Hormone imbalances account for around 10% of all male factor infertility cases, and can manifest themselves in myriad ways, ranging from sexual dysfunction to low sperm concentration. Generally speaking, hormone imbalances are both detectable and correctable.
As we alluded to in the last lesson’s discussion of azoospermia, hormones are regulated in the brain. The hypothalamus detects hormone levels in the body, and messages to the pituitary gland (also in the brain), to begin producing hormones at the necessary levels. The pituitary produces Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH), amongst others.
LH impacts the testes' ability to produce testosterone, which dictates libido and erectile function, while FSH (along with testosterone) regulates sperm production. To complete the loop, the hypothalamus measures the body’s level of these hormones, and determines which signals to send to the pituitary to produce more, or less, of each.
Typically, a blood draw (done in the morning as levels change during the day) accurately detects hormone levels and this is where the ranges typically fall:
If a hormone imbalance is detected, your urologist should be focused in determining the root cause. For instance, an elevated prolactin level can indicate risk of a pituitary tumor. When there is an FSH or LH deficit, it’s customary to prescribe hormones that mimic the function of naturally-made FSH and LH.
Few male factor patients are seen by a reproductive urologist, who will focus on treating the man’s underlying issues. Instead, male infertility is often ignored as the couple is ushered directly to IVF with ICSI. In this course we train patients to ascertain if they’re being treated by the proper clinician and whether IVF or ICSI are appropriate measures. We’ll cover the data on where the semen analysis is helpful and unhelpful, and the non-surgical ways fertility can be improved by correcting lifestyle habits and hormone imbalances. Patients will also understand when and how intervention is appropriate to remove varicocele and work around azoospermia.