Hormonal Evaluation

Hormonal evaluation studies help identify hormonal imbalances that may impair your fertility. Hormones control every step in achieving pregnancy-from stimulating the development of an egg to ovulation and implantation of a fertilized egg in the uterus. Each hormone that plays a role in conception must be produced in a specific amount at a precise time in your menstrual cycle. Hormonal studies measure the levels of certain hormones produced by your body during your cycle. You are likely to have a series of blood tests at various points in your cycle. The tests your healthcare provider orders may help determine your diagnosis as well as identify the best treatment options.

Serum Estradiol

Estradiol is produced by the ovarian follicles. Estradiol is important for the growth of the lining of the uterus (endometrium) and the production of mucus in the cervix. Estradiol is measured when on gonadotropins for ovulation stimulation to assess egg maturity.

Follicle Stimulating Hormone (FSH)

Follicle stimulation hormone is produced by the pituitary gland and stimulates the growth of the eggs in the ovary. It is often measured during menses to indirectly evaluate egg quality.

Lutenizing Hormone (LH)

Lutenizing hormone is also produced by the pituitary gland and triggers the release of the egg from the ovary.

Serum Progesterone

Progesterone is a hormone that only appears in the blood after ovulation. The level of progesterone present depends upon the time that has occurred since ovulation and the quality of ovulation. Blood is usually drawn 7-9 days after expected ovulation. Usually, this means around day 20-23 of the menstrual cycle.

Thyroid Stimulating Hormone (TSH)

Thyroid stimulating hormone is produced by the pituitary gland and stimulates the thyroid gland to produce various thyroid hormones. These thyroid hormones perform many functions within the body. An abnormal TSH level may be associated with infertility.

Prolactin

The hormone prolactin is produced by the pituitary gland and stimulates the production of breast milk in the pregnant woman. Elevated levels of prolactin can affect fertility.

Anti-Mullerian Hormone (AMH) 

Anti-Mullerian Hormone is produced within the ovary. This hormone is a direct measure of a woman’s egg quality and ovarian reserve.

Androgens

Androgens are male hormones like testosterone and dehydroepiandrosterone sulfate (DHEAS) that are produced in women in low levels by the ovaries and adrenal glands. Excess production of androgens are seen in conditions like polycystic ovarian syndrome (PCOS) and can affect fertility.

Prenatal Testing

Prenatal screening laboratory tests (blood type, RPR, HbsAg, hepatitis C, HIV, rubella immunity, cystic fibrosis screening) are recommended on all women who are planning to conceive. In addition, women who are at risk to transmit certain genetic disorders based on their ethnicity may be recommended to have additional screening blood tests drawn. Cervical cultures for chlamydia and gonorrhea may be obtained at the first office visit.

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