVF Failure: The Immunologic Link
https://drive.google.com/file/d/1iYKz-EkAjMqwMa1ZcufIloRdxnAfDH8L/view
- If you are interested in having an online consultation with me, please contact my assistant, Patti Converse at 702-533-2691 or go to concierge@sherivf.com .
- Also, I have just started a new Podcast https://rumble.com/c/c-3304480. Feel free to take a look-see……… And please spread the word!
General information only, not medical advice for your own situation. For that, book a consultation.