The Hormones Involved

When I started this journey I had no ideas the scope of hormones involved. I also had no clue as to how many steps it takes before even considering intrauterine insemination (IUI) or in vitro fertilization (IVF). It was only when I started testing through my OBGYN that I realized how amazingly complicated it is to get pregnant. Simply put – it’s a miracle.

In October of 2010 I was given an ultrasound to check the size of my ovaries. Needless to say I was excited and relived to find out I actually had some! The doctor was looking for abnormalities in the size of the ovaries as well as the number of follicles nestled within each. The test results came back normal. The size of the ovaries were fine and I had about 10 to 11 follicles in each ovary. * A woman who has what’s called Polycystic Ovarian Syndrome has an even greater number of follicles and may have cysts. Other indications, according to Web MD, include irregular menstrual cycles, failure of the ovary to release eggs (anovulation) and elevated levels of male hormones.

With the ultrasound complete I had blood drawn to take a look at the levels of several different hormones. I will list them here with a brief description of their role in pregnancy and a link to each if you want more information:

LH – luteinizing hormone helps regulate the menstrual cycle and egg production. Each month, for those on a regular cycle of 28 days, you would typically test for the “LH surge” around day 14 to know when ovulation will occur – between 12 and 72 hours after the surge. If progesterone (more on this hormone below) levels are normal a woman’s “luteal phase” will normally last for 14 days until she either gets a positive pregnancy test OR begins her menstrual cycle.

FSH – follicle stimulating hormone works in conjunction with luteinizing hormone. Both are produced by the pituitary gland. According to Wikipedia, FSH stimulates the growth and recruitment of immature ovarian follicles in the ovary. FSH is typically measured in the early follicular phase of the menstrual cycle, typically day three to five, counted from last menstruation. At this time, the levels of estradiol (E2) and progesterone are at the lowest point of the menstrual cycle.”

Prolactin – sharedjourney.com had the most comprehensive answer I could find about prolactin, “Prolactin doesn’t just cause your body to increase milk production – it also affects your ovulation and menstrual cycles. This is why it is nearly impossible to become pregnant when you are breastfeeding.  (In fact, prolactin is 90% effective against pregnancy in the first months after birth). Prolactin inhibits two hormones necessary to your ovulation: follicle stimulating hormone (FSH) and gonadotropin releasing hormone (GnRH).  Both of these hormones are responsible for helping your eggs to develop and mature in the ovaries, so that they can be released during ovulation.  When you have excess prolactin in your bloodstream, ovulation is not triggered, and you will be unable to become pregnant.  Prolactin may also affect your menstrual cycle and the regularity of your periods.”

Progesterone – this is the hormone I am most familiar with. When I was originally tested in November and December of 2010 this hormone continued to come back low. Healthywomen.org has this to say, “Progesterone plays a role in maintaining pregnancy. The hormone is produced in the ovaries, the placenta (when a woman gets pregnant) and the adrenal glands. It helps prepare your body for conception and pregnancy and regulates the monthly menstrual cycle.” Progesterone plays a key role in preparing the uterine lining to allow a fertilized egg to implant. If this hormone is low, as in my case, the lining will not be thick enough. The result? Lack of pregnancy each month. *Since my levels were low my doctor told me I have what is called a Luteal Phase defect. I was not producing enough progesterone and the lining was not being built up, resulting in a shorter time before my period would start.

I’m posting the projesterone jellybean again!

Estrogen – probably one of the more recognizable hormones, estrogen also helps to thicken the uterine lining and works in tandem with progesterone. According to healthywomen.org, “The term “estrogen” includes a group of chemically similar hormones: estrone, estradiol (the most abundant in women of reproductive age) and estriol. Overall, estrogen is produced in the ovaries, adrenal glands and fat tissues. More specifically, the estradiol and estrone forms are produced primarily in the ovaries in premenopausal women, while estriol is produced by the placenta during pregnancy.”

With all of my other hormone levels within normal range I began taking progesterone supplements (200 mg) in January of 2011. I take a single yellow pill as soon as I receive a positive LH surge test. Since I’ve been taking the progesterone I have noticed a difference in the length of time before my next cycle begins. It has extended the phase by three to four days. I’m not a 28 dayer – my cycles fluctuate a bit between 28 days to 35 days. It is frustrating at times but there is not much I can do about it.

Are you exhausted yet? In my next post I’ll get into the details of my hysterosalpingogram (Say that three times fast!) that I had done in July of this year.

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