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Is Poor Thyroid Function Impacting Your Fertility?

Dr. HelloDox Care #
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The human body works as directed by the various hormones released by the endocrine system. These hormones are essential for coordination of various body functions. From the height a person achieves to the metabolic reactions in the body to the reproductive cycle to the stress levels a person can handle, all are hormone controlled.

Pregnancy is another critical, complicated phase that a woman goes through. It is one of the most awaited phases in a woman’s life; however, it is not very simple either. The above-noted hormones play a major role in this pregnancy, as the baby is dependent on the mother for its initial supply of hormones until it can start producing its own hormones. If the baby does not receive the require amounts, there could be various detrimental effects during development and post birth.

Hypothyroidism or an underactive thyroid is extremely common in women and there are multiple theories about how hypothyroidism can affect a woman’s chances of getting pregnant. While the correlation between hypothyroidism and pregnancy are quite well researched, a strong connection stating hypothyroid women being not able to be pregnant is yet to be proven.

The following are some correlations between hypothyroidism and pregnancy.

Increased chance of miscarriage: Women with reduced thyroid functions have double the chances of having a miscarriage. Women suffering from thyroid are at a risk of recurrent miscarriages during the first trimester. The chances of miscarriages during the second trimester are also about 40% higher in hypothyroid women. These women are also at a risk of:

Premature labour

Low birth weight

Increased chances of stillbirth

Maternal anemia

Postpartum hemorrhage

Developmental defects and/or delays in the newborn

Placental abruption

High blood pressure

One of the reasons identified for infertility in women is hypothyroidism. This range varies from 1% to 40% and so remains to be proven still. In addition, the hypothyroid mother will have a set of symptoms to live through, which may be further complicated given the pregnancy. Thyroid replacement should be religiously done and monitored to ensure TSH levels are at the optimal required levels (2.5 to 3 mIU/L) during the entire duration of pregnancy.

If you have the following, be sure to go through a comprehensive thyroid screening before and during pregnancy.

Family history of thyroid

History of thyroid dysfunction or goitre or thyroid antibodies

Clinical signs and symptoms suggestive of hypothyroidism

History of repeated miscarriages

History of head and neck radiation

Family/personal history of autoimmune disorders

While it still remains to be proven that hypothyroidism per se can stop a woman from being pregnant, there are definitely effects of hypothyroidism on the developing child and the mother. A comprehensive screening and close monitoring through pregnancy are extremely essential.

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Zika Virus May Lead To a Miscarriage in Pregnant Women

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The case of the Zika virus was first discovered in Uganda. It is a severe disease which is transmitted by the Aedes mosquito, the same type of mosquito that carries the dengue fever, yellow fever, and chikungunya virus. Zika virus disease is a communicable disease therefore, a mosquito bites an infected person and then passes the virus to other people it bites. Some studies have also shown the virus can be found in blood, semen, urine, and saliva of infected people, as well as in fluids in the eye. In addition, infected pregnant women can pass the virus on to their fetus. According to a recent study, Zika virus could lead to a greater risk of miscarriage in the early stage of pregnancy. The study was published in journal, Nature Communications.

Researchers at Johns Hopkins University Bloomberg School of Public Health administered Zika virus directly into the reproductive tract of pregnant mice that have an intact immune system for the research. The researchers found that the Zika virus appears to create disorganization in the cellular layers of the placenta that keeps toxins, bacteria and viruses from crossing. This disorganization could be how the virus penetrates the placenta to infect the fetus. Researchers have discovered a mechanism by which Zika may be keeping antiviral proteins in the body from doing their job of protecting cells from the virus. For the research, the scientists developed a new mouse model which they say is uniquely capable of helping them to understand the mechanisms behind Zika transmission to the fetus.


For conducting the research, they injected Zika virus directly into the reproductive tract of the pregnant mice during what would be the equivalent of the first trimester in a human. The researchers used several different strains of the virus, using older strains – one from an outbreak in Nigeria in 1968 and another from Cambodia in 2010 – and contemporary ones from Brazil and Puerto Rico, from the most recent epidemics. The viability of fetuses after Zika infection was reduced, regardless of which strain was used. Viability ranged from 56 percent from infection with the Brazil strain to 71 percent following infection with the Nigeria strain. That means anywhere from 29 to 44 percent of pregnancies were lost following infection. When the researchers infected the mice in the equivalent of the late second trimester instead, however, many fewer miscarriages occurred, suggesting that there is less vulnerability to Zika later in pregnancy.

The placenta plays a key role in a healthy pregnancy. It is typically organized into discrete layers of tissue. Under a microscope, the researchers found that the layers of tissue in the placentas of the mice infected with Zika virus were no longer organized well and might be how the virus could penetrate the fetus. While the virus appeared to cross into the placenta fairly easily during the first trimester, the same was not true in the second trimester. As in humans, the direct effects on the pregnancy were much less pronounced if the infection occurred later in pregnancy.

