Which disorders can contribute
In women, hormonal causes may include disordered ovulation from PCOS, high prolactin, thyroid disease (hypothyroidism and hyperthyroidism), hypothalamic or pituitary disorders and ovarian insufficiency. In men, disorders of sex hormones, of the pituitary or high prolactin can affect fertility. Not every case of infertility has an endocrine cause: other causes are blocked tubes, endometriosis and poor sperm quality, so the couple should be assessed.
When assessment should begin
It is usually recommended after 12 months of regular intercourse without contraception when the woman is under 35, or after 6 months when she is 35 or over. Over 40, a more immediate assessment may be needed. Do not wait for these intervals if periods are absent or very irregular, there is a known condition that affects fertility or a suspected problem in the partner.
How the hormonal assessment is done
The doctor reviews the cycle, medicines, changes in weight, symptoms and reproductive history. Tests are chosen case by case and some must be done on particular days of the cycle. TSH, prolactin when indicated, gonadotropins (FSH, LH), sex hormones or an assessment of ovulation (for example progesterone in the second half of the cycle) may be needed. The same hormone panel is not recommended for everyone. AMH shows ovarian reserve, but alone does not determine the possibility of natural pregnancy. Assessment may also require gynecological examination and semen analysis at the relevant service.
How it is treated
Treatment targets the hormonal cause and is tailored to plans for pregnancy. It may include treatment of the thyroid, of hyperprolactinemia (usually with drugs) or of ovulation disorders. If assisted reproduction procedures are needed, a specialized center is recommended. Do not use hormones, ovulation drugs or fertility supplements without assessment. Checks take place every 6 months to a year, or sooner when the doctor considers it reasonable.
Care at Tirana Polyclinic: we offer endocrinology and gynecology consultation, interpretation of tests and coordination of the work-up of hormonal causes.
Key sources
This information is educational and does not replace a visit to the doctor. Do not change your treatment without consulting your doctor. Updated: October 2026.