In a patient with a history of two consecutive miscarriages, subclinical hypothyroidism currently managed with levothyroxine (Thyronorm) 50 mcg for 20 days (initial TSH 6.27 mIU/L), and positive IgG titers for Rubella and CMV currently being treated with spiramycin (Rovamycin Forte), is it safe to begin attempting pregnancy immediately, or is it advisable to wait for thyroid levels to stabilize and further evaluation to be completed?
I understand how deeply you want to welcome a healthy baby, especially after your difficult losses. It is highly advisable to wait before attempting pregnancy. First, your thyroid needs time to stabilize on levothyroxine (Thyronorm); we want your TSH levels to be ideally under 2.5 mIU/L, which usually requires rechecking after 6 to 8 weeks of treatment. Second, it is crucial to complete your spiramycin (Rovamycin Forte) course and ensure your infections are fully resolved. Finally, further evaluation for your recurrent miscarriages will help us create the safest plan for you. Please discuss these steps with your obstetrician first. You are doing great taking these proactive steps.