Thyroid and infertility

Thyroid and infertility

Autoimmune disorders such as Hashimoto’s thyroiditis, Lupus, Celiac disease and Diabetes have all been shown to have a potentially negative impact on both fertility and pregnancy outcomes showing higher rates of infertility, miscarriage and preterm deliveries. Due to the potentially negative outcomes, it is important for women of reproductive age to be properly assessed for potential autoimmune conditions before trying to conceive. This is particularly relevant when it comes to Hashimoto’s thyroiditis as it often goes undiagnosed.

Hashimoto’s thyroiditis is the most common cause of hypothyroidism or underactive thyroid function. It is very common and affects up to 4% of the population. Hypothyroidism is a condition in which the thyroid doesn’t make enough thyroid hormone either T4 or its active form T3. Some of the symptoms of hypothyroidism include weight gain, mental fog, dry skin/hair/nails, constipation, difficulty regulating temperature (generally presents with feeling cold) and fatigue. When we look at thyroid function there are 5 lab values of relevance.

1. Thyroid stimulating hormone (TSH) – this is a hormone that comes from the pituitary and tells the thyroid to make thyroxine (T4)

2. Thyroxine (T4) is a hormone made by the thyroid

3. Triiodothyronine (T3) is a thyroid hormone that is made through the conversion of T4. T3 is the hormone that works actively in our cells.

4. Thyroid peroxidase antibodies (TPO). These are antibodies that can be a sign of Hashimoto’s thyroiditis. You can also see TPO antibodies in a condition called Graves’ disease. This is also an autoimmune disease and the most common cause of hyperthyroidism. Hyperthyroidism is a condition in which the thyroid makes too much of certain thyroid hormones.

5. Thyroglobulin antibodies (Tg). These antibodies can also be a sign of Hashimoto’s disease. Most people with Hashimoto’s disease have high levels of both Tg and TPO antibodies.

TSH tells the thyroid to make T4. Then T4 goes out into circulation and converts into T3. T3 is active in our cells and regulates several processes in the body including metabolism and temperature regulation. Once T4 and T3 reaches a level where the cells are happy, feedback is given to the pituitary to slow down the production of TSH. If not enough T4/T3 is getting into the cells, we will see the TSH levels increasing on our lab work.

A combination of looking at all five of these lab values is needed to properly determine if a patient has Hashimoto’s and to determine if treatment is working.

When it comes to pregnancy if a woman has elevated antibodies, even with other thyroid labs values being normal, it can still have a negative impact for reproductive outcomes.

How can we lower elevated antibodies?


Research has shown some patients with Hashimoto’s are sensitive to a protein called gluten. If you have a gluten sensitivity (gluten is found in grains including wheat, rye, spelt and barley) this can promote inflammation in the body and therefore contribute to thyroid symptoms. Gluten has a similar appearance to thyroid tissue so in some cases, when the immune system starts attacking gluten, it also will attack the thyroid tissue. The same mechanism can happen with corn. For anyone who has seen elevated antibodies it is a great idea to start by eliminating both gluten and corn from their diet for at least three months. Repeat the antibody testing after three months to see if numbers have improved. For some patients, I find it helpful for them to follow a modified paleo diet to reduce overall inflammatory load. This involves focusing the diet on lean proteins, healthy fats, lots of fruits and vegetables and limiting any processed or packaged foods, sugars and grains.


The oil of an Indian seed called black cumin has research showing it can help lower TSH as well as antibodies. It also works to help reduce inflammation – a very useful oil when it comes to supporting patients with Hashimoto’s.

Curcumin, which is an extract from a spice called turmeric, also has some great research promoting a healthy immune balance by changing the body’s response to inflammation. Over time it can shift the immune system function to reduce its attack on itself.

Omega 3 fatty acids, predominantly derived from fish, help our bodies to promote a healthy response to inflammation. Most people in North America are deficient in omega 3s which can promote pain and inflammation in the body. Fish oil can also help improve the signalling of thyroid hormone within cells. As the feedback loop improves, we will see a natural lowering of TSH levels.


For patients that have elevated TSH levels it is recommended that, along with diet changes, they also use a thyroid medication such as levothyroxine. Ideally, this will result in their lab values normalizing and antibody levels coming down. For other patients though, being on a thyroid medication may normalize their TSH, T4 and T3, but their immune system can still present elevated antibodies showing it is still actively fighting itself.

