WOMENS-HEALTH Messages for July, 1998: PCO, hypothyroid, Clomid

PCO, hypothyroid, Clomid

From: Patti (anonymous@obgyn.net)
Thu, 9 Jul 1998 21:05:17 -0500 (CDT)

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Hi there,

I have a high TSH with (so far) normal T4 that my internist started treating with 0.1 mg Synthroid. I then consulted with a medical endocrinologist to discuss the thyroid and my mild case of PCO. At that time, a two-hour GTT with 4 insulin tests was normal, as was my TSH and T4. FSH:LH ratio and testosterone were abnormal. He suggested consulting with an RE when seeking pregnancy, but there is nonesuch in our area. He concurred with the Synthroid Rx, saying I should retest in a month or two.

I since started seeing a GYN with an infertility practice. He advised to start Clomid. My first cycle, 100 mg x 5 d, was ovulatory based on the progesterone level. At the same time, I had a TSH done, which was slightly elevated. The GYN is telling me that high TSH can be associated with an increased risk of miscarriage, and I should consult with my medical endocrinologist. I was surprised that the GYN did not consider thyroid issues within his scope of practice; in fact, some of his comments appear to demonstrate a poor understanding of basic thyroid evaluation.

I have a few questions: Should I be concerned about the TSH level, although T4 has never been high? Should I be concerned about seeing a fertility specialist uncomfortable with thyroid issues? Should I discontinue the Clomid cycling until TSH is normal? If there are diminishing returrns for the individual couple on Clomid, then I'd hate to "lose all my chances" for success on Clomid while trying to stabilize the TSH.

Thanks a million.

--
Patti

Next message: Sue: "Squamous Papilloma - Vaginal Infections"
Previous message: J.Glenn Bradley MD: "Re: Going for Laparoscopy 7-17"

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