Follicle Stimulating Hormone
The Glandular Axis
Many of the conditions that cause infertility are treatable with fertility drugs such as Clomid and FSH (follicle stimulating hormone), commonly referred to as "ovulation inducing agents." When everything is working well, a normal menstrual cycle involves the recruitment and growth of a follicle (egg), the development of the endometrium (uterine lining), ovulation, fertilization, and ultimately implantation of the egg in the uterus. Hormones produced by three particular glands regulate the process. The hypothalamus, adrenal and pituitary glands work together to cause ovulation and if there is a malfunction somewhere along the line, then it can lead to anovulation-the lack of ovulation-which ultimately means infertility.
How It All Works
The production of FSH, LH (luteinizing hormone) and other hormones may be influenced by the use of fertility drugs that work on the hypothalamus or pituitary gland. The hypothalamus is similar to a thermostat, monitoring and balancing the levels of hormones such as FSH, LH, and estrogen. Different drugs affect and influence the production of hormones produced individually in each of the glands of the "axis" of hypothalamus, adrenal, and pituitary glands.
FSH is produced by the pituitary gland which is influenced by gonadotropin (GnRH) released by the hypothalamus. In the case of IVF (in vitro fertilization), it is necessary for a woman to produce a large number of eggs, since some eggs do not mature properly and are not suitable for fertilization. When FSH is given by injection, it directly stimulates egg production. When a woman undergoes treatment with FSH, careful monitoring is done by measuring estradiol, using ultrasound to see the ovaries and eggs, and by physical examination. Other drugs are used along with FSH to control the timing of ovulation.
Strict Monitoring And Professional Administration Are Vital
The proper administration of this hormone is critical and requires a qualified specialist familiar with the application of fertility drugs and hormones. The dosages must be monitored carefully to avoid ovarian hyperstimulation or high order multiple births-a common result of FSH stimulation in IUI (intrauterine insemination).
When FSH was initially used as a fertility aid, it was considered a natural product. This was because it was derived and purified from the urine of post-menopausal women. However, since it was produced from human sources, it also contained luteinizing hormone, considered a pollutant. The hormone was given in the form of a very painful injection intramuscularly. Genetic recombinant technology has created a product that can now be given under the skin, in pure form, eliminating the other hormones, and ultimately is much more effective.