Huyen experienced infertility due to a hormonal imbalance, while her husband had weak sperm. They had two unsuccessful intrauterine insemination (IUI) attempts and one ectopic pregnancy from in vitro fertilization (IVF). She required surgery to remove her right fallopian tube and tie off her left, completely losing the ability to conceive naturally.

Doctor Cao Tuan Anh, from the Center for Reproductive Assistance, Tam Anh General Hospital Hanoi (IVF Tam Anh), noted Huyen's thyroid hormone tests showed an elevated anti-TPO thyroiditis marker. A thyroid ultrasound revealed a thyroid nodule, classified as TIRADS 5 – the highest level on the thyroid nodule classification scale. A biopsy confirmed thyroid cancer.

The thyroid gland plays a crucial role in women's reproductive health, influencing hormones related to endocrine function and ovarian activity. During IVF, thyroid hormones such as TSH and FT4 directly affect oocyte development, ovulation, egg quality, and embryo implantation. Uncontrolled thyroid dysfunction can reduce the effectiveness of ovarian stimulation, increase the risk of implantation failure, and lead to pregnancy complications. Therefore, thyroid screening is an essential step before ovarian stimulation or embryo transfer.

For Huyen, Doctor Tuan Anh explained that if IVF had resulted in a successful pregnancy, additional thyroid nodules might have appeared or existing ones could have increased in size, leading to impaired thyroid function. Hypothyroidism during pregnancy increases the risk of miscarriage, fetal growth restriction, or premature birth. Furthermore, radioactive iodine treatment is contraindicated for pregnant women as it can harm the fetus, potentially causing birth defects and other complications. Delaying treatment would also complicate the mother's condition, making it difficult to manage.

Doctors advised Huyen to undergo ovarian stimulation, oocyte retrieval, and sperm collection to create embryos for cryopreservation before starting cancer treatment. This approach aimed to prevent a reduction in egg quantity and quality, which could affect embryo formation. Huyen successfully retrieved 9 oocytes. Her husband's sperm sample was lysed in an incubator at 37 degrees Celsius, then filtered and washed to select healthy sperm for fertilization with the eggs using intracytoplasmic sperm injection (ICSI). The process yielded one day 3 embryo and 4 day 5 embryos, which were cryopreserved in liquid nitrogen at -196 degrees Celsius.

Huyen underwent a near-total thyroidectomy and did not require chemotherapy or radiation therapy because the tumor had not metastasized. A multidisciplinary team of endocrinology, nutrition, and reproductive assistance specialists collaborated to examine her and develop an appropriate hormone adjustment regimen, preparing her body for IVF treatment. After three months of stable hormone medication, Huyen received medication to prepare her uterine lining, and one good day 5 embryo was transferred into her uterus. She became pregnant and gave birth to a healthy baby boy.

Huyen's son. Photo: Provided by subject.

Doctor Tuan Anh emphasized that in addition to assessing reproductive function, women preparing for IVF treatment should undergo breast cancer screening via ultrasound, X-ray, or mammogram, and a family history should be taken before ovarian stimulation. Before embryo transfer, patients also need to be checked for gynecological conditions and undergo cervical cancer screening. Cervical cancer often progresses silently with few clear symptoms, making it easily overlooked without proactive screening. If undetected, it can directly impact reproductive health and pregnancy. Early detection allows for timely treatment and helps plan a safe and appropriate pregnancy.

At IVF Tam Anh, infertile patients receive coordinated multidisciplinary treatment when other health abnormalities are discovered. Doctors develop individualized regimens that both effectively manage underlying conditions and ensure reproductive safety. Once their health stabilizes, patients continue with IVF treatment, increasing the rate of successful and healthy pregnancies.

Trinh Mai