Can I Get Pregnant With Hypopituitarism

Short answer: Yes, you can!

Assisted reproductive techniques (ART) have developed rapidly and successfully during the last four decades, which has greatly increased the prevalence of women with hypopituitary diseases achieving fertility. In everyday practice, the replacement of pituitary hormones is optimal for women with hypopituitarism seeking fertility and increasing their chances of becoming pregnant. In addition, pituitary hormones have been studied in various populations seeking fertility using ART. Based on current data on hormonal changes during pregnancy and fertility, hormone replacement is always intended to restore the normal physiology pattern.

‍If you have hypopituitarism but haven’t had a child, you have likely thought about the effect your condition could have on your fertility. The place where you can find answers is here if you are looking for them.

How is Hypopituitarism Defined?

It is a rare disorder to have hypopituitarism. Hypopituitarism is caused by the limited production of one or more of the eight hormones generated by the pituitary gland. Selective hypopituitarism occurs when there is a reduction in the release of one particular pituitary hormone. However, when the pituitary gland produces fewer hormones or none at all, it is known as panhypopituitarism.

Pituitary hormones are responsible for vital body activities like reproduction, growth and development, and metabolism. The pituitary gland seems to be a relatively small pea-sized gland at the center of the brain that is firmly attached to the hypothalamus. The hypothalamus is divided into two lobes: the anterior pituitary, which generates hormones, and thus the posterior pituitary, which contains nerve cells. Posterior pituitary glands produce hormones such as antidiuretic hormone (ADH), which regulates blood osmolality during pregnancy, and oxytocin, which acts as an inducer of labor.

This releases hormones which stimulate the anterior pituitary gland to release its hormones, namely:

• Thyroid-stimulating hormone
• Adrenocorticotropic hormone
• Luteinizing hormone
• Follicle-stimulating hormone
• Growth hormone or somatotropin
• Prolactin

Through a feedback mechanism, all these hormones, thyroxine, cortisol, estradiol, progesterone, testosterone, and IGF-1, are released by effector hormone glands in the body. Direct action of prolactin is seen in the mammary glands.

Different Forms of Hypopituitarism

Hypopituitarism can be classified into two types depending on the lack of hormones:

• Solated pituitary deficiency: Deficit of a single pituitary hormone and lacking.
• Panhypopituitarism: There is a deficit of all pituitary hormones, and they are all lacking.

Hypopituitarism can be classified into three types based on its cause and how it affects the pituitary gland:

• Primary hypopituitarism: Primary hypopituitarism occurs when your pituitary gland is damaged, or disorders occur in the gland.
• Secondary hypopituitarism: Secondary hypopituitarism occurs when your pituitary gland is damaged, or disorders occur in the hypothalamus through the pituitary stalk. Hypopituitarism can be caused by issues with the hypothalamus, which signals the pituitary to release certain hormones.
• Idiopathic hypopituitarism: This condition cannot be determined.

Who is Affected by Hypopituitarism?

Even though hypopituitarism is a very rare condition, it could affect anyone at any age. Even it affects children also. It is very rare to see a person suffer from hypopituitarism. An estimated 10 to 40 new cases occur per million people each year.

Hypopituitarism Causes

Hypopituitarism can be caused by a variety of conditions and circumstances. Health care providers are sometimes unable to pinpoint the reason for the problem. The condition is known as idiopathic hypopituitarism. In general, hypopituitarism is caused by these three factors:

1. Pituitary and hypothalamus glands are under pressure (compressed)

Pituitary gland pressure can be caused by several conditions, such as:

• Pituitary adenomas: Hypopituitarism is primarily caused by a pituitary adenoma. It is possible that the adenoma, depending on its size and growth pattern, can block blood flow to the pituitary gland and put pressure on it.
• Brain tumors: There are certain brain tumors that grow near the hypothalamus and/or pituitary gland that could cause hypopituitarism.

