In medical terms, it’s called “pregnancy loss”. In families, friends’ circles and the larger community, the word “miscarriage” is usually said in quiet voices.
For so many women, that positive home pregnancy test equates to a real live baby in about 9 months. Few, especially with their first pregnancy, expect any other outcome.
Despite nearly 10% of all pregnancies (though with early detection test options, now the figure may be up as high as 50%) ending in miscarriage, it is nearly always a shocking and heartbreaking experience. For certain groups, miscarriage can be even more common: 20% of pregnancies in women over 35 and 40% of pregnancies in women over 40 will end in pregnancy loss.
Even knowing that the 12 week line means you are most likely “safe” (80% of all miscarriages happen in the first trimester), it’s nearly impossible to believe that little blue plus sign could be wrong. The pain, isolation, and grief that follow can seem surprising to people on the outside of your immediate circle. Nothing changed in their lives so they struggle to know why it devastated you. But everything changed for you. It was like the sun came out and was shining on you and everything was perfect. And then it wasn’t. You were locked in a dark, grey, cold room with no explanation as to why and no direction about what to do next.
50% of miscarriages happen because of genetic abnormalities. That means you did nothing wrong. You did nothing to cause it. There’s not anything you could have done to prevent it. This knowledge rarely makes the pain any less brutal.
But what about the other 50%?
Thyroid disease affects about 4% of the overall population of America, meaning over 13 million people (males and females). Roughly 10 million people have hypothyroidism.
Autoimmune Hypothyroidism (also called Hashimoto’s) is the most common cause of hypothyroidism and is 8x more common in women than in men. Autoimmune Hypothyroidism is even more common in women with endometriosis or PCOS.
Thyroid dysfunction where “even minimal hypothyroidism can increase rates of miscarriage and fetal death and may also have adverse effects on later cognitive development of the offspring.”1
Having antibodies that attack your thyroid is more of a factor in causing infertility and miscarriage than having hypothyroidism2.
Despite knowing this, many patients never get thoroughly tested for thyroid dysfunction until AFTER their first pregnancy loss (many don’t get tested until after their 3rd pregnancy loss).
The American College of OB-GYN does not recommend screening for thyroid disease in pregnancy unless a patient is “high risk”, meaning: she (or a close family member) already has thyroid disease or another autoimmune disease, PCOS, a previous miscarriage or premature baby. So, don’t be surprised if your OB-GYN tells you it’s not necessary to check your thyroid function if you are trying to conceive (and for women, it may not happen during your first set of prenatal blood tests).3
There is a gap though. Between all the low risk women in America and the smaller percentage of women who are at a higher risk for thyroid disorders and miscarriage. How do we know precisely which group one of our patients is in?
As Naturopathic physicians, we are trained to prioritize treatment of the individual. We practice individualized health care. To do our best work, we like to have data that lets us tell patients exactly which group they are in. So we are believers in testing. We want to know and we want our patients to know. If testing all of our fertility patients helps us prevent even one heartbreaking miscarriage, we want to do it.
If you are looking for doctors who prioritize optimizing your individual fertility, call to schedule a free consult with us. We would love to hear your story and help you get the clearest view of your health.
Subclinical hypothyroidism in the infertile female population: a guideline. Fertil Steril. 2015;104(3):545-553. doi:10.1016/j.fertnstert.2015.05.028
Seungdamrong AM, Steiner A, Gracia C, et al. Antithyroid antibodies, but not thyroid stimulating hormone, are associated with decreased pregnancy rates in infertile women. Fertil Steril. 2015;104(3):e36-e37. doi:10.1016/j.fertnstert.2015.07.111
ACOG Guidelines at a Glance Thyroid Disease in Pregnancy. Contemporary OBGYN. https://www.contemporaryobgyn.net/contemporary-obgyn/news/acog-guidelines-glance-thyroid-disease-pregnancy. Published July 1, 2015. Accessed April 9, 2019.