The ups and downs of hormone balance in fertility

Having a baby is a life-changing event, but the journey to get there can sometimes be filled with bumps. Even before trying to conceive, many couples planning for pregnancy will look for ways to improve their health and wellbeing ahead of time. Extra trips to the gym, taking the right supplements, cutting out smoking and reducing the beer intake are all great lifestyle decisions for both men and women, boosting their chances of conception and a healthy pregnancy to follow.

How sex hormones control fertility

In women it’s not just lifestyle that impacts pregnancy chances, but the balance of hormones that govern fertility and support pregnancy. Hormones controlling fertility are released by the brain, adrenal glands and ovaries. These hormones work in synergy to provide the key conditions every month for egg release (ovulation), fertilisation and embryo implantation into the womb (uterus).

The steroid sex hormones, estrogen and progesterone, are major players in preparing the ovaries for ovulation, and the lining of the uterus for a pregnancy. Androgens, whilst typically thought of as a male hormone, are also key in maintaining egg health, and women predominantly get their androgen supply in the form of DHEA (dehydroepiandrosterone).

These steroid hormones, which can be accurately measured in saliva, act in harmony to regulate the average 28 day menstrual cycle:

Fertility hormone progesterone and estradiol ovulation chart

Estradiol (E2) is the main form of estrogen produced by the ovaries, and rises during the first half of the menstrual cycle (d1-14), peaking prior to ovulation. Estradiol levels drop off after ovulation and then increase again during the second part of the menstrual cycle (luteal phase). Estradiol supports egg health and primes the uterus for a pregnancy.

Progesterone (P4) is secreted by the ovaries in the second half of the menstrual cycle (d15-28), called the luteal phase. Progesterone is made by the corpus luteum, which forms only after ovulation has occurred. Progesterone peaks at d21 and is essential for supporting a pregnancy.

DHEA (dehydroepiandrosterone) is pumped out by the adrenal gland and signals to the ovaries to make the sex hormones estradiol and testosterone. DHEA is the building block of the sex hormones and normal levels are essential to maintain overall sexual function, including sex drive. DHEA levels remain generally constant during the menstrual cycle.

For women planning a pregnancy, knowing how these hormones are behaving can be highly reassuring, giving a picture of hormonal balance, and identifying if ovulation is occurring.

Pulsatile Hormone Observation

For those looking for a broad overview of reproductive hormones, TestoChecker offer the Fertility Balance G2 Comprehensive Hormone Test Kit, combining measurements of estradiol, progesterone, testosterone and the precursor hormones DHEAs.  Irregular DHEAs can hinder the production of the sex hormones, and often coincides with cortisol irregularity requiring for further investigation.

What about the other fertility hormones huh?

Unlike the steroid sex hormones mentioned above, other protein hormones that are involved in fertility are not readily measured in saliva, but can be detected and accurately measured by blood tests. These hormones may be measured as part of a wider investigation into fertility health in consultation with a GP or endocrinologist.

Anti-Mullerian Hormone, shortened to AMH, is a hormone secreted by the growing egg follicle. The egg resides within a house of cells called the follicle, which provide the egg with the instructions needed to grow and mature ready for ovulation. The level of AMH in the bloodstream is proportionate to the number of eggs that are growing in the ovary giving an indication ovarian reserve. AMH testing can be useful in older women who want to conceive and would like assurance that growing eggs are present.

Despite being manufactured some distance from the ovaries, it is the brain that ultimately controls fertility through secreting key reproductive hormones. LH and FSH are two hormones produced in the brain by the pituitary gland, travelling in the bloodstream to the ovaries.  LH and FSH signal to the egg follicles to produce hormones (such as estradiol) and other factors needed for egg growth and maturation.

While LH and FSH have different biological actions they are required to act in concert and the ratio of these hormones is key to normal ovarian function, including the timing of the menstrual cycle and normal egg development. Testing these hormones in the blood can help to diagnose the causes of irregular menstrual cycles and/or infertility.

A note on that thing called stress

No article on planning for pregnancy would be complete without mention of the S word – stress. In fact, stress can be one of the biggest influences on sexual function, affecting many aspects of fertility in both men and women. Being a little stressed is completely normal in our packed day to day lives, but periods of extreme or pro-longed stress can prevent a couple conceiving.

The stress hormone, cortisol is released by the adrenal gland. When large amounts are produced in response to stress, cortisol can have negative impacts on target organs including the brain and the ovaries/testes.

Cortisol directly inhibits the brain from producing reproductive hormones, and suppresses ovarian hormone production, thereby placing a road block on ovulation. In men, high levels of cortisol can reduce sperm count and quality. Lowered levels of the sex hormones also reduce libido in both sexes.

Managing stress levels is an important step towards planning for pregnancy, and something that both partners can participate and support each other in.

The Fertility Balance G2 Comprehensive Hormone Test Kit from TestoChecker includes a cortisol measurement, ideal to provide a snapshot of cortisol levels in the context of overall hormonal balance.

For men or women wishing to monitor cortisol more closely over time, or determine adrenal function by the pattern of cortisol secretion within a day, TestoChecker also offer comprehensive cortisol tests for this purpose, including the Comprehensive Cortisol Test Kit or the Adrenal Function Extended Profile Test Kit.

To conclude…

There is a wealth of information out there for couples planning for pregnancy and guidance for the practical lifestyle choices that pave the way to a healthy mind and body. Taking care of ourselves and avoiding stress is one thing we can try to control, but what our hormones decide to do can be another matter entirely.

Testing of fertility hormone balance in saliva is a simple and sure way to provide reassurance, or indeed, if hormone levels look out of whack, seek medical advice. Saliva hormone testing not only provides rapid and accurate laboratory-based measurements of whether fertility hormones are up or down, but importantly how they are balanced with one another.

Understanding, the relationship of hormones and fertility is a positive step towards a smooth road to pregnancy.

Author: Guy Saywell
TestoChecker Hormone Test Kits ®
Phone: +61293271336
Address: Suite 1A, Level 2, 802 Pacific Highway,
Gordon, NSW, 2072.

Updated 18 June, 2021.