Introduction

All endocrine problems can affect the couple’s gonadal function either directly or indirectly by having an effect on the hypothalamus – pituitary axis. Among the endocrine problems that are directly related to fertility are high prolactin levels, abnormal thyroid function (either high or low), polycystic ovarian syndrome (mentioned on that section), poorly controlled diabetes, as well as endocrinopathies such as congenital adrenal hyperplasia and acromegaly.

High prolactin levels are associated with growth at the prolactin gland. In most circumstances it is identified during blood investigations for infertility. Occasionally symptoms such as breast milk production or visual field involvement may occur.

Thyroid disease is common in young women. Both high and low levels cause anovulation in women. Those with high levels not only experience absence of menses but also weight loss. Fertility returns to normal with regular cycles once thyroid levels are normalized with medical treatment. Low levels of thyroid hormones not only cause infertility but can have a profound effect on fetal neurological development.

Poorly controlled diabetes can cause disturbed ovarian function in women and increases the risk of congenital anomalies and pregnancy complications. In men it can cause problems with erection, ejaculation and sperm production. Therefore it is important that couples ensure good compliance with medical treatment to optimize their chances of pregnancy.

Endocrine Glands

Endocrine Glands And Associated Medical Disorders

1. Pituitary – Hyperprolactinemia & Acromegaly
2. Thyroid – Hyper or Hypothyroidism
3. Adrenal gland – Congenital adrenal hyperplasia
4. Pancreas – Diabetes
5. Ovary – Polycystic Ovarian Syndrome

Normal Ovulatory Cycle

References

• Endocrine disorders & female infertility. Best Pract Res Clin Endocrinol Metab.2011 Dec
• Infertility in Practice. 2^nd Churchill Livingstone