Pituitary adenomas can cause infertility in women. However, these small tumors often go undiagnosed for years- despite producing symptoms.
Any pituitary adenoma can cause infertility by disrupting the hormone system, which is dependent upon a normally-functioning pituitary gland. Tumors in the pituitary gland can inhibit the production of follicle-stimulating hormone (FSH) or luteinizing hormone (LH). In rare cases, pituitary adenomas may secrete FSH or LH. FSH and LH work in tandem to stimulate ovulation. Infertility can occur when FSH or LH levels are too low to trigger ovulation- disrupting your menstrual cycle.
Pituitary adenomas are fairly common, occurring in about one out of five adults. Many never cause symptoms. However, symptoms are possible.
In addition to decreased libido, abnormal menstrual cycles and infertility- pituitary adenomas can cause other physical and psychological symptoms. Many patients report challenges with memory, headaches, depression or fatigue. As the pituitary adenoma grows, it may push on the optic nerve and cause vision problems. Share any symptoms you may be experiencing with your fertility specialist.
If your fertility specialist suspects you may have a pituitary adenoma, an MRI is typically recommended. This type of tumor is generally under one centimeter, so an MRI scan is the best mechanism to detect one. CT scans may not have the resolution required to identify a small pituitary adenoma.
For pituitary adenomas that produce excess hormones, medications can be effective in blocking or correcting hormone production. Adenomas not successfully treated by medication may be surgically removed. Using the transsphenoidal approach, the tumor is removed through the nasal cavity. Surgical treatment is a last resort after medical therapy has failed due to its greater morbidity.
Complications from surgery include meningitis, leaking cerebrospinal fluid from the nose and hormone deficiencies. Hormone replacement medications can be used to treat hormone deficiencies. Speak with your fertility specialist about any of your questions or concerns.
