Lab Testing and Hormonal Assessment for Infertility

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Joined: 04/03/2014
Lab Testing and Hormonal Assessment for Infertility

Thank you Leslie! I learned so much from your class!

I have a question about TSH levels. My patient's TSH level was 4.51 when tested at the beginning of her pregnancy. She miscarried at the end of her first trimester. The day after her miscarriage her TSH level was tested and it was 2.75. Then about a month later it was 3.30. (All other thyroid and hormone tests you recommended were run and everything was within the normal range that you recommend). This was her 3rd miscarriage. She is 40 years old and is in otherwise great health. Is it normal for the TSH to fluctuate this much? I understand that the functional range should be between 1-2. But the labs say that between 1-4.5 are normal. Do you think this is a factor affecting her ability to carry a pregnancy to term?

I really appreciate your help!!

ProD Speaker
Joined: 10/16/2012

HI, Priscilla,

Yes, thyroid levels can fluctuate. The lab range will b e 0.5 - 4.5, however the endocrinologists want to see the TSH below 3.0, and if the patient is ttc, or pregnant, or on thyroid meds, they want to see it below 2.5 if not below 2.0.

Hypothyroid status can definitely lead to a miscarriage. At age 40 there could be egg quality issues that are causing the miscarriages. However, you want the thyroid to be in the optimal range.

I would strongly encourage the patient to be evaluated by an endocrinologist for support during pregnancy.


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