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The Orchestration of the Female Hormones

a blog by Traci Shahan, RN, WHNP-BC, Doctor of Nursing, Albrecht Women’s Care Denver IVF, January 30, 2012

This afternoon as I finished reading about Celtic spiritual practices, I glanced up to see my daughter Taylor staring into a neatly labeled chart, which I recognized immediately (even without my corrective lenses) as that of an impeccably rendered human female menstrual cycle. One aggravating dynamic of seminary curriculum is that, unlike my prior stint in graduate school, divinity studies seldom have one right answer. To me, Ockham’s Razor does not provide the succor as does the constant Avogadro’s number. Having cut my academic teeth via the rigors of science, in which there is a correct answer, theology is a jot shy on right, wrong, hypothesis and null.

I miss the certitude of science, so I practically shot off the couch when she asked me to quiz her in preparation for a test about reproduction. A chart! Of fastidiously diagrammed female hormones — estrogen, progesterone, FSH, LH, the whole, happy gang, ebbing and flowing in sinuous curves, just as nature programmed!

Taylor and I got to it right away: estrogen rises during the first half of the menstrual cycle, known as the follicular phase, then abates as progesterone rallies during the second half, the luteal phase. Meanwhile FSH rises early on, and LH peaks right around day 12 to cause ovulation. Just. Like. That.

Or not.

Many women experience no or a diminutive ovulation, which, of course, disallows pregnancy. This can be a very straightforward issue or one that requires more sophisticated treatment such as both oral and injectable fertility drugs during treatment. If you are one of these women who does not ovulate effectively, you live at exactly the right time, during an era in which we have effective therapies available to foster ovulation. These are typically administered during the first part of the menstrual cycle — the follicular phase — beginning roughly during or shortly after menstruation. Each fertility drug works in a little different way to, ultimately, coax one or more follicles from the ovaries. The roughly two weeks after ovulation — the luteal phase — is a time during which the area(s) from which the ovaries released eggs begin to secrete progesterone, which will allow a fertilized egg to implant into the uterus.

Seems easy enough.

But sometimes this orchestration of hormones is disrupted; for example when another hormone in the body is abnormal — like thyroid hormones or male hormones. (Yes, even the most feminine among us has a component of male hormones and, yes, even the most burly men have female hormones, which confounds my earlier assertion that science is black and white.)

When you have an appointment with your fertility doctor, s/he will evaluate your body’s level of these hormones early on. If an ovulation disorder is discovered, you will oftentimes be prescribed medications, treatments and monitoring. Most of the time, ovulation induction is achieved easily after identification and treatment. It will be very important that you take the medications and adhere to recommendations to enhance your chances of conceiving, knowing that during any one cycle, except many IVF cycles, the odds are against conceiving. Yes, you read that right. No matter that we live in a country in which nearly half of pregnancies are unintended, it is still unlikely that even a young woman with no known fertility issues will conceive during a cycle in which she has exposure to sperm.

If you have one of these issues, listen to your medical team, follow their advice, and keep your expectations reasonable. And remember my adage that, if you stay persistent and remain open to modern options and treatments, the odds are, in the end, that you will attain parenthood.


Comments (1)

The definitive answers of science versus the reality of, as you put it, the disruption of the orchestration of hormones. The knowledge that we now have regarding this subject and the amount of treatments that are available is truly astounding when you consider how things used to be. Your appreciation for the science and for the elements of (for lack of a better word) chance that also contribute to each individual woman's situation makes for an interesting and insightful article.

D Alishouse

This has been posted on behalf of the Indianapolis reproductive gynecology clinic, American Health Network reproductive medicine, providing a Female Reproductive Endocrinologist and supporting IVF in Indianapolis. The information is not medical advice, and should not be treated as such. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.

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