If you are unable to become pregnant after one year of unprotected intercourse, or six months of unprotected intercourse if you are a woman over 35, you and your partner should have a full physical and medical evaluation.Several blood tests are available to determine if you, your partner, or both of you have a problem that is causing infertility. FSH
Follicle-stimulating hormone (FSH) helps control a woman’s menstrual cycle and the production of eggs. In men, it regulates the production and transportation of sperm.
For women, a FSH test is done on the third day of the menstrual cycle and is used to evaluate egg supply. For men, the test is used to determine sperm count.
Estradiol is an important form of estrogen. An estradiol test is used to measure a woman’s ovarian function and to evaluate the quality of the eggs. Like FSH, it is done on the third day of a woman’s menstrual cycle.Luteinizing Hormone Level
In women, luteinizing hormone (LH) is linked to ovarian hormone production and egg maturation. In men, it stimulates the hormone testosterone which affects sperm production.
An LH test is used to measure a woman’s ovarian reserve (egg supply) and a man’s sperm count. It is done during a woman's menstrual cycle to see if she is ovulating
Progesterone is a female hormone produced by the ovaries during ovulation. It causes the endometrial lining of the uterus to get thicker, making it receptive for a fertilized egg.
A serum progesterone test is used to determine if ovulation is occurring. Since progesterone levelsincrease towards the end of a woman’s cycle, the test is done during the luteal phase of the menstrual cycle (just before her period starts).
The hormone prolactin is made by the pituitary gland and causes milk production.
In women, a prolactin test is done to find out why they are not menstruating, or why they are having infertility problems or abnormal nipple discharge. The test is done in men when there is a lack of sexual desire, difficulty getting an erection, or if there might be a problem with the pituitary gland.
Testosterone is probably the most well-known androgen and it affects the sexual functioning of both men and women.
In men, an androgen test is used to find the cause of a low sex drive, the inability to get an erection, or infertility. In women, it is used to determine the cause of irregular periods or a low sex drive.
Female Hormonal Assays
Hormonal assays are advised and recommended by your obstetrician/gynecologist when irregularities are identified in your menstrual cycle or physical examination. We at ARMC offer various hormonal procedures such as tests to check FSH and LH levels, estrogen and progesterone levels, testosterone, thyroid tests, androgens and prolactin levels. The results of these hormonal tests are helpful in determining the cause of any irregularities and also the best treatment plan for each patient.
• Thyroid Tests: The thyroid-stimulating hormone (TSH) is checked for any problems affecting the thyroid gland. This hormone plays a crucial role in fertility, the ability to get pregnant and sustain a normal pregnancy, successful breastfeeding etc.
• Estrogen: Estrogen is important as itstimulates the development of the endometrium, the membrane that lines the uterus. There are three types of estrogen found in the body - estrone, estradiol (E2), and estriol. Reduced levels of estradiol indicate unhealthy eggs present in the follicles. Estrogen levels are normally measured over many days since they vary greatly during the menstrual cycle.
• Progesterone:The hormone progesterone is produced after ovulation and it indicates if there has been a successful implantation. The progesterone test is carried out four to nine days after predicted ovulation to identify if ovulation has in fact occurred. Low levels of progesterone indicateabsence of ovulation or anovulation.
• Prolactin: The prolactin hormone is responsible for stimulating production of milk during pregnancy. Excess prolactin secretion results in a condition called hyperprolactinemia which can cause a number of reproductive dysfunctions such as absence of menstruation, irregular ovulation and menstruation and galactorrhea.
• FSH and LH Levels: Follicle Stimulating Hormone (FSH) and Luetinizing Hormone (LH) control the functions of the ovaries. These hormone tests are normallyadvised for women who have irregular menstrual cycles or who do not ovulate normally.
• Testosterone and Other Androgens: The ovaries and adrenal glands usually produce small amounts of male hormones called androgens such as testosterone. Over-production of these androgens adverselyaffects normal ovulation.
Male Hormonal Assays
Male hormonal testing is recommended by doctors tohelp couples understand what factors may be contributing to their inability to conceive. Infertility affects men and women with almost equal frequency. Factors that contribute to male infertility includepoor sperm motility, low sperm count and abnormal semen levels or function. At ARMC, we evaluate male hormones vitalfor sperm production, such asluteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin and testosterone.
• Testosterone Tests:Testosterone is a hormone that stimulates production of sperms and is crucial for sperm motility. Low testosterone levels often translate to a low sperm count.
• Prolactin Tests:High levels of the hormone prolactin cause abnormal semen production.
• Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH)Tests: The FSH hormone stimulates the production of sperms while the LH hormone stimulates the testes to secrete the hormone testosterone. High levels of both the hormones indicate a failure of testicular function while low levels of FSH and LH may indicate that the testes are not receiving an adequate stimulatory message from the pituitary gland or hypothalamus which can be improved with hormone therapies.
Hormone Assays (Tests)
Why are hormone assays required
A woman's fertility is not perceived merely in terms of mucus, or tubes or ovaries. The complex relationship between the brain, pituitary gland and the ovaries also needs to be studied. It is often essential to measure the levels of the various hormones in the body, which may play a part in the control of ovulation
Infertility treatment takes a holistic approach. A woman's fertility is not perceived merely in terms of mucus, or tubes or ovaries. The complex relationship between the brain, pituitary gland and the ovaries also needs to be studied. It is often essential to measure the levels of the various hormones in the body, which may play a part in the control of ovulation.What will hormone assays tell the doctor
There are certain key hormones that are involved in the whole process of ovulation. These are follicle stimulating hormone (F.S.H.), luteinizing hormone (LH), estrogen and progesterone. In addition, another pituitary hormone called prolactin can interfere with the normal pituitary secretion of F.S.H. Disorders of the thyroid gland can also adversely affect fertility. If, for example, your periods are very infrequent or have even stopped altogether (and you are not pregnant!), assays of prolactin. F.S.H., estrogen and thyroid hormone levels can be very useful in indicating the cause of your problem and thereby suggest a particular line of further investigation or treatment.How is the normal production of these hormones determined
Your progesterone level should be at the maximum level at the mid-point of the luteal phase of the cycle, between ovulation and the next period. This is a sign that ovulation had taken place. A low progesterone level at this time of the cycle (about day 21 of a 28 day cycle) indicates that normal ovulation in this cycle has not occurred. This, in turn, may be linked to an inadequate release of both F.S.H. and L.H. from the pituitary gland. A basal body temperature chart with a short luteal phase of less than 11 days may also indicate inadequate progesterone production.