It is very reassuring that your ultrasound shows a healthy baby. At four months, minor spotting is quite common and often harmless, potentially caused by increased blood flow to the cervix or minor irritation. Your thyroid medication, levothyroxine, is safe and essential, so do not adjust your dose without medical advice. Your normal blood pressure, blood sugar, and hemoglobin are excellent signs. Please rest, avoid heavy lifting, and inform your obstetrician. They will likely check your cervix and perform a routine thyroid-stimulating hormone (TSH) blood test to confirm if your current levothyroxine dosage is still optimal for your pregnancy.

Yes, these are appropriate medications. Levothyroxine helps normalize your thyroid levels, which is vital for regulating your menstrual cycle and supporting a healthy pregnancy. Dehydroepiandrosterone (DHEA) is a supplement used to improve egg quality and ovarian function, which is highly beneficial for PCOD. Together, they help optimize your body for conception. Depending on your response, your gynecologist may later suggest additional treatments, such as ovulation-inducing medications or insulin sensitizers. Please continue taking these prescribed medications and consult your fertility specialist to track your ovulation and safely plan your pregnancy journey.

Your TSH spiked because fertility treatments (like HCG) raise estrogen levels, which drastically increase your body's thyroid hormone requirement. Your current Eltroxin 50mcg dose is now insufficient. High TSH directly impairs ovulation and prevents conception. Recommended Plan: 1. Adjust Eltroxin: Consult your doctor immediately to increase your Eltroxin dose, aiming for a TSH below 2.5 mIU/L. 2. Review Diabetes Meds: Discuss switching Tendia (teneligliptin) to pregnancy-safe alternatives like Metformin or insulin. 3. Pause Fertility Treatments: Hold HCG injections until thyroid levels stabilise. Once TSH and blood sugars normalise, your chances of successful conception will improve significantly.