How do hormones affect fertility?

Hormones have a big impact on female reproduction, especially those controlling the menstrual cycle.

Getting pregnant relies on these hormones, guiding the growth and release of an egg from the ovary and preparing the uterus for possible implantation.

Similarly, in men, hormones help in sperm development, which is crucial for making a baby. Issues like missing or irregular hormone levels can make it tough to conceive.

So how exactly do hormones affect your fertility, and how can you check for them when you’re trying to conceive?

Read on to know!

Understanding Hormonal Issues and Fertility

Different hormonal problems can disrupt ovulation, making it harder to get pregnant. Conditions like anovulation, polycystic ovary syndrome (PCOS), and hyperprolactinemia often mean irregular or infrequent ovulation, affecting the chances of having a baby. To know your hormonal levels, here are some basic tests that can provide an insight:

Basic Blood Tests

These tests are advised for an overall health check up prior to evaluating any specific hormones.

Anti-Mullerian Hormone (AMH)

AMH is also termed the ‘gold standard’ among fertility tests. This hormone is secreted by the small antral follicles in the ovary and serve as a predictor of egg reserve. It can also be checked for, at any point of your menstrual cycle.

AMH levels also serve as a good predictor of response to fertility treatments like intrauterine insemination (IUI) or IVF. This figure may help your gynaecologist recommend a personalised treatment and medication dosage.

Follicular Stimulating Hormone (FSH) and Estradiol (E2)

FSH and E2 levels indicate the hormones that the pituitary gland in your brain produces to stimulate egg growth in your ovaries. Higher FSH levels suggest increased effort by your ovaries to ovulate each month. An E2 test also helps measure your ovarian function and the quality of your eggs.

Both FSH and E2 test is often done on the second or third day of your menstrual cycle.

Thyroid Stimulating Hormone (TSH)

TSH is an important predictor of your fertility levels as increased TSH (Hypothyroidism) and decreased TSH (Hyperthyroidism) can both affect your ovulation, menstrual cycles and in some cases, the quality of your egg as well. Hence, a thyroid test is often recommended to check and ensure that the levels are more optimal before starting IVF or any other fertility treatment.

Vitamin D

Some studies suggest a link between [low vitamin D levels and fertility in IVF cycles]. Consequently, you may be recommended a vitamin D test separately or it may be a part of your total blood tests.

Advanced Blood Tests

While not everyone may need these tests, discussing them with your healthcare provider could be beneficial if you have specific concerns.

Prolactin

Elevated levels might indicate an issue affecting fertility. An overproduction of the hormone can affect estrogen production, interfering with ovulation by slowing it down. This can lead to absent or irregular periods. ASRM doesn't immediately recommend this test for those with regular cycles, thus categorising it as advanced.

Full Thyroid Panel

Initially, only TSH is tested, but a comprehensive assessment of thyroid function involves additional tests for Free T4 (thyroxine) and Free T3. This can diagnose conditions like hypothyroidism or hyperthyroidism, impacting fertility by affecting ovulation or the luteal phase.

Testosterone

While testosterone is often related to men, women require optimal levels of testosterone for regular menstrual cycles. High levels may relate to PCOS, requiring other tests for a complete diagnosis.

Progesterone

Measuring progesterone levels at specific times in the luteal phase can indicate ovulation. [Low levels] might necessitate additional progesterone during pregnancy.

Immune Testing and Thrombophilias

There are various immune tests with differing opinions on their relevance to most patients. Here are some examples:

Thrombophilias

Genetic issues that increase blood clotting risk, such as Factor V Leiden and prothrombin thrombophilia.

Antinuclear Antibodies (ANA)

[Higher levels] could indicate an autoimmune condition, potentially affecting pregnancy rates and miscarriage rates in IVF/ICSI.

Antiphospholipid Antibody (APA)

These may trigger increased blood clotting, more prevalent in women and individuals with lupus. Antiphospholipid antibody syndrome may lead to recurring abortions, complications during pregnancy, and restricted intrauterine growth.

Antithyroid Antibodies (ATA)

Antibodies targeting the thyroid gland that impact thyroid function, associated with poorer IVF outcomes.

Natural Killer (NK) Cell Assay

This cell assay isnt conducted on a routine basis, but rather is recommended in cases of recurrent implantation failure and miscarriages in IVF. It is speculated that in such situations, there are abnormalities in the uterine natural killer cells. Women with infertility having more than 12% natural killer cells is used as an indication for treatment. Testing these cells in blood doesn’t always indicate uterine natural killer cells, requiring an endometrial biopsy for confirmation.

Reproductive Immunophenotype

A less common test measuring lymphocyte percentages in the blood.

How do I Recognise Signs of Hormonal Imbalance?

Usually, hormonal issues become noticeable when there are issues when you’re trying to conceive.

Women might notice changes like irregular or missing periods, spotting between cycles, or heavy and painful periods. They might also see more hair on their face, neck, chest, or back, gain weight without a clear reason, or have stomach problems like constipation or diarrhea.

While men are less likely to have hormone problems that affect fertility, they might have trouble getting erections, have fewer sperm, less body hair, or notice thinning hair.

Getting Professional Help

If there are worries about not being able to conceive, it's important to talk to a doctor who specializes in reproduction when experiencing these symptoms. These experts can offer advice and run tests to understand what might be causing the problem, along with provide personalized solutions.

How Arva can play a role in simplifying your hormonal tests

Finding out about hormone problems often involves simple blood or urine tests for both men and women. Fertility hormone tests check different hormones related to your fertility, and to assess whether the levels are at an optimal level, when you’re trying to conceive.

Hormone tests dont have to be daunting. They can be as easy as a simple at home blood test, such as Arva’s AMH test. We’re a simple call away for questions, and your test results can equip you with the right information to make decisions that benefit your fertility journey!