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Hormonally Speaking

How Hormones Affect the Fertility Cycle

By Teri Brown

Hormones are the perfect example of "can't live with them, can't live without them." From the time we are teenagers, we have to deal with the emotional and physical changes they bring. By the time we get to childbearing age, hormones take on mythic proportions with comments such as, "Oh, she's just being hormonal."

Elizabeth Mlotkiewicz from Wichita, Kan., has heard it too many times. Having been diagnosed with Premenstrual Dysphoric Disorder (PDD), Mlotkiewicz is used to the havoc hormones can play after five months of fertility therapy. "They made me feel PMSy all month long," she says. "Mood swings, outbursts, irrationality. The worst of the worst PMS symptoms extended for five months! It was so awful that my husband and I have tried to block it from our minds."

We know that hormones affect emotions, growth and fertility, but what are they really? Which ones are the major players, and which ones play smaller roles in fertility and well being?

Dr. Daniel Shapiro specializes in reproductive endocrinology with Reproductive Biology Associates in Atlanta, Ga. He says many hormones play parts in a woman's cycle. "With regard to reproduction, there are probably 25 to 30 hormonal agents that regulate menstruation, ovulation and pregnancy," says Dr. Shapiro. "The major players are FSH (follicle stimulating hormone), LH (leutinzing hormone), estradiol (the estrogen of ovulation) and progesterone (the hormone that appears after ovulation and helps support early pregnancy)."

According to Dr. Shapiro, the master hormone controlling reproductive function is a substance that is both simple in structure and unknown to most of the lay public. This hormone is called GnRH, or gonadotropin releasing hormone, and comes from a small area at the base of the brain called the hypothalamus. The nubbin of brain tissue from which this hormone comes is called the GnRH pulse generator, and it is where the story of reproduction really begins.

"No one knows for sure how the pulse generator gets started at the time of puberty, but it does," says Dr. Shapiro. "Initially, it starts sending out pulses of GnRH at night, and as puberty progresses, it sends pulses throughout the day."

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