Hormonal problems

Hormonal balance as a factor of fertility

Hormones play a key role in your body. As the body’s messengers, they control a wealth of biological processes – including vast areas of female and male reproductive physiology. A hormonal problem can therefore be the reason why you have not been able to become pregnant yet. To determine this, we conduct targeted hormone analyses in our laboratories. These provide information about your hormonal situation and the treatment options we can offer you in our clinic. 

What causes hormonal problems and what are the consequences?

The body’s hormonal system is complex – even small changes can upset the delicate balance. Hormonal imbalance is often triggered by a malfunction in the hormone-producing centres, such as the pituitary gland or the thyroid. But problems involving the hormonal messengers – such as GnRH, which controls the production of sex hormones in the pituitary gland – can also have an indirect influence on a woman’s fertility, through:

• impaired egg maturation
• ovulation not taking place
• insufficient production of corpus luteum (yellow body)/progesterone

Being seriously under- or overweight, major 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 malfunction of the ovaries as a result of several hormonal problems that mutually influence and reinforce each other. Elevated levels of male sex hormones (androgens) in a woman’s blood is characteristic of PCOS. Due to increased production of FSH and LH, many ovarian follicles in the ovaries start maturing. However, elevated testosterone levels prevent follicle maturation – the follicles wither away without ovulation taking place. The remains of the ovarian follicles show up on an ultrasound as small black “cysts” in the ovaries. PCOS is almost always associated with irregular menstruation or no menstruation at all (amenorrhoea). Should PCOS be the reason why you have not yet become pregnant, you have various treatment options available in terms of medication or, alternatively, artificial insemination.  

Other hormonal causes for pregnancy not occurring

Many hormonal problems have an interactive effect. For instance, hypothyroidism (underactive thyroid) is usually associated with elevated prolactin levels, and PCOS with elevated androgen levels. Our specialists will analyse your hormones and provide you with comprehensive feedback about the causes and symptoms.  

• Pituitary gland dysfunction/GnRH dysfunction: The pituitary gland (hypophysis) controls the production of the female sex hormones FSH and LH. If the pituitary gland or production of the messenger GnRH in the hypothalamus is impaired, this can affect egg maturation.
• Yellow body deficiency: If the yellow bodies resulting from ovulation produce too little yellow body hormone (progesterone), this makes implantation of an egg in the uterus more difficult and increases the risk of premature miscarriage.
• Elevated prolactin: The hormone prolactin is actually secreted during the lactation period and inhibits the production of FSH and LH so that ovulation will only rarely take place. If there is increased production of prolactin in women who are not currently breastfeeding, this is triggered by dysfunction of the pituitary gland.
• Hypothyroidism: If the thyroid produces too little iodine-containing thyroid hormone, this causes the hypothalamus to increase secretion of the thyroid-stimulating hormone TSH. TSH also stimulates the production of prolactin, and the elevated prolactin levels can lead to a failure to ovulate.
• Premature menopause (POF, premature ovarian failure): If a woman’s ovaries stop working before the age of 40, ovulation will no longer take place.

As a rule, specific hormonal problems can be established through blood analysis. However, please bear in mind that the causes for a failure to become pregnant are very complex – quite often, there are several different reasons. Our doctors align the diagnosis and subsequent treatment methods to your individual case, thereby giving you the best possible chances of a successful pregnancy.