Is fertility possible if I have hypopituitarism?
Fertility is never certain for anyone, even adults with a normal pituitary gland (10% of all “normal” couples are infertile). Infertility related to hypopituitarism is the result of LH and FSH deficiency. Sometimes PRL levels are high, which results in reduced LH and FSH levels. In such a situation, fertility may be restored by lowering PRL levels with medication such as bromocriptine or cabergoline. A large pituitary adenoma or hemorrhage can also cause LH and FSH deficiency. In that case, treatment (by injection) of LH and FSH equivalents can stimulate the ovaries to produce eggs or the testes to produce sperm assuming the ovaries and testes are otherwise normal. The sperm cycle in men is long, over 70 days, and a year or more of treatment may be required for a man to achieve a sperm count adequate to father a baby. Thus, for men who are interested in fertility, it is prudent to obtain a semen analysis at the time a pituitary problem is diagnosed. If the patient has an adequate sperm count at diagnosis, sperm can be collected and frozen for future use. Unfortunately, the current technology for freezing eggs is not yet optimal.
Important: If a woman with hypopituitarism becomes pregnant she should be monitored closely. Doses of thyroid and steroid replacement may need to be adjusted. GH treatment is not approved for use in pregnant women.
