University Reproductive Associates’ Dr. Kavitha Persaud discusses hormonal therapy, a broad-range approach used to help many couples in their quest to become pregnant.
According to the National Institutes of Health, one in eight couples experience infertility, a condition that can be driven by everything from the timing of sexual intercourse to the quality and quantity of a woman’s eggs; the quality, quantity or motility of a man’s sperm; the presence of an underlying medical condition in either partner; or a combination of any of the above. Thankfully for these couples, several options are available to help increase their chances of a successful pregnancy. One of these includes hormonal therapy.
“An estimated 40% of the reason why couples are infertile is due to a female factor, a portion of which involves releasing a women’s egg from the ovary, so hormonal treatments — typically involving ‘follicle stimulating hormone’ and ‘luteinizing hormone,’ to alter the body’s estrogen levels, administered either in the form of oral treatments or injectable medicine — stimulate the ovaries to grow and release eggs,” explained Kavitha Persaud, MD, fertility specialist at Hasbrouck Heights-based University Reproductive Associates (URA). “We start by getting a baseline overview of the functionality of the woman’s ovaries and, assuming she’s a good candidate for hormonal therapy, will suggest either oral or injectable medication, depending on the functionality of her ovaries and the type of treatment she desires.” She noted that the injectable option offers a stronger formulation of the hormones and will typically drive a more robust response.
“There are three ways a woman can get pregnant,” Dr. Persaud shared. “Either through conventional sex at the right time within a month so that the egg and sperm meet, or else through insemination, during which we’ll administer either an oral or injectable form of medication and place sperm into the woman’s uterus, or through in vitro fertilization (IVF), during which we’ll give hormonal injections to stimulate the ovaries to release as many eggs as possible.”
“Overall, hormonal treatment can be used on its own or incorporated into any of these approaches depending on the treatment cycle and/or the patient’s goal,” Dr. Persaud continued. “For certain patients, hormonal therapy can simply help them ovulate and experience a greater likelihood of fertility when they have conventional intercourse at a certain time. For others, oral or injectable hormone therapy can increase the number of good-quality eggs released. We can also administer hormonal treatment to those undergoing insemination or IVF to help enhance their chances of success.”
According to Dr. Persaud, the likelihood of a couple getting pregnant through conventional means every month is 20%; insemination has a similar success rate of 20%, while IVF offers the highest success rate of 60-70%. “If a patient pursues IVF, we’ll give her the strongest hormonal treatment possible for her situation,” she said. She added that when prescribed, oral hormone therapy is typically administered as a five-day course, while injectable hormone therapy given during IVF is usually administered for one to two weeks.
“Patients considered ideal for hormone therapy in general are those whose ovaries have sufficient enough functionality to respond to these treatments,” said Dr. Persaud, who noted that a measure of their ovary functionality and hormone levels will determine how positively their system will respond. “If the patient’s ovaries are no longer functioning, however, no amount of supplementation will help, and a woman’s age plays a primary factor too. After age 35, a woman’s estrogen levels start to decline, and beyond her early 40s, hormonal treatment becomes less effective because the quality of her eggs wanes. Though it certainly depends on their baseline hormone functionality, the chances of women that age having a successful pregnancy even with hormonal treatments can be as low as 5%.”
Helping Women Build Their Family
According to Dr. Persaud, the specialists at URA take a highly personalized approach to patients undergoing hormonal treatment for infertility and deliver a uniquely positive experience.
“We pride ourselves on working with each patient on an individualized basis, conducting a thorough patient history and evaluation, and presenting every single option available to them; we’ll then collaborate with them on their best treatment option based on a shared decision-making model,” she said. “We provide a lot of education and like to share knowledge with each patient to help them make the most informed decision possible.”
While she noted that some people are hesitant to pursue hormonal treatment because they’ve heard it can create mood swings, “the hormones we use help stimulate a woman’s body to release its own hormones; in addition, hormonal therapy is a short-lived process — just five to 14 days — so it’s out of her system quickly,” Dr. Persaud said. “Some patients are also concerned that taking hormones could increase their risk of cancer and/or drive them into early menopause, but studies have shown that there have been no scientific links between hormonal therapy and either of those outcomes at all.”
“Overall, hormonal therapy has been proven effective and helps enhance the successful functionality of a woman’s ovaries,” Dr. Persaud confirmed. “Hormonal therapy is part of a whole spectrum of treatments for infertility that can help overcome obstacles and support a woman’s desire to build her family.”