Hormone treatment for infertility

Both men and women are affected by hormonal imbalances, and treating these imbalances correctly are crucial for couples who are trying to fall pregnant.

This is because hormones play a crucial role in fertility of both the male and female partner.

Fortunately, hormone treatment can be used successfully to treat infertility for both men and women and to increase the chances of conceiving.

Hormonal imbalances that impact women’s fertility

Confused hormonal signals are the cause in most women who are not ovulating regularly or at all. In fact, irregular periods or not ovulating is the cause of infertility in almost a third of female fertility patients!

Regular or even absent ovulation is one of the main causes of infertility in women because without ovulation, there is no egg to fertilise, and falling pregnant naturally is impossible. Similarly, if a woman has irregular ovulation, she has fewer chances to conceive, since she ovulates less frequently. In addition, it seems that late ovulation doesn’t produce the best quality eggs, which may also make fertilisation less likely.

What regulates ovulation is a small gland in the base of the brain called the pituitary gland, which secretes the two hormones – follicle stimulating hormone (FSH) and luteinizing hormone (LH) – that are essential to normal ovulation. An abnormality with the secretion of FSH and LH will result in irregular ovulation, or even the absence of ovulation.

During a natural menstrual cycle, LH and FSH released from the pituitary gland stimulate the growth of a follicle – a fluid space in the ovary where the egg grows. Although several follicles grow each month, in a natural cycle, only one becomes mature enough to ovulate its egg.

“Pituitary dysfunction” refers to a group of disorders in which ovulation occurs on an infrequent basis.

“Pituitary failure” refers to anovulation – when ovulation fails to occur at all – and there are no periods (also called amenorrhoea). Anovulation is the failure of the ovary to release an egg (oocyte) for more than three months. Amenorrohoea – or the absence of periods – is experienced by many women with ovulation issues.

The term “ovulatory dysfunction” refers to menstrual cycles that are shorter than 21 days, or longer than 36 days; or cycles that fall within the normal range of 21 to 36 days, but varies widely in length from month to month – for example, one month it is 22 days long, and the next it’s 35 days long. It is possible to have cycles on an almost normal schedule and not ovulate, though this isn’t common.

Another hormone that can cause infertility when unbalanced is prolactin. This hormone naturally produced by a woman’s body when she is pregnant and breastfeeding. Raised prolactin levels reduce the production of the hormones FSH and LH, both critical for a pregnancy, and can also cause problems with regard to the thinning in the lining of the uterus.

Hormonal irregularities can also lead to other issues, like lack of fertile cervical mucus, thinner or over thickening of the endometrium (where the fertilised egg needs to implant), abnormally low levels of progesterone, and a shorter luteal phase – all of which will also impact fertility and the chances of conception.

Other hormonal conditions that interfere with ovulation or affect fertility are polycystic ovary syndrome (PCOS); an overactive or underactive thyroid; early menopause; and Cushing’s syndrome causing very high levels of cortisol – the “stress” hormone.

Hormone treatments for women

There is no one-size-fits-all hormone medication that will assist every woman, as there are many different reasons why a woman may not be ovulating regularly or not ovulating at all – ranging from hormone imbalances and stress to being over- or underweight, and from serious conditions such as PCOS or endometriosis to ovarian failure.

Given all the possible causes for ovulation dysfunction, the medication or treatment required will differ from one woman to another, depending on the cause or causes.

The most common treatment for anovulation is fertility medication. Below are some of the medications and treatments recommended by the fertility specialists at Medfem Fertility Clinic and provided at our world-class fertility clinic.

Usually, Clomid (clomiphene citrate) is the first fertility medication tried. Clomiphene is a weak, estrogen-like hormone that works to increase the levels of FSH and LH. Clomid can trigger ovulation in 80% of anovulatory women, and help about 45% get pregnant within six months of treatment.

If Clomid doesn’t work, there are other medications that may be used such as Femora (Letrazole).

For women with PCOS, insulin sensitising medication such as Glucophage (metformin) that may help a woman start ovulating again.

Usually, six months of treatment is required before you’ll know if the particular medication you have been prescribed will work.

Women who do not ovulate at all may be prescribed gonadotropins (forms of FSH and/or LH) by injection to stimulate the growth of one or more eggs during ovulation induction treatment for patients with ovarian dysfunction and endometriosis, or those who have not responded to simpler medications, such as clomiphene tablets. It is also used for women who have unexplained infertility. Most often, ovulation induction is used in women with polycystic ovarian syndrome (PCOS).

Hormonal imbalances that impact men’s fertility

A male hormonal disorder occurs when there is a deficiency in the luteinizing hormone (LH) and the follicle stimulating hormone (FSH) that control testicular function.

In men, the LH and FSH cause the testes to produce testosterone and sperm.

Any condition that affects the pituitary gland which makes these hormones, or that lowers LH and FSH levels, can result in low or no sperm production and low blood testosterone levels, which will negatively impact fertility. For example, non-obstructive or pre-testicular azoospermia is caused by impaired production of the hormones responsible for creating sperm.

Levels of the hormone prolactin can also be raised in men, and this causes abnormalities in the semen.

If the underlying cause of infertility in a man is low hormone production, hormone treatments and medications may help.

A hormone imbalance may be successfully treated with injections of hormone preparations called gonadotrophins. Hormone treatments will cause the testes to increase in size and produce testosterone in normal amounts. Sperm should appear in the semen after several months of treatment.

If the cause of infertility is low testosterone, treatment with hormone injections (LH and FSH) is usually successful. However, it may take a year or longer of hormone therapy to get enough sperm production and bring back fertility.

Where to get hormone treatment

If you want to know more about whether hormone imbalances are affecting your fertility, we would like to invite you to contact us at Medfem Fertility Clinic.

We are a committed and understanding team of medical professionals, who have the experience, knowledge and desire to provide you with the best chance of a successful outcome at the end of your treatment.

Since the 1980’s, Medfem Fertility Clinic’s team has assisted couples struggling with infertility to experience the joy of parenthood, helping to bring more than 18,000 babies into the world.
Simply click here to book an initial consultation or contact us telephonically on +27 (11) 463 2244.

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We look forward to meeting you!