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The Infertility Dilemma

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Dr. Simone Scumpia of Austin Thyroid & Endocrinology highlights the warning signs of malfunctioning hormones that can lead to infertility.

By Shelley Seale

Today’s high-tech world is full of robotics, quantum computers and artificial intelligence, with new technology breakthroughs happening every day. Yet the complex systems within our own bodies are still more highly developed than any supercomputer out there.

The endocrine system is one of these: a tightly regulated biochemical process that involves our hormones and glands such as the pituitary, thyroid, testes and ovaries. For women who are trying to become pregnant, irregularities in this system can wreak havoc. A host of complications, from diabetes and fatigue—often caused by stress—to disorders such as congenital adrenal hypoplasia and polycystic ovarian syndrome, can interfere with the ability to conceive.

“It is a very precise system,” says Dr. Simone Scumpia, the founder of Austin Thyroid & Endocrinology. “The beginning of menstruation starts a complicated cycle for a woman. The number of eggs every female has in her lifetime is determined when she herself is in utero. For one of those eggs to be fertilized, the woman needs to have normal thyroid, adrenal and reproductive systems.”

When the ovaries mature, a signal is sent to the pituitary gland, a gland Scumpia calls the “queen of all glands.”

“Hormones then begin to be secreted throughout the woman’s body, which command release of the egg,” she says. “In a way, the entire cycle of a woman is in anticipation of the possibility of pregnancy. In order to have a normal cycle, all of these glands and the reproductive system need to be working correctly.”

From her first year in medical school, Scumpia began training in endocrinology, and was later mentored by many prominent endocrinologists. She completed her internship and residency in Canada, moving to Austin in 1991 to work at Austin Diagnostic Clinic.

Early on, she envisioned having her own independent hormone institute, offering comprehensive endocrine assessment and treatment. Her dream was realized in 2002, when she opened the integrated center in North Austin. Scumpia has been called a sleuth in endocrinology and medicine because of her passion to find the root cause of a patient’s symptoms, often for patients who seek her help as a second or third opinion.

“The problem with the endocrine system, and what makes it so fascinating, is that at any step, something can go wrong,” she says. “We are known as detectives because we have to know the whole system. The symptoms can be very vague, and people end up seeing other specialists for things that are caused by the endocrine system. It can affect any organ in the body.”

Irregularities in the endocrine system that can affect the ability to get pregnant can be inherited or caused by factors such as illness or surgery. Scumpia has even seen women who run or workout too much, which can result in a lack of body fat that distresses the cycle and ovulation. Irregular periods are often a sign of a problematic endocrine system, and women—even young girls just beginning menstruation—should always consult a doctor about an abnormal cycle.

“It can set the stage for her entire reproductive life,” Scumpia advises. “Don’t ignore the signs and think it’s temporary, or just start the pill. Have it checked out.”

Scumpia outlines numerous symptoms that signal possible problems with the endocrine system. If you experience one or more of these, you should have it checked out by a doctor:
• swelling
• excessive fatigue
• a lump in the neck
• prominent eyes
• excessive hair growth
• irregular menstrual cycles
• heart palpitations
• excessive acne
• abnormal pigmentation of the skin

Infertility and Hormone-replacement Therapy Hormonal balance is necessary to get pregnant. When hormone problems cause infertility, there are several options for treating it, both natural and synthetic.

1. Bio-identical Hormone-replacement Therapy, or BioHRT: These hormones are isolated from plants, minerals or animal sources and are considered natural duplicates of steroid hormones. Although some hormones may be bio-identical from biological sources, they may not be considered human-identical.

2. Synthetic Hormones: These hormones are made in a lab and are patented medications. They have a similar effect to our own endogenous hormones and are commonly used for hormone-replacement therapy, or HRT, and artificial reproductive technology, or ART. The most common use of synthetic hormones is birth control.

3. Xenohormones: These are human-made chemicals that mimic our natural hormones. The most common xenohormones mimic human estrogen and are called xenoestrogens.

A combined dose of estrogen and progesterone is usually the recommended approach for women struggling with infertility. The combined dose can help to put hormones back in sync and help the body to regulate the reproductive cycle, increasing a woman’s chances of becoming pregnant.

Like all fertility treatments, hormone-replacement therapy does carry risks. Some studies have indicated a risk of developing breast cancer, heart disease, stroke or blood clots. As a result, patients who have an increased risk of heart attacks or blood clots should consider alternative treatments.

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