Hormonal problems

What causes hormonal problems?

The body’s hormonal system is complex – small changes can come from anywhere and can end up disrupting the delicate balance.

However, hormonal imbalance is often triggered by a malfunction in the hormone-producing centres, including the pituitary gland or the thyroid. These can also have an indirect influence on female fertility. This could be through:

• Impaired egg maturation

• Ovulation not taking place

• Insufficient production of corpus luteum (yellow body)/progesterone

Being seriously under- or overweight as well as large changes in weight, stress, medication and – in rare cases – tumours, can also upset the hormonal balance.

PCOS: A common cause of fertility problems

Polycystic ovarian syndrome (PCOS) is a very common malfunction of the ovaries caused by hormonal abnormalities.

For instance, women with PCOS may have elevated levels of male sex hormones (androgens) in their blood. However, elevated testosterone (a kind of androgen) levels prevent follicle (egg) maturation and the follicles wither away without ovulation occurring, which means there is no egg to be fertilised. The remains of these eggs show up on an ultrasound as small black “cysts” in the ovaries, which is where the syndrome gets its name.

PCOS is usually associated with irregular menstruation or no menstruation whatsoever (amenorrhoea). Luckily, if PCOS is why you have not yet become pregnant, there are various treatment options.

Other hormonal causes for pregnancy not occurring

We'll analyse your hormones and provide comprehensive feedback about any hormonal abnormalities we find. These could be:

• Pituitary gland dysfunction/GnRH dysfunction: The pituitary gland (hypophysis) is what controls the production of the female sex hormones follicle-stimulating hormone (FSH) and luteinizing hormone (LH). If there is an impairment in the pituitary gland or the messenger GnRH in the hypothalamus is impaired, egg maturation may be affected.

• Yellow body deficiency: Yellow bodies are a result of ovulation and involved in the production of progesterone. If they are too few, implantation of an egg in the uterus more difficult and chances of miscarriage increase.

• Elevated prolactin: The hormone prolactin is secreted during lactation (breastfeeding). It stops the production of FSH and LH, so ovulation during breastfeeding is rare. A dysfunction of the pituitary gland can cause increased production of prolactin in women who are not currently breastfeeding.

• Hypothyroidism: If the thyroid produces too little iodine-containing thyroid hormone, then thyroid-stimulating hormone (TSH) is increasingly secreted. TSH also stimulates the production of prolactin, and elevated prolactin levels can lead to a lack of ovulation.

• Premature menopause (POF, premature ovarian failure): If a woman’s ovaries stop working before the age of 40, ovulation will no longer take place. This means natural pregnancy will not occur.

Specific hormonal problems can be established through blood analysis, however conception is a complicated process. Our doctors align the diagnosis and subsequent treatment methods to your individual case, giving you the best possible chances of a successful pregnancy.