what is Thyroidectomy?
Thyroidectomy is surgical removal of all or part of the thyroid gland, which is located in the front of the neck. The thyroid gland releases thyroid hormone, which controls many critical functions of the body.
How is thyroid disorders treated during pregnancy?
As surgical thyroidectomy for Graves disease can lead to isolated fetal hyperthyroidism, most pregnant women with toxic goiters are treated effectively with antithyroid drugs. Definitive surgical management of both benign and most malignant thyroid disorders can usually be delayed safely until after delivery.
Does radioiodine affect fertility?
In particular, the ovaries may be particularly sensitive to the radiation from radioactive iodine and this may lead to future problems with fertility. In women, radioactive iodine therapy has been associated with irregular menstrual cycles, earlier menopause, and delayed pregnancy.
Can you have a baby if your thyroid is removed?
Women are advised to wait 6-12 months before becoming pregnant after treatment with radioactive iodine after thyroidectomy for thyroid cancer because of a concern for possible effects of radiation in developing baby.
Does having no thyroid affect fertility?
Low levels of thyroid hormone can interfere with the release of an egg from your ovary (ovulation), which impairs fertility. In addition, some of the underlying causes of hypothyroidism — such as certain autoimmune or pituitary disorders — may impair fertility.
Why is thyroidectomy contraindicated in pregnancy?
Although thyroidectomy can be performed during pregnancy for malignancy, many authors cite postponing surgery until after delivery if possible, secondary to risks to the fetus from the anesthesia. Indications for surgery during pregnancy include aggressive cancers or airway compromise.
How long does it take to get pregnant after a thyroidectomy?
In some cases of thyroid cancer, radioactive iodine therapy is needed after surgery to remove thyroid gland. Currently, the American Thyroid Association recommends women to wait at least 6 months to become pregnant after radioactive iodine therapy
How can get pregnant after thyroidectomy?
Women after a thyroidectomy are usually placed on thyroid medication, and if your thyroid hormones are improved then your chances of ovulating and getting pregnant are significantly improved. You may want to continue to be under close observation of an endocrinologist.
When is thyroid surgery performed during pregnancy?
Thyroid surgery is rarely required. If needed it should ideally be performed during the middle three months of pregnancy. Radioactive iodine, another treatment for hyperthyroidism, should never be used during pregnancy.
What effect do thyroid drugs have on pregnancy?
There are several complications to be aware of if you have (had) hyperthyroidism. There is, unfortunately, an increased risk of miscarriage in the early stages of pregnancy if your hyperthyroidism is not under control. If you are taking antithyroid drugs there is a very slight increased risk of the baby having developmental abnormalities so some patients choose to have definitive treatment for Graves’ disease with radioactive iodine or surgery to allow them to have a pregnancy without needing to take antithyroid drugs. Also, if the dose of antithyroid drugs is too high, the baby’s thyroid may become underactive and the baby may develop a goitre. When trying to conceive or during pregnancy, do not stop taking antithyroid drugs before speaking to your doctor. There is greater risk to the pregnancy from an untreated overactive thyroid gland than from taking antithyroid medication.
What is the effect of pregnancy if the thyroid is not treated?
Untreated hyperthyroidism can also lead to complications of high blood pressure in pregnancy, poor growth of the baby and premature delivery. You will require regular thyroid function tests in pregnancy to ensure you are on an appropriate dose. If you have been treated for Graves’ disease with radioactive iodine or surgery in the past, or need antithyroid drugs during pregnancy, you may have Graves’ antibodies (also known as TSH receptor antibodies (TRAb)), which can cross the placenta. On rare occasions these can cause temporary hyperthyroidism in the baby during pregnancy and after birth, but this is treatable. A simple blood test to measure the TRAb level in the mother can help predict whether the baby will be affected in this way. If the levels of antibodies are high it is likely that you and your baby will be monitored more closely.
References
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/thyroidectomy#:~:text=Thyroidectomy%20is%20surgical%20removal%20of,critical%20functions%20of%20the%20body
https://www.nature.com/articles/nrendo.2009.211#:~:text=As%20surgical%20thyroidectomy%20for%20Graves,delayed%20safely%20until%20after%20delivery.
https://www.mayoclinic.org/diseases-conditions/female-infertility/expert-answers/hypothyroidism-and-infertility/faq-20058311
https://www.medscape.com/answers/1891109-100619/what-are-the-contraindications-for-thyroidectomy
https://www.medicinenet.com/script/main/art.asp?articlekey=53712
https://www.btf-thyroid.org/pregnancy-and-fertility-in-thyroid-disorders
