Can sub clinical hypothyroidism affect fertility? i have hashimoto's; tsh levels were up and down for years. unable to get pregnant during that time.

Yes: Thyroid disease is one of many issues we consider for those unable to get pregnant. It's important to get your thyroid condition treated appropriately & optimally. And then it's even more important to monitor your thyroid function throughout your pregnancy as it can & will change, requiring different doses. So go see your family doc, OB or reproductive endocrinologist for preconception counseling.

Yes: Womem with thyroid disease do have more difficulty with getting pregnant than the average woman. They also have a higher risk of miscarriage and preterm labor.

Not the only cause?: It it's really subclinical hypothyroidism (tsh in the upper part of the range but normal thyroid hormone levels and no symptoms) it may not have as much effect on fertility as full-blown hypothyroidism. We treat to reduce OB complications in women trying to conceive. You should see a reproductive endocrinologist for testing if you haven't got pregnant in "years", there may well be other causes ...

TSH level: Most endocrinologist and fertility specialist will advocate for keeping TSH below 2 in women who have hashimoto's disease and desire pregnancy. Recent guidelines by the american thyroid association (ata) advocate for TSH between 0.1-2.5 for conception and first trimester. Good luck.