The Truth About Hormones by Vivienne Parry

Author:Vivienne Parry
Language: eng
Format: epub
Publisher: Atlantic Books

Infertilty

We have talked of fertility and the pill and covered one of the common, hormonally induced causes of infertility, PCOS. Another hormonal cause of infertility is a luteal phase defect (LPD). Basically the womb lining isn’t in the right place at the right time. To get that wonderful shag-pile effect, progesterone is required. In LPD, either because the follicle isn’t good, or because the corpus luteum packs up before it should, the womb lining hasn’t had the progesterone needed to do its thing, so no implantation will take place. Extra progesterone or other hormones are used as treatment.

Infertility and its treatment is a complex and growing field, which is too large to cover here, but I did want to draw your attention to one fact. Whatever the cause of infertility – and there are many, including straight plumbing problems like blocked tubes – hormones are almost certain to be used in treatment. In fact, without the manufacture of hormone-based drugs, IVF would not be possible, nor would many of the very successful treatments now available.

Let me briefly introduce some of the main hormone treatments used in infertility treatment. Clomiphene (Clomid) is a first-line treatment for ovulation induction – in other words, something that your GP might prescribe. It’s an anti-oestrogen which fools the pituitary into thinking that more FSH is needed, which may be enough to kick-start ovulation. You should not take it for more than six months – for no other reason than if you aren’t pregnant by this time, you and your partner need a more thorough assessment of your needs and there is no point in delaying it.

Human menopausal gonadotrophin (Pergonal, Humegon) is used in a clinic setting, after more detailed investigations, and is a mixture of two hormones, FSH and LH. Injections are given daily, so that the ovaries begin developing follicles. These are followed 7–12 days later by an injection of human chorionic gonadotrophin (the hormone of pregnancy), which tells the ovaries to release the eggs that have been developed. More than 75 per cent of women will ovulate with this regime of drugs.

Initially, these drugs were produced using millions of gallons of human urine. Yet, no matter how refined the processing, the drugs still contained impurities. But in the mid-1980s, bioengineering became possible, and in 1997, the two principal companies in this market, Serono and Organon, announced recombinant DNA versions in which bioengineered cells produce the hormone, rather than nuns. Hormones produced in this way combine very high purity and very specific biological activity. They have fewer side effects and are more effective. Recombinant technology is now the main method of manufacturing hormones.

This chapter has been about the ‘juicy’ hormonal years, those from roughly from thirteen to fifty. What happens when this regular cycle disappears and hormones crash is the subject of our next chapter.

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