It is best to seek the help of a specialist in Reproductive Medicine and Fetal Medicine if you are under 35 years of age and have not achieved pregnancy in 12 months. For couples over 35, it is recommended after 6 months of effort.
We know that getting into a fertility clinic for exams can be stressful when you do not know what to expect. To help, our fertility experts have created this article that outlines some things you need to know. We will introduce you to the different types of infertility tests and prepare you with a general idea of what constitutes a positive or negative result for each test.
What kind of tests are there to check for fertility?
When you visit our Center, Alexandros Traianos, a specialist in Reproductive Medicine and Fetal Medicine, will want to know about your complete medical history and any previous treatments you may have had, including an overview of the results of previous infertility tests.
A general physical examination of both partners will probably also be needed, where required, in order to assess your general health. Not all types of infertility tests will be needed on a case-by-case basis, so this basic assessment can give the specialist an idea of where to start.
Infertility tests fall into two main types. First, there are blood tests: these tests can analyze the presence and / or amount of different hormones. The second type is imaging that can help the fertility specialist "see" inside your reproductive system to identify what, if any, the problem is. In this article we will analyze blood tests.
Blood tests for infertility
The human body naturally produces a whole range of powerful hormones, each of which has a different role in the complex system that regulates menstruation, ovulation and the reproductive cycle, including pregnancy. Blood helps a doctor evaluate these hormones. Usually, your doctor will ask for them before starting any fertility treatment.
When considering the effects of different hormone levels, it is important to remember that they differ from person to person and can be a sign of different things depending on many factors, such as age and general health history.
Estradiol
Estradiol is one of the most powerful groups of steroid hormones known as estrogens. Controls the development and maintenance of female sexual characteristics and acts on the female reproductive organs, including the lining of the vagina and fallopian tubes. Estradiol is produced by the growth of the follicles, the tiny sacs that contain eggs in the ovaries and leads to the production of fertile mucus from the cervix, as well as preparing the lining of the uterus for a fertilized egg or embryo for implantation.
- Estradiol levels are measured in picograms per milliliter (pg / ml).
- Normal levels vary widely depending on the phase of the menstrual cycle and can range from 30 to 400 pg / ml.
Anti-slip hormone (AMH)
The non-slip hormone is mainly produced in a woman's ovaries.
- Blood AMH levels are measured in nanograms per milliliter (ng / ml).
- Normal levels are considered to be at least above 1.0 ng / ml, although very high levels may indicate another problem.
Follicle stimulating hormone (FSH). Follicle-stimulating hormone is produced by the pituitary gland in the brain. Blood levels vary depending on the menstrual cycle. The increase in FSH during the first half of the cycle stimulates the growth of the follicles and as they mature, it acts together with other hormones to induce ovulation. After ovulation, feedback to the pituitary gland inhibits the release of FSH, lowering levels. - FSH is measured in international units per milliliter (mIU / ml).
- A good level for a baseline test, when FSH should be low, is probably less than 10 mIU / ml, but the results need careful interpretation by a fertility specialist as part of the overall hormone balance.
- Abnormally high FSH levels may be a sign of low ovarian reserve.
Luteinizing hormone (LH)
After the initial stimulation of the follicles by FSH during the first part of the menstrual cycle, an increase in LH produced by the pituitary gland stimulates the release of an egg from the follicle or the process known as ovulation. A measurement of this wave is often used to predict a woman's most fertile period.
Progesterone
- Progesterone prepares the uterus to be ready for implantation of a fertilized egg or fetus after ovulation. If you become pregnant after ovulation, progesterone levels rise and help maintain the pregnancy. If you do not become pregnant, progesterone levels drop and this helps to start a menstrual cycle.
- In a normal menstrual cycle, progesterone levels fluctuate throughout the month.
- You would expect the highest levels in the middle of the lunar phase of your cycle and usually concentrations above 3 ng / ml indicate that you are ovulating.
- levels of 8-10 10 ng / ml are desirable for pregnancy.
Androgens
It is normal to produce small amounts of "male hormones" or androgens, such as testosterone and DHEA-S. However, overproduction leading to unusually high levels could affect follicle development and ovulation. Elevated testosterone levels are often found in polycystic ovary syndrome (PCOS), which can be associated with infertility.
- Blood testosterone is measured in nanograms per decimal (ng / dL).
- Normal levels in women range between 15 and 70 ng / dL in most laboratories.
- Levels that are either lower or higher than this range can cause fertility problems as well as other symptoms.
Prolactin
Prolactin has many functions, but it is commonly known to stimulate milk production in those who are breastfeeding. It is also increased during pregnancy. In the absence of pregnancy, the body usually has low levels of this hormone. High levels could be a side effect of certain medications or be produced by a small growth in the pituitary gland of the brain and can lead to menstrual disorders.
- A normal prolactin level for non-pregnant or lactating women in most laboratories is less than 25 ng / ml.
- Almost all cases of hyperprolactinaemia are easily treated with oral medications.
Thyroid hormones
An underactive thyroid is known as hypothyroidism. A recent study by a team at Harvard Medical School found that, among women with unexplained infertility, low thyroid function was twice as common as women without the condition.
Blood tests for thyroid levels usually measure the amount of thyroid stimulating hormone (TSH) from the pituitary gland. With low circulating thyroid hormone levels, the brain works "overtime" to try to restore optimal levels.
- TSH is measured in thousand international units per liter (mIU / L).
- Normal TSH levels range from 0.4 to 4.0 mIU / L, with levels above this range usually indicating an inactive thyroid. It is important to remember that with all of these blood tests, a single measure of a particular hormone can not be considered a diagnostic of fertility or infertility as hormones are constantly fluctuating. For some hormones, the day of the menstrual cycle when the measurement is taken is critical. In others, there may be reasons for abnormal results not related to fertility. A qualified and experienced fertility specialist is needed to interpret blood test results and make treatment recommendations.
* The content on this blog is not intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of qualified health care providers with questions you may have about medical conditions.