Regulating thyroid function or other autoimmune conditions is essential to conceiving and being able to maintain a healthy pregnancy. If you suspect you have any thyroid related symptoms, have your blood tests run with your health professional so you can work to optimize these levels before your pregnancy. Once you do have a positive pregnancy test you should continue to monitor your blood levels especially during the early stages of pregnancy. This is a time where we can see a lot of fluctuation and adjusting medication levels may be needed.

Autoimmune conditions such as Hashimoto’s thyroiditis can be complex to manage, so please seek the care of your health professional for support.

For more fertility-based support and tips follow Jodie on Facebook or Instagram @enhancefertility

Or visit



The Importance of a Preconception Multivitamin

The Importance of a Preconception Multivitamin

The Importance of a Preconception Multivitamin

By Dr. Jodie Peacock ND

Optimizing your health before trying to conceive can help improve the overall health of your future baby. The development of both egg and sperm takes approximately three months, so this is a particularly critical time to focus on the health of both partners.

In general, your diet should be rich in fruits, vegetables, lean proteins, healthy fats and minimally processed carbohydrates. You should strive to limit or eliminate refined sugars, alcohol and processed foods.

Both men and women should consider starting a prenatal or preconception multivitamin about three months before trying to conceive. There are several nutrients that when not at optimal levels can have a negative impact on both overall health, conception and health pregnancy. When choosing a prenatal you should be aware that there are more and less desirable forms of several vitamins. You want to ensure that the dose is between 2-4 capsules per day. A one-a-day will not be able to provide the essential nutrients that you require.

Here are some key things to look for:


Taking either folate or 5-methyltetrahydofolate (5-MTHFR) will be better utilized then folic acid which is synthetic and not as easily converted to its active form. Approximately 50% of the population has a reduced ability to convert synthetic folic acid to its active form 5-MTHFR. If you are one of these individuals and are not consuming the active 5-MTHFR form, this can contribute to higher rates of infertility, miscarriage and neural tube defects. For this reason, if I don’t know the genetic status of my patient, I recommend a supplement with the active form of folate 5-MTHFR.


Making sure your iron is at an optimal level before trying to conceive is very important. If iron is low this can impact the ability for your body to circulate both nutrients and oxygen necessary to sustain a healthy pregnancy. Heme iron or iron glycinate forms are both well absorbed and are generally well tolerated causing very little constipation, while seeing good improvements in iron levels.


B12 comes in different forms with methylcobalamin being one of the active forms that is more easily absorbed. B12 is a nutrient that is important for neurological development and for DNA replication. Ensuring optimal levels is both important for development of sperm and egg as well as overall health for the baby.

Vitamin D

Low vitamin D can contribute to bone loss, depression, sleep disorders, immune deficiencies, and hormonal imbalances. There are also multiple studies that have shown deficient vitamin D can impair the body’s ability to achieve, as well as maintain, a pregnancy.

A simple blood test can be run to assess your status of each of these nutrients. This is something you can discuss with your health provider.

There are several other supplements such as CoQ10, carnitine, NAC, ALA, inositol, chastetree, maca and others that may be helpful depending on your individual situation. For example, there are some important nutrients that can help to optimize hormonal regulation, egg and sperm quality and can be added to a supplement regime based on your individual requirement.

For more tips on fertility, please follow us on Facebook and Instagram @enhancefertility.

While the world is healing we wanted to share this story of how the pandemic has temporarily divided one new family.

While the world is healing we wanted to share this story of how the pandemic has temporarily divided one new family.



While the world is healing we wanted to share this story of how the pandemic has temporarily divided one new family.

It is brought to you by Gaia Fertility, one of the partners of the International Fertility Company.

Intended parents A and C approached Gaia in 2018 with a burning desire to start their own family. As a married same sex couple they had previously considered a number of options which all turned out to be fruitless. Determined, the couple contacted Gaia and chose our same sex surrogacy programme which offered a pregnancy guarantee using sperm from both men and a single egg donor.

They were delighted to welcome their first born, a son in 2019 and the new parents returned home after four short weeks to begin family life. Keen on having a sibling for their son, the couple immediately began their second journey and received the fantastic news that baby number two, another boy was expected in April 2020!

