Hormones / Endocrine System Research and Fertility
The endocrine system is a series of glands in your body, which produce hormones that are released into the bloodstream. These hormones act as chemical messengers to control various functions in the body. If one or more of the endocrine glands aren’t working properly, these hormone levels may not be optimal, and it may become more difficult to conceive.
Roughly the size of a pea, the pituitary gland plays an important role in fertility by releasing two hormones directly responsible for ovulation (release of a woman’s egg):
Follicle stimulating hormone (FSH): Stimulates the growth of eggs during your menstrual cycle. As a women ages and the number of eggs declines, FSH levels increase. Increased FSH levels (blood test drawn on day 3 of the menstrual cycle), can indicate that you may have diminished ovarian reserve. When a woman does not get her menses and the levels of FSH are very low, this may be due to a problem with the function of the pituitary gland.
Luteinizing hormone (LH): This hormone tells the ovaries to release a mature egg. This process is called ovulation. High levels of LH could be a sign of a pituitary disorder or polycystic ovary syndrome (PCOS) Low levels of LH may be a sign of a pituitary disorder or a hypothalamic problem and can be observed in women with an eating disorder, over-exercising, or high stress levels.
Gonadotropin releasing hormone (GnRH): Produced by the hypothalamus in the brain and signals the pituitary gland to produce FSH and LH.
Anti-Mullerian Hormone (AMH): This hormone is the most sensitive hormone marker of fertility potential. It is produced by the granulosa cells which surround and support the early developing eggs in the ovaries. Over a lifetime, as the number of eggs decreases, the granulosa cells decrease and AMH levels decrease. In combination with an antral follicle ultrasound, it provides a reasonable estimate of ovarian reserve (number of eggs). The AMH level also predicts the response of the ovaries to injectable fertility medications and will assist your physician in customizing your treatment protocol for IVF.
Hormones and Fertility Treatment
Hormones often play a crucial role in fertility treatment. Oral medication and FSH and LH hormone injections are the main treatment for women with ovulation disorders and for women with unexplained fertility. Oral fertility drugs like clomid and letrozole increase both FSH and LH and increase the number of eggs produced. FSH and LH injections are more potent than oral agents and are also used to increase the number of eggs produced.
Personalized Ovarian Stimulation Protocols
The goal of ovarian stimulation in IVF treatment is to assist your ovaries to produce multiple eggs. Ovulation is intentionally delayed so that the eggs can be retrieved and fertilized in the lab. CCRM is unique in that we develop custom ovarian stimulation protocols and an individualized fertility medication regime for each and every patient.
Important characteristics that are taken into account when developing your treatment protocol include: age, medical history, prior reproductive history, ovarian reserve testing results (FSH, estradiol, AMH levels), antral follicle count, and prior fertility treatments (if applicable)
CCRM’s research team is continuously finding new ways to improve patient success. The following CCRM clinical studies are currently underway on ovarian stimulation protocols:
- Trigger Timing Study: A randomized control trial to examine the timing of trigger in an IVF cycle and its potential to impact patient outcomes. Learn more about our Trigger Timing Study.