On the difficult path to parenthood, finally comes the moment when the infertile couple goes to the office of an endocrinologist – a doctor specializing in hormonal disorders. How can an endocrinologist help an infertile couple in their efforts to get pregnant? You can find out by reading our article!
On the difficult path to parenthood, finally comes the moment when the infertile couple goes to the office of an endocrinologist – a doctor specializing in hormonal disorders. How can an endocrinologist help an infertile couple in their efforts to get pregnant? You can find out by reading our article!
Endocrinologist – hormone specialist
The endocrinologist is a doctor involved in the diagnosis and treatment of any irregularities within the endocrine system. In his work, he focuses primarily on hormonal disorders. The production of hormones occurs in endocrine glands, which include the pituitary gland, thyroid gland, adrenal glands, testicles and ovaries. Unfortunately, sometimes, due to illness, these glands do not function properly. The task of the endocrinologist is to determine why this is happening and to propose appropriate therapy. In the treatment of infertility, endocrinologists usually work closely with gynecologists. Often, they also decide on a double specialization, becoming gynecologists-endocrinologists.
Hormone economy and its influence on human health
Each of the endocrine glands secrete a hormone responsible for some important body function, e.g. body growth and development, metabolic changes or fertility. Statistics show that 30-40% of women who have difficulty getting pregnant are caused by a malfunctioning endocrine system.
How do hormonal disorders affect woman’s fertility?
Hormonal disorders can completely upregulate the menstrual cycle, even causing complete suppression of ovulation. Meanwhile, ovulation is a prerequisite for a couple to conceive. It is worth recalling that normal menstrual cycles should last from 21 to 35 days. And if they actually last that long, then you can probably suppose that ovulation occurs. Any abnormalities of the menstrual cycle – its lengthening, shortening, very scanty or very heavy menstrual periods, may suggest ovulation disorders, and thus fertility disorders.
One of the most common causes of menstrual disorders among women is polycystic ovary syndrome (PCOS). It also happens that menstruation is degraded due to a malfunctioning thyroid gland (e.g. due to Hashitmoto’s disease) or hyperprolactinemia, i.e. high levels of prolactin in the woman’s body.
Endokrynologist may also help in case of male fertility
Hormones have a huge impact on the ability to fertilize, not only in women, but also in men. Hormonal fluctuations and abnormal levels may affect the quality of male sperm, lower libido or cause erectile dysfunction.
A man, just like a woman, may suffer from the aforementioned hyperprolactinemia, i.e. a state of elevated levels of prolactin in the body. Too high a concentration of this hormone produced by the pituitary gland may cause secondary testicular failure. Deficiency of thyroid hormones will also lower sperm parameters, also causing other troublesome ailments, such as drowsiness and fatigue or uncontrolled weight increase.
Male sperm may also be of inferior quality due to congenital adrenal hyperplasia, i.e. small glands located directly above the kidneys that produce androgens, cortisol and aldosterone. In men with congenital adrenal hyperplasia, the level of adrenal androgens increases, which unfortunately is reflected in the condition of the spermatozoa – there are fewer and slower they move. In the ejaculate of a man with congenital adrenal hyperplasia, a higher percentage of immature sperm is also observed.
With which symptoms a couple have to go to the endocrinologist?
Irregular menstruation is not the only symptom that may suggest hormonal disorders. People with very different ailments and health problems: unexplained weight gains or decreases, excessive hair growth of various body parts, acne, oily hair, excessive sweating, palpitations or difficulties with conceiving a child are consulting with an endocrynologist.
Endocrinological fertility – which hormonal tests can the endocrinologist recommend?
Before the endocrinologist provides the patient with any treatment plan, the doctor must ensure that the woman’s cycles are ovulatory. To determine it, a blood progesterone test needs to be done. The doctor will probably want to assess the woman’s ovary reserve as well. It is determined by examining serum AMH, FSH and estradiol levels. It is worth remembering that the low ovarian reserve does not yet eliminate the chance of parenting. Nevertheless, the results of the tests carried out allow this opportunity to be determined.
When there is a suspicion that infertility may be due to an endocrine factor, the doctor recommends examining the thyroid gland. Abnormalities within this gland are in fact the most common endocrine cause of problems with conceiving a child. They can be caused by hypothyroidism, including Hashimoto’s disease, and hyperthyroidism. To assess its condition, the endocrinologist directs the patient to examine thyroid hormones: triiodothyronine (fT3) and thyroxine (fT4) and pituitary thyroid stimulating hormone (TSH).
A very similar hormonal panel is provided for an infertile man. In addition to thyroid hormones, prolactin, FSH, LH and estradiol, it also includes testing for total and free testosterone.
Endocrinologist will propose effective treatment
Hormonal infertility usually requires treatment, which includes medication. The therapy is selected individually. Most often it involves taking tablets or taking injections containing the appropriate doses of specific hormones. In this way, we can improve the function of the thyroid gland, ovaries or pituitary gland. Because the level of hormones in the body is also affected by external factors, such as the amount of sleep, stress level or body weight, infertile couple is often forced to change their current, not always hygienic lifestyle.
