Key hormones in a woman's life. What to prescribe and when?

Today, it is difficult to imagine fertility management without hormonal testing. A good diagnosis of the hormonal context allows for the identification of any anomalies and timely correction, which is particularly important for women considering pregnancy, as well as for those undergoing artificial insemination procedures such as in vitro fertilization (IVF). In this article, we will examine in detail which hormones should be measured and when, as well as the specifics of their values in different clinical situations.

Follicle-Stimulating Hormone (FSH)

FSH is a protein-structured hormone produced by the anterior lobe of the pituitary gland. In women, this hormone stimulates the growth and maturation of follicles, preparing them for ovulation. An increase in FSH levels from Day 2 to Day 4 of the menstrual cycle beyond 8 to 11 mUI/ml may indicate a decrease in the ovarian reserve. This indicator is an important marker for assessing ovarian reserve in preparation for IVF and can influence the choice of treatment protocol.

Luteinizing Hormone (LH)

LH is a hormone produced by the anterior lobe of the pituitary gland whose main function is to stimulate ovulation. Excessive production of LH can lead to increased production of androgens (male sex hormones) in the female body, which is often the cause of polycystic ovaries and hormonal imbalance.

FSH and LH are typically measured between Days 2 to 4 of the menstrual cycle in the case of regular cycles and on any day in the case of amenorrhea. The study of these hormones is important not only in the diagnosis of infertility but also in the preparation process for IVF, as they help the physician determine the maturity level of the follicles and assess the body's readiness for the protocol.

Thyroid-Stimulating Hormone (TSH)

TSH is a glycoprotein synthesized in the anterior lobe of the pituitary gland. It regulates thyroid function and the formation of triiodothyronine (T3) and thyroxine (T4). It is important to evaluate TSH levels as part of preparation for pregnancy, especially before IVF, as thyroid abnormalities can negatively impact the success of embryo implantation and the development of pregnancy.

Prolactin (PRL)

Prolactin is a hormone responsible for breast development and lactation. In non-pregnant women, it contributes to the production of progesterone, promoting the normal course of ovulation. Excessive levels of prolactin can result in an absence of ovulation and a reduction in fertility, which is particularly important to consider when planning for pregnancy and IVF.

Free Testosterone Index and its Derivatives

Testosterone, dihydrotestosterone, and dehydroepiandrosterone sulfate (DHEA sulfate) are male sex hormones, but in the female body, they play an important role in regulating puberty, follicle formation, and maintaining overall hormonal balance. An excess of androgens can lead to polycystic ovary syndrome (PCOS) and hinder normal ovulation.

Estradiol and Progesterone

Estradiol is the main hormone responsible for the formation of the reproductive system and the preparation of the endometrium for implantation. Estradiol levels are important for preparing the body for IVF and embryo transfer. Progesterone, on the other hand, plays a key role in maintaining pregnancy. An imbalance between estradiol and progesterone can lead to failed IVF attempts or early miscarriages.

Anti-Müllerian Hormone (AMH)

AMH indicates a woman's ovarian reserve and serves as an important marker for assessing reproductive potential. Its level is taken into account when choosing an IVF protocol, especially for cases where donor eggs are planned. AMH can be measured on any day of the menstrual cycle and remains stable regardless of fluctuations in other hormones.

The use of in vitro fertilization (IVF), egg donation, and double donation

Modern assisted reproductive technologies (ART) allow many couples to find the joy of becoming parents. IVF is one of the most common techniques, in which a woman's eggs are fertilized by sperm in the laboratory. IVF may involve egg or sperm donation, as well as double donation, where both types of gametes are used.

IVF with Donor Eggs

This technique is used when a woman's ovarian reserve is depleted or genetic diseases prevent the use of her own eggs. In such situations, donor eggs provide a chance for successful pregnancy and the birth of a healthy child. It is important to consider that the hormonal preparation of the woman before embryo transfer will differ from the standard IVF protocol.

IVF with Double Donation

This is a technique that uses donor eggs and sperm, applicable in cases where both partners have reproductive disorders. These protocols require special attention to hormonal preparation to ensure the most favorable conditions for embryo implantation.

Impact of Hormones on IVF Success

Hormone levels play an essential role at all stages of IVF, from ovarian stimulation to luteal phase support and endometrial preparation. An unfavorable hormonal profile can significantly reduce the likelihood of successful implantation or lead to early pregnancy loss. That is why monitoring the hormonal context and its correction through medications is an integral part of a successful reproductive strategy.

It is important to remember that when choosing an assisted reproduction method, it is necessary to consider all hormonal parameters, as well as the characteristics of the woman's body. An individualized approach to each case allows for the optimization of treatment tactics and achieving the best outcomes. Artificial insemination with donor sperm opens new possibilities for women suffering from severe forms of infertility, allowing them to become mothers even in complicated cases.

This information highlights the importance of hormonal control, particularly in the preparation for artificial insemination. Accurate diagnosis and timely intervention help many couples achieve the desired pregnancy and the birth of a healthy child.