Hormone-Related Infertility
Hormone-related infertility means a hormonal imbalance -- rather than a structural or male-factor cause -- is preventing pregnancy, evaluated per ACOG Committee Opinion 781 and ASRM guidance.
Symptoms
Irregular or absent ovulation is the most common sign, often reflected in irregular periods; some causes (like elevated prolactin) also cause galactorrhea (unexpected milk production) or headaches.
Causes and risk
PCOS is the most common cause of ovulatory infertility; thyroid dysfunction, elevated prolactin, and diminished ovarian reserve (naturally declining egg quantity and quality with age) are the other major categories.
How it is evaluated
A hormonal panel (TSH, prolactin, FSH/LH/estradiol) plus ovarian reserve testing (AMH, antral follicle count) identifies the cause; prolactin is checked only when symptoms warrant it, not routinely.
Treatment
Letrozole is first-line ovulation induction for PCOS-related infertility; correcting thyroid dysfunction or elevated prolactin often restores ovulation on its own. In vitro fertilization or donor eggs become options when ovarian reserve is significantly diminished.
When to seek care
Ovarian hyperstimulation syndrome (severe bloating, pain, rapid weight gain during fertility treatment) and ectopic pregnancy (one-sided pelvic pain, especially with a positive pregnancy test) are the highest-yield emergencies in this population and need immediate care.