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Answers to questions from the endocrinologist Morshneva Svetlana Petrovna

With thyroid disease, what is the chance of becoming pregnant at 35?

If the thyroid function is normal and / or thyroid status is compensated, then in this case, there is no negative effect on reproduction.

Will a mother’s thyroid disease affect her baby during IVF?

No, they will not. However, it is worth noting that maternal thyroid diseases can lead to complications during pregnancy. Therefore, it is important, before and during pregnancy, to be observed by an endocrinologist

Can plasmophoresis help to improve thyroid function?

There are currently no official data confirming the effectiveness of this procedure in patients with thyroid diseases.

Is it possible to carry out IVF during remission of the thyroid gland? What is the probability of a positive result?

Can. A positive result is influenced by many factors, including general health, age, previous illnesses, and the state of the reproductive system.

Can I get pregnant with diffuse toxic goiter?

It is possible, but it is desirable that the pregnancy be planned, against the background of normal thyroid status and without taking thyreostatics.

Tell me, can radiation affect thyroid dysfunction?

Of course it can. At the same time, the thyroid gland is one of the first to suffer, it accumulates about 30% of the iodine radioisotopes absorbed by the body.

How to pass the analysis of TSH, since within a month the results are different from 0.5 to 2.6?

The maximum concentration of TSH in the body occurs in the morning, until 11.00, regardless of the day of the menstrual cycle. Therefore, taking this analysis is best in this period. A few days before the analysis, exclude alcohol, tobacco, fatty and spicy foods. And also, if possible, stop taking any drugs, including dietary supplements.

After the treatment you prescribed, TSH fell to 1.81, is this a good indicator or not?

Yes, this is a good indicator.

With which TSH indicator is it better to enter the IVF protocol? Two units or less?

Less than 2.5 units

Tell me, TSH is increased, I normally keep it with L-Thyroxine. But still high antibodies, do you need to do something with them? Do they somehow affect treatment, pregnancy?

We can’t medically affect antibodies, the main indicator that affects reproductive function is TSH.

Antibodies do not directly affect pregnancy. The only thing that is important is to plan a pregnancy at normal TSH, and during pregnancy, monitoring the thyroid status of the pregnant woman is necessary

If TSH is normal, then can T3 and T4 be abnormal?

Yes, such evidence is possible. Moreover, with normal TSH, T3 and T4 can be either increased or decreased, which indicates different types of disease.

If BMI and GTT are normal, is it necessary to follow a low-carb diet for PCOS?

Any diet should be individual and balanced, taking into account the calorie content of foods, BZHU balance and tolerance of products. Calorie content and diet are determined depending on the general state of health, age, physical and mental activity. It is very important to understand the goal that you want to come to with a diet. And if the main goal is health, then only a specialist can choose the right diet for you.

Is varicose veins inherited from the father?

A genetic predisposition to the occurrence of the disease exists. According to medical research, it is 60% (if more than one of the parents). If both mom and dad suffer from varicose veins, then the probability increases to 80%.

What is the reason for the increase in estradiol (according to the results of 4500-6500) after embryo transfer?

One of the main functions of estradiol is the loosening of the endometrium so that the embryo can maximize its fixation in the uterine cavity and its development begins. In a fresh transfer, a high level of estradiol is due to the production of estrogen follicles, and later by fresh yellow bodies, especially if the cycle is stimulated. In the cryoprotocol, the level of estrogens rises medically to achieve the optimal thickness of the endometrium (10-12 mm), which, in turn, is due to the high level of estradiol. It is important to note that the result depends on the level of estradiol, there is a low indicator at which pregnancy may not occur or may be terminated due to its insufficiency. This happens with primary ovarian failure!

Tell us about the value of progesterone and estradiol in the luteal phase.

The main change occurring in this phase is a change in the function of the follicle from estrogen-secreting to the production of progesterone and estrogens, as well as androgens. In more detail, this issue should be considered depending on the evidence at a personal consultation.

What types of prolactin to take? Which macroprolactin or micro take into account?

Initially, an analysis is needed to determine the overall prolactin index. And only after consultation with a specialist will it be clear whether further examination is necessary. We take into account all types of prolactin.

What to do with a prolactin index of 40-50 units? Is IVF possible?

In this case, I recommend normalizing prolactin levels before starting the IVF protocol. Since prolactin directly affects the reproductive function of women. With its increase, inhibition of follicle-stimulating and luteinizing hormones occurs. As a result, blocking egg maturation, irregular ovulation, infertility.

Is it possible to balance your hormonal background by changing your lifestyle?

