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Conditions
Reproductive endocrinology: hormonal infertility and pregnancy planning
Short answer
Hormonal imbalance can cause infertility. In the doctor's words, diagnosing it is very easy: the endocrinologist orders the necessary tests based on signs and complaints, and the underlying cause comes to light (video). Infertility is the term used when a couple that is planning a pregnancy does not conceive despite at least one year of married life without contraception.
The reference range varies by laboratory and age.
General information
- Endocrine causes:
- PCOS (PMOS) — one of the main causes of infertility in women;
- high prolactin;
- thyroid disorders;
- insulin resistance and overweight — can cause infertility in both women and men;
- excess cortisol;
- excess androgens.
- TSH and infertility. The doctor notes that one of the treatable forms of infertility in adults is due to underlying conditions that prevent TSH from normalizing. In patients with complaints, it is important to keep TSH within the range the endocrinologist recommends.
- AMH (anti-Müllerian hormone).
- In the womb, AMH plays a role in the correct formation of the fetus's sex: in a male fetus, it inhibits the development of the female internal reproductive organs.
- After birth, it shows testicular reserve in men and ovarian reserve in women.
- Normal values are often in the range of 2–5 ng/mL (the reference range varies by laboratory and age).
- In PCOS it can rise many times over, while it declines near menopause. In an adult woman, a level below normal shows that the ovarian reserve has decreased.
- The doctor usually orders this test when pregnancy has not occurred despite planning for more than a year, or when PCOS is suspected.
- Checks before pregnancy:
- thyroid function (TSH, FT4) and autoimmune antibodies;
- prolactin;
- AMH and PCOS assessment if needed.
Target thyroid values are different in pregnancy, so planning should be done in advance → Thyroid in pregnancy.
In the doctor's practice
- The doctor lists “infertility of hormonal origin” and “delayed periods of hormonal origin in women” among the conditions seen at appointments in Baku and Gabala (video).
- The doctor gave a talk on “Endocrine infertility” at Labstyle Hospital.
- According to the OTX interview, the problem the doctor encounters most often in the Ganjabasar region is infertility.
Q&A
Can a hormonal imbalance cause infertility? How is it determined?
Yes, it can. Diagnosis is easy: the endocrinologist orders the tests considered important based on signs and complaints, and the underlying cause comes to light (video).
What is the AMH test done for?
AMH shows ovarian reserve in women and testicular reserve in men. It is ordered when pregnancy has not occurred for more than a year and when PCOS is suspected.
The doctor’s videos
The videos are in Azerbaijani.