Hormone Levels

Your hormone levels play a huge part in the overall makeup of your general fertility. Some of the easiest testing that can be done to determine fertility issues will be done with timed blood draws to check the levels of certain hormones in your body. Your team of fertility experts will then review this information and discuss with you what the lab work means and how to proceed from this point.

Estradiol (E2)

Your estradiol, or E2, levels are a measure of the estrogen that is being made by your follicles. Typically this number will reflect the size of your follicle, if fertility-enhancing medications are not being used during that cycle. Your E2 levels are often measured in conjunction with other hormones like the follicle stimulating hormone (FSH). Together these numbers can tell you more about your egg quality or ovarian reserve.

The E2 blood test is also used in fertility procedures, like ovulation induction and IVF to measure when it is time to trigger the release of the eggs from the follicles with the hCG injections. It will be measured multiple times during your cycle.

Follicle Stimulating Hormone (FSH)

The FSH test looks for the amount of FSH being produced by your body on day three of your cycle. This test indicates how many quality eggs you have in your ovaries, referred to as your “ovarian reserve.” This test may also indicate how likely your body is to respond to injectable medications for fertility treatments.

Remember, your body works to produce FSH in order to stimulate production of eggs in order for you to ovulate. In the normal course of your life, as you age, the levels of FSH will increase as your body tries to encourage the ovaries to produce follicles.

If you are suffering from premature ovarian failure or have other problems with your egg quality or production, you may see altered levels of your FSH at day three. If the levels of FSH are high on day three and your E2 levels are low, this may indicate a problem. While the problem may be age related, it can also be related to cysts on the ovary.

Clomid Challenge Test (CCCT)

The Clomid Challenge Test (CCCT) is used to help determine ovarian reserve or how well your ovaries function. Your FSH and Estradiol (E2) levels will be tested on day three. You will then be prescribed Clomid (Clomiphene Citrate, 100 mg) from cycle days 5–9. Your FSH and E2 levels will also be checked on day 10. Both day three lab values (FSH and E2) and your day 10 lab values should be within normal limits to be considered normal. If your day 10 FSH levels are higher than 10 mIU/ml you are said to have diminished ovarian reserve. This test is commonly used in women over 35 or if your practitioner suspects that you may have premature ovarian failure.

Progesterone Levels

Your progesterone levels may be checked to determine if your body is producing enough progesterone to sustain a pregnancy. Progesterone begins to rise midcycle, peaking just before menstruation would begin. If a pregnancy has occurred, the progesterone continues to rise. If you did not conceive, your progesterone levels fall, indicating a start to your menstrual flow. Sometimes your progesterone falls even when you are pregnant, and a pregnancy loss occurs. Doctors and researchers do not yet know if the progesterone falls because the pregnancy is lost, or if a drop in progesterone actually causes the pregnancy to be lost. Taking progesterone supplements may help. Progesterone supplementation is designed to help sustain a pregnancy in case it is the drop in progesterone that causes the loss.

Thyroid Levels

The hormonal response systems involved in your body work intricately together to move toward pregnancy. Your thyroid plays a large part in your fertility. If you are experiencing fertility problems or you are having difficulty in conceiving, your practitioner may suggest that you have your thyroid hormones checked, as altered levels may increase the likelihood of infertility.

By checking your thyroid stimulating hormone (TSH) levels and other thyroid hormones, you can get an overall picture of your thyroid's functioning. If indeed, there are problems with your thyroid, simple hormones to help regulate these hormones can have a tremendous effect on your ability to get pregnant.

Other Blood Work

There are many other tests that can be performed to help diagnose fertility problems you may be having. Many of these tests are done based on the outcomes of other test results or based on your medical and family history. For example, if every other test you have is within normal limits, your doctor and fertility team may start looking for causes of infertility that are more genetic in nature. They may do a genetic screening on both you and your partner to ensure that you are not passing down chromosomes that are incompatible with each other.

Another example of this type of testing is to screen blood work to determine if you are experiencing problems with antibodies. This could mean that your body is producing antibodies that either prevent you from getting pregnant or that actually attack a pregnancy that occurred, therefore making you lose the pregnancy very early on in the cycle.

Either of these may be determined by blood work alone or with a combination of blood work and other testing. Talk to your fertility experts about the possibility of this in cases of unexplained infertility, if it has not been brought up to you before.

Be leery of doctors that promise you cure-alls for problems with antibodies. While there are many doctors who practice ethically when it comes to these issues and use methods of treatment that are backed by valid research, there are others who are not so trustworthy. Remember to always check out the references and get second opinions, or you may get scammed.

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