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Pregnant Women, Think Before Taking Antibiotics as It May Increase Risk of Miscarriage

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Antibiotics are commonly prescribed during pregnancy but it is very important to be aware of the possible dangers it has and also the side effects it can cause. The increasing use of antibiotics has become quite controversial. Antibiotics are powerful drugs that destroy or slow down the growth of bacteria. Therefore, they are also known as anti-bacterials and are often prescribed for minor infections like cold, flu, cough and sore throat. But, in the recent years, there has been a lot of talk about the side effects of popping antibiotics regularly, especially for children and pregnant women. According to a new study, published in the Canadian Medical Association Journal, taking certain antibiotic drugs may increase the risk of miscarriage by 60% to 100%.

The study that was conducted by researchers at the Universite de Montreal in Canada warns women who take antibiotics during the early stages of pregnancy. The team studies data from about 9000 cases miscarriage including women between the ages of 15 to 45. It was seen that many common antibiotics such as macrolides, quinolones, tetracyclines, sulfonamides and metronidazole had a strong link with the increased risk of miscarriage in early pregnancy. Interestingly, a certain class of antibiotic drugs that are commonly used during pregnancy were not found to be harmful. For instance, antibiotics like erythromycin and nitrofurantoin that are often used to treat urinary tract infections in pregnant women were not associated with the risk of miscarriage.

According to the researchers, the risk is small and only pertains to the consumption of antibiotics during early pregnancy. Infections are common during pregnancy and although, in some cases antibiotics can actually help decrease the risk of premature birth or low birth weight, certain antibiotics have been found to increase the risk of spontaneous abortion as per this new study. The study also took into consideration facts like women who miscarried were more likely to be older, living alone, and may have had multiple health issues and infections while analyzing the results. Therefore, you should always avoid self-medication and consult your doctor before you decide to take any pill.

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High BP before pregnancy may raise miscarriage risk

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High blood pressure before conception and early in pregnancy may increase the risk of pregnancy loss, even if the woman does not have a hypertension diagnosis, new research has found.

“Elevated blood pressure among young adults is associated with a higher risk of heart disease later in life, and this study suggests it may also have an effect on reproductive health,” said lead author of the study Carrie Nobles from Eunice Kennedy Shriver National Institute for Child Health and Human Development (NICHD) in Maryland, US.

Millimeter of mercury, or mm Hg, is the unit of measure used for blood pressure.

The findings, published in the journal Hypertension, showed that for every 10 mm Hg increase in diastolic blood pressure (pressure when the heart is resting between beats), there was 18 per cent higher risk for pregnancy loss among the study population.

The researchers also found a 17 per cent increase in pregnancy loss for every 10 mm Hg increase in mean arterial pressure, a measure of the average pressure in the arteries during full heart beat cycles.

The researcher studied more than 1,200 women who had already experienced one or two pregnancy losses and were trying to become pregnant.

The findings were similar for preconception and early-pregnancy blood pressure.

“The impact of cardiovascular risk factors starts really early in life. Physicians treating women of reproductive age should pay attention to slightly elevated blood pressure because it may have other not-well-recognised effects, such as adverse pregnancy outcome,” said senior author of the study Enrique Schisterman from NICHD.

“Preconception is a previously unrecognized critical window for intervention such as lifestyle changes that can help prevent later heart disease and may also improve reproductive health,” Schisterman said.

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High blood pressure before pregnancy may raise miscarriage risk

Dr. HelloDox Care #
HelloDox Care
Consult

NEW YORK: High blood pressure before conception and early in pregnancy may increase the risk of pregnancy loss, even if the woman does not have a hypertension diagnosis, new research has found.

"Elevated blood pressure among young adults is associated with a higher risk of heart disease later in life, and this study suggests it may also have an effect on reproductive health," said lead author of the study Carrie Nobles from Eunice Kennedy Shriver National Institute for Child Health and Human Development (NICHD) in Maryland, US.

Millimeter of mercury, or mm Hg, is the unit of measure used for blood pressure.
The findings, published in the journal Hypertension, showed that for every 10 mm Hg increase in diastolic blood pressure (pressure when the heart is resting between beats), there was 18 per cent higher risk for pregnancy loss among the study population.

The researchers also found a 17 per cent increase in pregnancy loss for every 10 mm Hg increase in mean arterial pressure, a measure of the average pressure in the arteries during full heart beat cycles.

The researcher studied more than 1,200 women who had already experienced one or two pregnancy losses and were trying to become pregnant.
The findings were similar for preconception and early-pregnancy blood pressure.

"The impact of cardiovascular risk factors starts really early in life. Physicians treating women of reproductive age should pay attention to slightly elevated blood pressure because it may have other not-well-recognised effects, such as adverse pregnancy outcome," said senior author of the study Enrique Schisterman from NICHD.

"Preconception is a previously unrecognized critical window for intervention such as lifestyle changes that can help prevent later heart disease and may also improve reproductive health," Schisterman said.

Dr. Amol Sonawane
Dr. Amol Sonawane
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Dr. Sadashiv K. Deshpande
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Dr. Sneha Kale
Dr. Sneha Kale
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Dr. Deelip Janugade
Dr. Deelip Janugade
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Dr. Pavan Prakash Pargaonkar
Dr. Pavan Prakash Pargaonkar
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