HYPOGONADISM – An Unfamiliar Cause of Female Infertility

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Infertility

New Delhi: Androgen deficiency in males has twice the chances of developing a condition known as Hypogonadism than in females.

The condition is linked to fertility issues as deficiency of gonadotropin hormones restricts the sex glands to produce very little or no hormone at all.

“The glands present in the testes and ovaries, when doesn’t work properly, leads to sexual problems and issues associated to erectile dysfunction or vaginismus. A reduction in the sexual desire can be seen in both men and women. This condition is severely known to affect sperm health and thus male fertility. The condition allows the body to only synthesize very limited amount of gonadotropin, whose low levels are associated with restricted secretion of testosterone thereby causing sperm production abnormalities, low sex drive, erectile dysfunction and ultimately male infertility.” says Dr. Sagarika Aggarwal, IVF Expert, Indira IVF Hospital, New Delhi.

According to several surveys conducted worldwide, reports clearly indicates that more than women, men with type 2 diabetes mellitus (T2DM) and obesity are twice as likely to suffer this condition. Approximately more than 30 lakh people around the world are diagnosed with this condition and over 48% of them are either pre-diabetic or suffer from T2DM.

“Though signs and symptoms defer depending on the severity of hypogonadism, it can begin since fetal development, before puberty or even in the adulthood. During the fetal development, if the body doesn’t produce enough testosterone it can result to impaired growth of the external sex organs. Child genetically born as a male can develop female genitals, genitals that are neither clearly male nor clearly female or underdeveloped male genitals. In males, hypogonadism can delay puberty or even lack normal development. It can also lead to an impaired growth of body hair, penis, testicles and breast tissue. Other symptoms include Infertility, erectile dysfunction, decreased libido and fatigue.” says Dr. Amol Lunkad, IVF expert from Pune.

Sex hormones also control the sex characteristics like breast development in women, testicular development in men, and pubic hair growth. These hormones also play a vital role in the menstrual cycle and sperm production.

People are unaware of a condition known as female hypogonadism and its symptoms can seriously affect women’s quality of life. The condition refers to the deficiency in the production of estrogen and progesterone by the ovaries. The symptoms include irregular or heavy periods, hair loss, depression and even ovarian cysts.

Hypogonadism is classified into two types: primary and secondary. Primary hypogonadism happens due to low testosterone levels, which results in abnormal testicular function. Secondary hypogonadism happens due to the problem in the hypothalamus or the pituitary gland, which results in a decreased secretion of pituitary hormones. Due to this testicles don’t receive the signals required for normal performance.

Low testosterone is not always responsible for infertility. Men with low testosterone can produce healthy sperm as sperm production is mainly stimulated by other hormones. But low levels of testosterone may result in decreased production of sperm. Normally the level of testosterone in the testicles, in which the sperm produced is higher than the testosterone levels in the blood.

“Low level of testosterone affects fertility in an indirect way which involves reduced sex drive, low libido, changes in erectile function, and possibly changes in morning erection frequency. In females, menstruation and ovulation are triggered by hormones such as oestrogen’s, lutenizing hormone, progesterone, and follicle stimulating hormone. All the hormones are controlled by gonadotropins. The low level of gonadotropins will affect the menstruation and ovulation. Both are important for the natural conceptions because, without egg produced during ovulation, it is not possible to conceive a child.” added Dr. Aggarwal.

A blood test is done to analyze the testosterone levels along with a sperm count test. Testosterone replacement therapy (TRT) is done through gel and patch form and also available in an injectable form.

 

 

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