NEW DELHI: In fertility practice, one situation repeats itself very often. A couple comes after one or two failed IVF cycles. They are emotionally exhausted, financially strained, and the most common question they ask me is — “Doctor, the embryos were good, then why did it not work?”
Many times, the answer is not in the embryo. It is in the hormones.
Many patients are surprised. They associate thyroid problems only with weight gain or tiredness. However, fertility is closely connected to hormonal balance, and the thyroid is one of the most important hormones for implantation.
Medical Director, Gynecologist and IVF specialist from Mother’s Lap IVF Centre and Founder Mumma’s Blessing IVF and Birthing Paradise in Vrindavan Dr. Shobha Gupta explains, “IVF is not only about creating embryos in the laboratory, it is about preparing the body to accept them.”
THE ROLE OF THYROID IN IMPLANTATION
IVF does not end when the embryo is formed in the lab. The most crucial step is implantation — when the embryo attaches to the uterine lining. For this to happen, the hormonal environment inside the body must be stable.
If thyroid levels are even mildly disturbed, the lining may not become receptive enough for the embryo to attach. In such cases, the embryo quality is not the problem — the environment is.
I often explain to patients, “A healthy seed cannot grow if the soil is not prepared properly.”
WHY ‘NORMAL RANGE’ IS NOT ENOUGH
Many women come with thyroid reports marked “normal.” For general health this may be acceptable, but fertility medicine follows stricter standards. For conception and IVF, the TSH level ideally should be around 2.5 mIU/L or lower. A borderline rise can reduce implantation chances and increase early pregnancy loss. This is why some patients experience repeated IVF failure despite good embryos.
Dr. Shobha Gupta says “we are not only trying to achieve pregnancy; we are trying to sustain it. Even mild thyroid imbalance can disturb that delicate hormonal stability.”
HYPOTHYROIDISM — A COMMON HIDDEN CAUSE
Hypothyroidism is very common in Indian women and often remains undiagnosed. Symptoms are mild and easily ignored, such as:
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Fatigue
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Hair fall
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Slight weight gain
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Delayed or heavy periods
Inside the body, however, ovulation quality and hormonal signaling are affected. During ovarian stimulation in IVF, eggs may not mature optimally, and implantation rates decline.
Correcting thyroid levels often improves ovarian response and cycle outcome.
RISK AFTER PREGNANCY OCCURS
Even if IVF leads to conception, uncontrolled thyroid can create complications. Early pregnancy depends on the mother’s thyroid hormone, especially for fetal brain development in the first trimester.
Uncontrolled levels may lead to:
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Chemical pregnancy
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Early miscarriage
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Poor placental formation
For this reason, do thyroid testing as soon as pregnancy is confirmed.
IVF success is not just a positive test; it is a healthy ongoing pregnancy.
TREATMENT IS SIMPLE BUT ESSENTIAL
The reassuring part is that thyroid-related fertility problems are highly manageable. Treatment usually requires:
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A small daily tablet on an empty stomach
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Regular monitoring every 4–6 weeks
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Dose adjustment during pregnancy
Sometimes I postpone embryo transfer briefly to stabilize thyroid levels says Dr. Gupta. Couples initially feel disappointed, but later understand the importance. A short delay can prevent repeated failure.
Advanced fertility treatments often make couples think the solution must be complicated. In reality, success sometimes depends on correcting a basic hormone imbalance.
“My consistent advice is simple: check and correct thyroid levels before IVF rather than after failure. Before searching for complex causes of infertility, first restore hormonal balance. When the thyroid is stable, the body itself becomes more ready for pregnancy, and IVF works with nature instead of against it” concluded Dr. Shobha Gupta.
Inputs by Medical Director, Gynecologist and IVF specialist from Mother’s Lap IVF Centre and Founder Mumma’s Blessing IVF and Birthing Paradise in Vrindavan Dr. Shobha Gupta