Endocrinology is the study of hormones- the unique chemical substances that encode signals found circulating in everyone’s bloodstream. Their role is critical to the process of reproduction as well as functional activity of bodily organs. It is through these hormones that the brain orchestrates and coordinates egg and sperm production from afar.
Reproductive endocrinology is the study of hormones that affect the reproductive system. Because many infertility problems are caused by hormone-related disorders, your fertility doctor, a reproductive endocrinologist, can help to resolve a wide variety of hormone dysfunctions. The reproductive endocrinologist is required to complete two years of sub-specialty training in reproductive endocrinology and infertility.
For an infertility couple, the best fertility evaluation and treatment is from a physician with a special interest and expertise in the area of infertility.
Major hormone-related Fertility Problems
- Anovulation(no ovulation)
- Oligoovulation(infrequent ovulation)
- Luteal phase defects(poor ovulation)
- Recurrent pregnancy loss
- Tumor associated with elevation of hormone
- Early or late onset of menstruation
When Is Fertility a Concern?
A condition of infertility exists when a couple is unable to achieve a pregnancy after a minimum of 12 consecutive months of unprotected relationship. Contrary to common belief, infertility is not rare. Approximately about one out of every six to ten couples are having fertility problems.
Finding the cause of infertility and treating it is a complex process. Problems with women reproductive health account for about 60 percent of fertility problem diagnosis. About 30 percent of the problems are associated with sperm production in men. In spite of all available medical work-up there remains about 10 percent of infertile couples with unknown causes. Timing, the health of both male and female reproductive system, and their physiological compatibility are all important variables in conception.
An important part of a fertility work-up involves a series of blood tests on the couple. The semen analysis is the corner stone of the evaluation of possible male factor infertility. Other lab tests and a careful history and physical help to diagnosis the cause of male infertility:
- Sperm production
- Anti-sperm antibodies (SpAb)
- Sperm Penetration Assay (SPA)
- Hormonal disorders
- Anatomical problems
- Sexual dysfunction
To evaluate infertility in a female, a general physical is done to determine the size, shape, position and condition of pelvic organs. Blood is drawn and analyzed to assess the levels of hormone activity in the body as well as the ovaries. A Hysterosalpingogram (HSG) and a Hysteroscopy is also indicated to evaluate the fallopian tubes and the uterus respectively.
Further procedures such as diagnostic laparoscopy which allow the physician to directly view the fallopian tubes, the uterus, and the pelvic cavity might also be necessary.
In their attempt to overcome infertility, many patients will seek treatments such as surgery of pelvic organs to correct any anatomical conditions or ovulation induction to improve the number of eggs and to correct ovulation problems. For other patients, the solution may require more involved procedures. Such revolutionized procedures are designed to increase the amount of sperm and/or eggs or bring them closer together, thus improving chances of conception for an infertility patient. These medical approaches have expanded into a whole family of treatments, known by the term Assisted Reproductive Technology (ART). The most commonly known ART procedure is in vitro fertilization (IVF). Since the first IVF baby was born on Dec. 28, 1981 in Norfolk Virginia, with the assistance of pioneer physicians, Howard and Georgeanna Jones, the growing popularity of the technique has been phenomenal.