Answer from: Wael Saab, MRCOG, Bsc
Estrogen is the female hormone, it’s the principal female hormone, so if you ask any lady what is the hormone that you are aware of that might be associated with fertility – everyone will mention estrogen. It’s quite important just a little bit of further details when we mention estrogen, we are not speaking about one hormone. Actually estrogen is a group of hormones and, for example, the most common hormone that when we mention estrogen, we mean is a hormone called estradiol but there are other forms of estrogen that we fail to mention, for example, there’s a hormone called estriol which is the hormone that is produced mainly by the placenta (which is the hormone that is checked during the first trimester among the first trimester screening during pregnancy for instance). There’s also estrone which is the hormone that is secreted principally by the fat tissue that is also an estrogen but when we mention estrogen, we mean estradiol which is a principal female hormone. While estradiol is not the hormone that does cause pregnancy, it’s obviously one of the key players in fertility treatment. Estrogen plays principally in preparing the lining for the embryo to implant. To simplify the matter the brain is stimulating the ovary, the ovary is giving us an egg but the ovary at the same time is producing estrogen. Estrogen will thicken up the lining inside the womb, it is described in books simply as if you are laying bricks on top of each other, so estrogen is thickening up the lining. If we keep on giving estrogen what will happen if we keep on putting bricks on top of each other, the wall will fall, so we need some form of sealant. So the embryo will sit in the lining that was thickened by estrogen and the sealant to prevent the lining from coming out or from shedding off is the progesterone. So there’s no pill – so you don’t give pills of estrogen to improve pregnancy but you give pills of estrogen or patches of estrogen or vaginal pessaries of estrogen or injections of estrogen to help in thickening up the lining mainly your doctor will give you estrogen supplements to prepare the lining in case the lining is thin or if you have a frozen embryo in order to thicken up the lining before we put back an embryo, so this is how the estrogen plays around in fertility – it plays a role directly and indirectly.
Answer from: James Nicopoullos, MD
They basically do the opposite because you’ve got almost like a feedback loop: if everything is working really well, as your egg grows, you produce estrogen and if you give estrogen artificially, what will happen is, the brain will actually think “okay, these ovaries are working really really well” and it will stop producing that stimulating hormone that makes your eggs grow. In essence, that’s how the contraceptive pill works – you give issues in a progesterone it switches off the drive from the brain to make eggs go every month. No, estrogen pills definitely won’t help you get pregnant as a default.
What is estrogen role in fertility? How it can be controlled?
Estrogen is considered a “female hormone” and why is that?. What are the types of the estrogen? How does it affect fertility? What levels are correct?