It became evident some time ago that Covid-19 was making steady progress towards Cyprus where Gaia are based so the parents were advised to return to the island before any travel restrictions were put in place. As one dad is a key worker the decision was made that he would remain in the UK with their son whilst his partner travelled to Cyprus.

Gaia’s advice was well timed. The dad managed to get a seat on the last plane to the island before travel was halted but had to be quarantined for 2 weeks in order to secure the safety of those around him.

At Gaia we are always prepared to walk an extra mile to ensure we provide a service for our intended parents and surrogate mothers which is second to none. We had no hesitation therefore in opening up our own home to the dad to ensure that his quarantine period was as comfortable and stress free as possible.

During this period baby number two was born healthy at 37 weeks but due to the obvious restrictions he has not been able to receive a cuddle from either dad!

We arranged for a full-time nanny, who is also a paramedic, to care for the little one at her own home until he is able to join his parents and brother. We celebrated his arrival with a cake and online greetings from his dad’s and grandma which have subsequently become a daily occurrence!

We recognise the situation is not ideal and is perhaps one which is being experienced by intended parents across the world. We do have the technology and commitment however to ensure families remain together, albeit virtually in some cases and we look forward to a time when this particular family can be reunited at home!

Get more information about Gaia and the services it offers here, quoting IFC.



The science behind sperm – how to naturally improve the health of your swimmers!

The science behind sperm – how to naturally improve the health of your swimmers!

When it comes to fertility concerns often the burden is left to the female partner to determine what is wrong and why a couple isn’t getting pregnant. The fact is thought that between 30-50% of infertile couples are due to male factor concerns. For this reason, it is essential to ensure that the male partner has their sperm tested to look at a variety of different parameters including total volume of semen, total count, morphology (how do the sperm look) and motility (can they swim and in the right direction) and DNA fragmentation.

A variety of factors contribute to male infertility, many environmental factors such as exposure to certain chemicals, medications, heavy metals, pesticides, heat, or electromagnetic radiation. Other factors can also include smoking, drug use, alcohol abuse, chronic stress, poor diet, obesity, urogenital trauma, and inflammation in the male reproductive system. All these factors inevitably lead to elevated reactive oxygen species (ROS) or oxidative stress, which plays a significant role in male infertility.

Excessive amounts of ROS may have a negative affect on sperm DNA, leading to concerns with sperm morphology. ROS production also leads to reduces the ability of the sperm to swim and disrupted sperm membrane integrity. It has been shown that the antioxidant capacity of semen from infertile men is less than that from fertile men. In addition to the environmental and lifestyle factors, mounting evidence points towards the vital role of nutrition in sperm quality and infertility. This is the reason that diet, lifestyle and nutrients and supplements have been gaining more attention in the treatment and management of male infertility.

New sperm are constantly being developed so there is lots of opportunity to improve their health. It takes around 75 days or roughly 2.5-3 months from when a sperm first starts to develop to when it is ejaculated from the body.

Even if your sperm parameters do meet the minimum requirements it is a great idea to do what you can to optimize the health of the sperm. 50% of your baby’s DNA will come from the one sperm that makes it into the egg, so you want to make sure that it is one of top quality.

What lifestyle factors can you start to incorporate to improve the health of your sperm?