2. Damage has occurred to the pituitary gland or hypothalamus

Here are some scenarios that may damage the pituitary and hypothalamus:

• Surgery: Surgical complications, such as those caused by removing a pituitary adenoma or brain surgery, are a common cause of primary hypopituitarism.
• Radiation therapy: Your pituitary gland or hypothalamus may be damaged by prior cancer radiation therapy.
• Brain or head trauma: When you are in a vehicle accident, fall, or participate in contact sports, there is a possibility that you will sustain a head injury or brain injury, which can damage your pituitary gland or hypothalamus.

3. You have a rare or infrequently occurring condition that causes hypopituitarism

Hypopituitarism can result from some rare conditions, including the following:

• Hemochromatosis: There is a condition called hereditary hemochromatosis that causes an excessive amount of iron in the bloodstream. As a result, there is a chance that it will harm your pituitary gland.
• Bacterial meningitis: Hypopituitarism is rare but can occur as a result of bacterial meningitis.
• Genetic mutations: In some rare cases, genetic mutations may lead to hypopituitarism.

Hypopituitarism Symptoms

Hypopituitarism is usually progressive, and the symptoms gradually appear over several months or years. In some cases, symptoms may appear suddenly. There is a wide range of symptoms from patient to patient, both as a result of pituitary hormone deficiencies. The following symptoms define this condition:

•  Swollen facial features or body
• Weakness and fatigue
• Sensitivity to cold
• Weight loss
• Decreased appetite

In the following list, we have listed some specific symptoms of pituitary hormone deficiency based on its type.

ACTH and Cortisol Deficiency

It is the adrenocorticotropic hormone (ACTH) that produces cortisol. In case of a cortisol deficiency, you may experience the following symptoms:

• Hypotension
• Hypoglycemia
• Low serum sodium levels
• Low levels of hemoglobin
• Fatigue

In the case of an acute deficiency, the following symptoms may occur:

• Circulatory collapse
• Nausea
• Dizziness
• Vomiting

There is a possibility that children will fail to thrive as well as not grow properly.

TSH and Thyroid Hormone Deficiency

A pituitary hormone known as thyroid-stimulating hormone (TSH) stimulates thyroid hormone production, which is crucial to metabolism in the body.

Many symptoms can occur when these hormones are deficient, including:

• Impaired memory and concentration
• Constipation
• Body puffiness
• Sensitivity to cold

Prolactin Deficiency

Breast milk production depends on the prolactin hormone (PRL) after childbirth. It plays a key role in the production of breast milk. In this situation, breastfeeding may be impossible for women with prolactin deficiency.

Growth Hormone Deficiency

GH deficiency may cause children to grow slowly, become short, and gain more weight. Adults with this deficiency have a greater risk of developing cardiovascular disease due to obesity, low muscle mass, and fatigue.

Hypopituitarism: How Is It Treated?

Hypopituitarism can be treated by treating its underlying cause to restore pituitary function to a partially or fully normal level. The doctor prescribes medications that work as a replacement for pituitary hormones that the body would have generated in the absence of a pituitary issue. There are several types of hormone replacement drugs, including:

• Corticosteroids: As a replacement for adrenal hormones, these oral  drugs function by replacing them with other chemicals in the body.
• Levothyroxine: It is used to replace thyroid hormones.
• Sex hormones: Sex hormones, including testosterone, are used to treat hypopituitarism in men, while estrogen and progesterone are used to treat hypopituitarism in women.
• Growth hormone: It promotes growth in children when injected into the skin.

How it Leads to Infertility?

When there is a lack of growth hormone production, a decrease in FSH or LH results, which can lead to irregular periods and sexual function problems, in some cases, it can also lead to infertility.

A Word From Hegde Fertility

It is very rare for patients suffering from hypopituitarism to have a successful pregnancy because hypopituitarism is associated with high risks of pregnancy complications such as abortion, anemia, pregnancy-induced hypertension, and premature birth. It is important to manage hypopituitarism carefully during pregnancy and the postnatal period. Pregnancy should be performed once hormone levels have been restored to normal.