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Pituitary adenomas are small, generally benign tumors found in the pituitary gland. However, in some cases these adenomas can lead to secondary infertility in men.
The pituitary gland is a key part of the endocrine system, which is responsible for producing hormones. The hypothalamus produces gonadotropin-releasing hormone (GnRH), which triggers the pituitary gland to produce luteinizing hormone (LH) and follicle-stimulating hormone (FSH) LH stimulates the testes to produce testosterone, and FSH signals the testes to produce sperm.
Although FSH- and LH-producing adenomas are rare, they can result in hormonal imbalances that negatively impact fertility. Healthy testosterone and sperm levels are required for optimal fertility. When LH levels are abnormally low, testosterone production will be reduced. Low FSH levels will reduce sperm production. If either LH or FSH are abnormally high, the hypothalamus will not stimulate the pituitary gland to release LH and FSH.
Up to 10% of adults may develop a pituitary adenoma at some point in their lives. However, the majority will never exhibit symptoms. Oftentimes, pituitary adenomas are discovered while investigating infertility. Symptoms will generally mimic those of low testosterone, such as fatigue, depression and lost sex drive. If you’re experiencing any of these symptoms, talk to your fertility specialist.
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.
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