Endocrine factors associated with infertility in women: an updated review

ABSTRACT

Introduction

Infertility is defined as the inability to conceive after unprotected sexual intercourse for at least 12 consecutive months. Our objective is to present an updated narrative review on the endocrine causes of infertility in women.

Areas covered

A comprehensive review was conducted using Scielo, Scopus, and EMBASE databases, comprising 245 articles. The pathophysiology of infertility in women was described, including endocrinopathies such as hypothalamic amenorrhea, hyperprolactinemia, polycystic ovary syndrome, primary ovarian insufficiency, obesity, thyroid dysfunction, and adrenal disorders. The diagnostic approach was outlined, emphasizing the necessity of hormonal studies and ovarian response assessments. Additionally, the treatment plan was presented, commencing with non-pharmacological interventions, encompassing the adoption of a Mediterranean diet, vitamin supplementation, moderate exercise, and maintaining a healthy weight. Subsequently, pharmacological treatment was discussed, focusing on the management of associated endocrine disorders and ovulatory dysfunction.

Expert opinion

This comprehensive review highlights the impact of endocrine disorders on fertility in women, providing diagnostic and therapeutic algorithms. Despite remaining knowledge gaps that hinder more effective treatments, ongoing research and advancements show promise for improved fertility success rates within the next five years. Enhanced comprehension of the pathophysiology behind endocrine causes and the progress in genetic research will facilitate the delivery of personalized treatments, thus enhancing fertility rates.

KEYWORDS:

• Fertility
• female infertility
• anovulation
• reproductive health
• ovarian reserve
• hormones

Article highlights

• Correcting underlying hormonal abnormalities enhances fertility in most patients.

• Polycystic ovary syndrome is a common cause of anovulation.

• Hormonal evaluation is crucial within the assessment of female infertility causes.

• Ovarian reserve should be evaluated using antimüllerian hormone and imaging.

• Healthy lifestyles contribute to improving fertility.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contribution statement

JEQA and MJCZ designed the outline of this article review. JEQA, JCA, MCDV, ERGO, JSR, SPIN and LPRR were the main writers and performed the literature review. MJCZ and JPI were reviewers and prepared the manuscript. All authors have read and approved the final manuscript.

Additional information

Funding

This paper was not funded.