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In natural fertilisation or insemination, hormones help to increase the woman’s fertility at the optimal time. The hormone clomiphene, for example, helps to stimulate egg maturation in the first half of the cycle and encourages the body’s response. Ovulation can be triggered more specifically with an ovulation injection. In this way, we can determine exactly at what time sexual intercourse is best or when the insemination treatment would be best carried out.
Treatment
The treatment consists of either tablets (of clomiphene, for approximately 5 days) or daily hormone injections, which the patient can administer herself after appropriate instruction from the staff at our practice. We determine the ovaries’ hormone levels and check the maturation of the eggs with the help of blood tests, taken several times during your cycle (additional ultrasounds are also an option). The exact time for the injection that triggers ovulation is decided by your assigned doctor.
The chances of successful artificial insemination (with IVF or ICSI) increase if several mature follicles are available at the same time. With the help of the body’s own hormones, called gonadotropins, we stimulate the growth of the follicles.
With the methods mentioned above, ovulation is triggered by an (ovulation) injection at a time determined by your doctor. Just prior to ovulation, the eggs contained within the follicles will be extracted and collected through a small puncture.
Treatment
The hormones are self-administered with an injection under the skin. Our practice staff will show you how to do this. You can also choose to administer your own injection that triggers ovulation.
Clomiphene stimulates a lack of oestrogen in the body, which in turn stimulates the ovaries to produce more hormones via the body’s own control hormones (the gonadotropins LH and FSH). This leads to the follicles having improved growth. Stimulation with clomiphene takes place between the 2nd and 5th day of the cycle. The patient needs to take 1-2 tablets daily for 5 days. The individual dosage will be determined by a doctor. Before ovulation, we will use an ultrasound examination to check whether several follicles have matured. With this method, the risk of multiple pregnancy can be detected in good time. Clomiphene is used to optimise the cycle for a naturally occurring pregnancy (through sexual intercourse) or insemination. Clomiphene treatment is discontinued after a maximum of six cycles. If pregnancy hasn’t occurred during this period, the chances of getting pregnant are no longer expected to increase. You can continue with fertility treatment, however with a different treatment option.
Gonadotropins are used if, for example, the ovaries or the lining of the uterus (with clomiphene stimulation) produce insufficient reactions. Gonadotropins mainly help to mature several eggs at the same time, which is necessary for artificial insemination via IVF or ICSI. The gonadotropins used in fertility treatment match the structure and effect of the body’s own hormones LH and FSH. The dosage is determined by our practitioners for each patient on an individual basis, depending on the respective treatment goal as well as our clinical and laboratory findings.
In the first few weeks, the luteum hormone stabilises the pregnancy. This hormone is produced by the remnants of the follicle that remains in the ovary. A luteum hormone deficiency cannot 54 usually be detected in early laboratory tests. As a result, fertility treatment supports the luteal phase after ovulation as a preventative measure. Artificial luteal hormones are introduced or injected through the vagina, to mimic the body’s own natural hormones. Alternatively, the body’s own luteal hormone production can be stimulated with the hormone HCG.
In our practice, we use hormone stimulation with caution, as a result of possible side effects or risks to the patient and the child. Thanks to the latest medical technology, we now need far fewer eggs for successful treatment than we did in the past, thereby reducing the risk of multiple pregnancies. Some patients may not be able to receive additional hormone therapy due to health reasons. Therefore, hormones are only administered on an individual basis and with constant consultation with your fertility specialist. In principle, however, it is possible to carry out all therapies with little to no hormone use.
You can find out more information by visiting IVF-Naturelle, a fertility network which we are a part of.
Some hormones support your cycle, while others can disrupt it massively. This is why we examine your thyroid and hormone balance and use medication to compensate for irregular hormone production.
An excess of male hormones triggers PCO syndrome
Women with irregular menstrual cycles often have an excess of male hormones in their blood. This is most often the case in patients with PCO syndrome (polycystic ovary syndrome). An overproduction of male hormones disrupts the cycle and means that ovulation cannot occur. On an ultrasound scan, the ovaries will show many small immature follicles, hence the name “polycystic”. Between 5 and 10% of women of childbearing age suffer from PCO syndrome, which can manifest itself externally through increased hair growth or acne. In the therapy we offer, we lower the amount of male hormones and thus eliminate cycle disorders and the associated stressful side effects.
Patients with an excess of male hormones tend to be overweight, which can trigger insulin resistance. This resistance can later develop into diabetes, which means that the body needs more insulin to take sugar molecules into its cells. Since insulin indirectly influences the central control mechanisms of the ovaries, an excess of insulin can lead to cycle disorders. In some cases, weight loss is a necessary step for wanting to have children. We can support you with medication to facilitate this more easily.
Prolactin is necessary for milk production during breast feeding and is secreted by the pituitary gland. Some patients however, may have elevated prolactin levels outside of pregnancy and breastfeeding, due to stress or medication (especially psychotropic drugs). In rare cases, a benign tumour in the pituitary gland may be the cause, resulting in cycle disorders. This can however be corrected with medication.
The thyroid gland is an important control centre for the immune system and the body. However, it can also become disruptive to your cycle and your pregnancy, if it doesn’t function properly. An underactive thyroid could pose a risk to your baby’s mental development. This is why we examine and recalibrate your thyroid’s function before we begin fertility treatment. A thyroid examination can also detect a common autoimmune disease known as “Hashimoto” disease, which can lead to miscarriage during pregnancy.
In order to be successful, hormone therapy begins with a detailed diagnosis and consultation. You can make your appointment right now with just a few clicks.
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