The body is a complex machine, and so is the hormonal system. Even small changes in the body are enough to affect the hormone balance. An imbalance could arise or be triggered by a pituitary or thyroid gland disorder. It could also be triggered by a disturbance of hormonal neurotransmitters such as GnRH. GnRH is a neurotransmitter that controls the production of sex hormones in the pituitary gland.
There are three reasons why neurotransmitters can indirectly affect a woman’s fertility:
1. Egg maturation can be disturbed
2. You might not ovulate
3. Development of the corpus luteum/production of progesterone might not occur.
Your BMI can also trigger a hormonal imbalance: This could occur if you are very under- or overweight, if there are big major fluctuations in your weight, or if you are stressed or on medication. In rare cases, it could be triggered by fibroids.
PCOS – a known cause of hormonal imbalance
PCOS—polycystic ovary syndrome—is a malfunction of the ovaries. The reason is that there are several hormonal disorders that have a mutual effect on one another and also reinforce one another. A typical feature of PCOS is that women have increased levels of the male sex hormones (androgens) in their blood.
The increased production of FSH and LH means that a larger number of follicles than normal ripen in the ovaries. However, the raised level of testosterone prevents the follicles from ripening. Instead they degenerate and the woman does not ovulate. The remainders of the follicles can be seen on ultrasound as small black “cysts” in the ovaries.
Women who suffer from PCOS will often have irregular or absent menstruation. If you want to become pregnant, you have several options including medicinal therapy or artificial fertilisation.
Other reasons why you have not become pregnant
Other reasons why you have not become pregnant could include multiple hormonal disorders that occur simultaneously. A metabolic disorder often coincides with raised prolactin levels. In addition, increased androgen levels in connection with polycystic ovary syndrome are often seen. At StorkKlinik, we can give you more advice about causes and symptoms, when you get the result of your hormone test.
Pituitary disorder/GnRH: The pituitary gland is a gland in the brain. The pituitary gland controls the production of the female sex hormones, FSH and LH. Therefore, a disturbance of the pituitary gland or in the production of the neurotransmitter GnRH in the hypothalamus can have a negative effect on the ripening of the egg.
Disorder of the corpus luteum: The corpus luteum develops after ovulation. If the corpus luteum produces an insufficient amount of the hormone progesterone, this makes egg implantation in the womb difficult. There is also an increased risk of a miscarriage.
Metabolism: If the thyroid gland does not produce adequate amounts of iodine-containing hormones, there is a danger that the midbrain (the hypothalamus) will trigger increased secretion of the thyrotropin-releasing hormone TRH. TRH stimulates the production of prolactin, so there is a danger you will not ovulate because the level of prolactin is too high.
Increased level of prolactin: Prolactin is excreted during breastfeeding. This inhibits the production of FSH and LH, and means that you rarely ovulate. In women who are not breastfeeding, the pituitary gland can trigger production of prolactin, and this means that you do not ovulate.
Early menopause (POF, Premature ovarian failure): Some women go through menopause before the age of 40 and cease to ovulate.
We can normally detect hormonal disorders with a number of blood tests. We always compare your blood tests with any other possible reasons why you are not becoming pregnant. The doctors at StorkKlinik will adapt treatment methods according to your situation and hopefully increase your chances of becoming pregnant.