Can High Antibody Levels and Uterine Fibroids Affect Pregnancy?

Uterine fibroids, elevated antibody levels, and frequent urination—can one still become pregnant?

Hello Dr.
Tsao,
At the end of last year, during a health check-up, I was diagnosed with hypothyroidism and thyroid nodules, as well as uterine fibroids.
The doctor mentioned that my thyroid levels were within a normal range at 4 and advised that I didn't need medication.
Later, when I expressed my desire to conceive, he prescribed medication for me, and I have been taking it for three months.
My levels have now dropped to 2.
The biopsy of the nodules was benign, but he also mentioned that my antibody levels were abnormally high and advised me to do some research.
He suggested that I engage in sexual intercourse during my ovulation period to see if I can conceive.
If I am unable to conceive within six months, I will need to consult a rheumatologist.
I would like to ask Dr.
Tsao how to manage the elevated antibody levels to bring them back to normal.
Can high antibody levels really affect fertility? Additionally, I would like to know if fibroids can compress the urethra.
I have been experiencing bloating and pain; previously, I had frequent urination, but it wasn't severe.
However, this month, I suddenly find myself running to the bathroom all night.
I feel a bloated sensation in my lower abdomen, and sometimes I experience a dull, bloated pain, similar to indigestion.
I have been unable to sleep well at night due to constant trips to the bathroom.
I went to the hospital for tests, including blood work, urinalysis, and an ultrasound, all of which came back normal.
The gynecologist advised monitoring the fibroids for six months without the need for removal.
So, I would like to consult Dr.
Tsao about what might be causing these issues and what could be the underlying problems.
Thank you, Dr.
Tsao, for your help and support.

Māomī, 40~49 year old female. Ask Date: 2021/03/26

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, regarding the issue with antibodies, it may be best to consult an endocrinologist.
Frequent urination, if the uterine fibroids are not large, should not be related.
However, if discomfort persists, it is advisable to see a urologist.
Wishing you good health.

Reply Date: 2021/03/26

More Info

High antibody levels, particularly in the context of autoimmune conditions, can indeed have implications for fertility and pregnancy. In your case, the presence of elevated antibodies, such as anti-TPO (thyroid peroxidase antibodies), suggests an autoimmune thyroid condition, which can be associated with thyroid dysfunction. While your TSH levels are currently within a normal range, the presence of these antibodies indicates that your immune system is reacting against your thyroid tissue, which could potentially affect your overall hormonal balance and fertility.

Research indicates that elevated thyroid antibodies can be linked to an increased risk of miscarriage and may impact the ability to conceive. Women with high levels of anti-TPO antibodies may experience difficulties in maintaining a pregnancy, even if their thyroid hormone levels appear normal. It is essential to monitor these antibody levels and discuss with your healthcare provider whether any treatment or further evaluation is warranted.

Regarding uterine fibroids, these benign tumors can also influence fertility and pregnancy. While many women with fibroids conceive without issues, certain types and locations of fibroids can interfere with implantation or lead to complications during pregnancy. For instance, submucosal fibroids, which grow within the uterine cavity, are more likely to cause problems than those located on the outer wall of the uterus. Symptoms such as frequent urination, pelvic pressure, or pain can occur if fibroids are large enough to press against the bladder or other pelvic organs.
Your experience of increased urinary frequency and discomfort could be related to the presence of fibroids, especially if they are located in a position that exerts pressure on the bladder. However, since your ultrasound and other tests have returned normal results, it may be beneficial to continue monitoring the fibroids as advised by your gynecologist. If your symptoms persist or worsen, further evaluation by a urologist or a specialist in pelvic pain may be necessary to rule out other causes.

In terms of managing high antibody levels, lifestyle modifications, such as maintaining a healthy diet, managing stress, and ensuring adequate sleep, can support overall immune function. Additionally, working closely with an endocrinologist or a reproductive specialist can help tailor a treatment plan that addresses both your thyroid health and fertility concerns. If you do not conceive within the next six months, as suggested by your physician, it would be prudent to seek further evaluation from a rheumatologist or an immunologist to explore any underlying autoimmune issues that may be affecting your fertility.

In summary, both high antibody levels and uterine fibroids can impact pregnancy and fertility. It is crucial to maintain regular follow-ups with your healthcare providers to monitor your thyroid function, antibody levels, and any symptoms related to fibroids. Open communication with your medical team will ensure that you receive the appropriate care and interventions to support your reproductive health.

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