It all depends on what stage is the “imbalance” of the hormonal background. Most often, patients turn to a specialist even when a malfunction in the hormonal system becomes noticeable. And this means, quite serious, requiring treatment. The right way of life is rather a preventive measure that will help maintain good health.

Does weight affect male infertility? How does male obesity affect sperm?

Male obesity negatively affects testosterone levels and, accordingly, spermatogenesis. According to studies, in 67.4% of men with impaired sperm quality, one or another form of excess body weight is observed.

Does any sportspit affect men’s health? For example – protein, vitamin-mineral complexes and other simplest additives adversely affect the ability to conceive a child?

It all depends on what kind of supplements a man takes. If we are talking about protein, vitamins, amino acids – then, in most cases, no. If they are of good quality and have no additives. It is also important to note such a factor as the level of vitamins – an excess can carry a negative effect on the body. In any case, at the stage of preparation for conception, I advise you to undergo an examination with a specialist and pass a number of tests, including a spermogram.

AT – TPO is it already autoimmune thyroiditis? Increased AT-TPO – is it the cause of infertility?

Antibodies to thyroperoxidase (AT-TPO) are not always a marker for the development of autoimmune diseases. According to statistics, 15–20% of people can simply be “carriers” of this group of antibodies without any health consequences.

What can you say about vitamin D? Is it possible to get the necessary dose of vitamin D, being about 40-60 minutes outside, or supplements?

As with any other drugs, everything is individual. In order to clarify the picture, it is advisable to examine 25-OH D3 before using the vitamin. It is also worth noting that the level of calcidol (25-OH D3) depends on the intake of Vitamin D2 and D3 into the body. And if we get D3 from exposure to UV rays (80% of the norm), then getting D2 is possible only from food, with a properly balanced diet. In any case, it is best to start with an analysis and consultation of a specialist.

With the indicator “androstenedione 5.56” at a rate of 3.3, is it possible to carry a child normally?

It is better to plan pregnancy at normal rates, since with such indicators, the likelihood of miscarriage remains. I want to draw attention to the fact that the time taken for the analysis depends on the hormone levels. It reaches its maximum dosage in the morning and depends on the day of the cycle (maximum in the middle of the cycle, ovulatory phase)

How does great physical activity affect men’s health?

It all depends on the load itself. If the load is intense, exhausting and you are not prepared: then it’s negative, because perceived by the body as stress. Almost all athletes know how important it is to dose loads correctly, to observe the load – rest regimen. Even if it seems to you that you can do more and everything is in order, then in fact you are on the path to frustration, stress, and sometimes even harm to health. Since any stress directly affects the release of hormones. In case of recurrence, a serious malfunction in the body begins.

When taking Veroshpiron, can I plan a pregnancy?

Not advisable. In this case, specialist consultation is necessary.

How often are hormone dynamics needed before and after transfer?

It all depends on individual indications and is adjusted based on the dynamics of treatment.

What is subclinical hypothyroidism?

Subclinical hypothyroidism is characterized by an increased level of thyroid-stimulating hormone (TSH) in the blood serum at normal concentrations of thyroid hormones T3 and T4. Mostly asymptomatic. However, in 25-50% of patients, the following symptoms may be mild:

– Deterioration of memory, decrease in concentration of attention, deterioration of intellectual and cognitive abilities.

– Depressed state. SG itself does not cause depression, but it lowers the threshold for the onset of the disorder. In approximately 52% of patients with depression, hypertension was detected.

– Violation of the menstrual cycle, hyperprolactinemia, infertility. Diagnosed in 28% of cases.

– Dyslipidemia, with an increased atherogenic index, rhythm and conduction disturbance, with resistance to antiarrhythmic therapy

– Increased intraocular pressure.

– The manifestation of myalgia and hypochromic anemia.

An early miscarriage – an occasion to visit an endocrinologist?

Required. Failure in the endocrine system is the most common cause of spontaneous termination of pregnancy. First of all, this may be due to dysfunction of the ovaries. Namely, the failure of the luteal phase and with a lack of progesterone.

The second possible factor is hyperandrogenism of various etiologies (including the hyperplasic state of the adrenal cortex), which is characterized by an increased index of androgens. A third cause of miscarriage may be diabetes.

This is not a complete list of possible reasons, each case is considered individually.

If BMI is normal, can there be insulin resistance in case of cystic fibrosis?

Yes maybe. Insulin resistance can occur not only in the form of changes in body weight, but also a number of other factors. This is due to a change in the metabolism of proteins, fats and carbohydrates, as well as gene expression.

Dosage of metformin in normal BMI in case of cystic fibrosis?

Any dosage is calculated individually, based on tests and a general history.

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