  1. Be careful about overheating the testicles. This includes things like hot tubs but also by wearing tight fitting clothing, avoiding prolonged sitting. If you have a desk job you want to make sure you are getting up and moving around at least once per hour to improve circulation and cooling for your testicles.
  2. Make sure you ejaculate regularly at least twice per week. The longer sperm sits the more likely it is to become damaged by ROS. Regular ejaculation is key to keeping the pipes cleaned out!!! Please feel free to share this one with your partner in case they don’t believe you!
  3. Reduce stress levels- Often times when speaking about fertility the male partner is left feeling they are just along for the ride. When test results come back that show there is a concern with the sperm this can leave thru male partner feeling very stressed. Starting with a simple daily practice of doing diaphragm or yoga breathing for 5-10 minutes can go a long way to helping regulate your stress hormones. It can also be extremely helpful to begin a regular yoga practice or seek the guidance of fertility counsellor.
  4. Exercise regularly but not excessively (now is not the time to start Ironman training this can divert testosterone away from the testicles). When it is comes to exercise and its impact on testosterone more is not necessarily better. For the purposes of fertility, it is recommended to exercise 5-6 times per week for 30-60 minutes.
  5. Make sure you don’t carry your cell phone in your pocket or sit with a computer on your lap these can lead to DNA damage. Any type of heat or device that send or emits data shouldn’t be near your testicles.
  6. Reduce your alcohol intake. Alcohol is a toxin in the body any toxins can result in more oxidative damage. If you are using alcohol as your stress reliever try to look for alternative options to help your stress.
  7. Clean up your diet. The more you focus on fruits and vegetables, lean proteins and healthy fats the better your overall health will be. This will also add more antioxidants into your body to help quench ROS and protect your sperm.
  8. Consider adding well researched nutrients that can improve your sperm parameters. Some of these nutrients include N-acetyl-l-carnitine, zinc, vitamin E and C and CoQ10.

N-Acetyl-l-carnitine (ALCAR), is an amino acid that is found in the highest concentration in the epididymis and plays a major role in the energy production and maturation of sperm. It helps move fatty acids into mitochondria to allow your cells to produce energy. If you are deficient in carnitine this reduces to amount of energy available to your sperm which doesn’t give them enough energy to swim and meet the egg.

Zinc is a crucial mineral for healthy sperm motility and production. A deficiency in zinc is related to lower testosterone levels and sperm count, as zinc is essential for proper sperm motility and production. Infertile men are usually characterized by lower zinc levels; therefore, zinc supplementation could be very useful in improving male infertility. Two individual studies have shown that zinc supplementation (24 and 89 mg of elemental zinc) resulted in an increase in testosterone levels and sperm count, along with successful pregnancies.

Vitamin E is a fat-soluble antioxidant that protects sensitive cell membranes by neutralizing free radicals (ROS). Vitamin E supplementation has been shown to significantly sperm motility and DNA damage. In infertile men, vitamin E inhibits the production of ROS.

Vitamin C is a water-soluble antioxidant and a key nutrient to supporting immune function and inhibiting production of ROS. High concentrations of vitamin C are found in seminal plasma and when used alone or in combination with other antioxidants, has been shown to improve sperm quality and reduce DNA damage.

Coenzyme Q10 (CoQ10), also known as ubiquinone, is a potent antioxidant and has gained wide attention for its beneficial effects in improving male infertility. In a double-blind study, coQ10 supplementation (200 mg/d) in 60 men with idiopathic asthenoteratospermia for six months improved sperm motility, and 12 spontaneous pregnancies occurred. Another study, in 228 infertile men with 28-week CoQ10 treatment, showed improvement in sperm count, motility, and morphology.

If you are trying to conceive ensuring you are incorporating these changes in your lifestyle will go a long way to improving the health of your sperm and ultimately the health your children.

For more information on improving your fertility follow us on instagram @enhancefertility or visit our website or pick up a copy of Preconceived to help guide you through the preconception process.

Rocío: “You shouldn’t see cancer as the end of something, but as the beginning of another opportunity to overcome any adversity”

Rocío: “You shouldn’t see cancer as the end of something, but as the beginning of another opportunity to overcome any adversity”

Rocío: “You shouldn’t see cancer as the end of something, but as the beginning of another opportunity to overcome any adversity”

 june 5, 2019URE Centro GutenbergReal testimonies

Today we bring you a new, true testimony to our blog. This is the story of Rocío, a brave and courageous woman who knew how to see further after a diagnosing of breast cancer.

​Rocío is the first woman in Malaga who has managed to become a mother after overcoming cancer.

She came to our fertility clinic in Malaga to freeze her eggs in 2010, before undergoing surgery and a chemotherapy treatment. She was 37 years old.

​Seven years later, being 44 and once the breast tumour had been overcome, she made her dream of becoming a mother come true after a fructifying in vitro fertilization (IVF) treatment with her frozen ovules.

​We wanted to record the story of Rocío and some colleagues involved in her case, because of the great value her testimony gives us. We think it is worth seeing and listening to it.

​We always hope and work very hard so all the stories of the patients of our fertility clinic have an ending as happy as that of Rocío and her little one.