Hormonal Evaluation

Certain blood hormone tests are performed on women to help evaluate possible causes of infertility or other problems, including ovulation disorders, deficiencies in egg quality, immunological disorders and exposure to infectious organisms. These blood tests often must be done at certain times of day or specific times in the menstrual cycle.

Follicle stimulating hormone (FSH) and estradiol (E2) levels are determined from blood tests performed on the second or third day of the menstrual cycle. These hormone tests help to determine how likely a woman is to respond to ovarian stimulation medications. This likelihood is known as the ovarian competence or ovarian reserve. Elevations in FSH and E2 levels may indicate diminished ovarian function and compromised egg quality and/or quantity.

A clomiphene citrate challenge test (CCCT) is sometimes used to determine the ovarian competence or reserve in a woman suspected of having possible compromised ovarian function. In this test, clomiphene citrate (Clomid), an ovulation-inducing medication, is taken by mouth (100 mg per day) on days 5 through 9 of the menstrual cycle. Blood hormone levels are determined on day 3 and day 10 of the menstrual cycle.

Anti-Müllerian hormone (AMH) level: This hormone test also helps determine how likely a woman is to respond to ovarian stimulation medications, and thus is another marker for ovarian competence or ovarian reserve. Low levels of AMH may indicate diminished ovarian function and compromised egg quality and/or quantity.

Estradiol (E2) levels are also determined on several mornings during a medication stimulation cycle. These hormone levels help to determine a woman’s response to the medications and help the physicians determine the appropriate medication doses to be used.

Progesterone levels are often used to determine if a woman is approaching or has already achieved ovulation.

Thyroid stimulating hormone (TSH) and prolactin levels are used to determine if the thyroid gland and pituitary glands are functioning properly. Elevations in these hormones might indicate hormonal disorders that can compromise fertility and reproductive health.

Testosterone, DHEAS and 17-hydroxyprogesterone levels are often used to determine if a woman is producing elevated levels of androgens (male hormones) and from what source in the body. These levels are often determined in women suffering from ovulation disorders with evidence of excess hair growth on the body, increased acne or scalp hair loss, with or without obesity.

An oral glucose tolerance test is used to determine if a woman has difficulty processing sugar (glucose), a possible consequence of a disorder called insulin resistance. In this disorder, the pancreas makes excess insulin which can cause the ovaries to release excess androgens, potentially having an adverse effect on general health as well as fertility. In this test, hormone levels are determined while fasting and then the woman drinks 75 grams of glucola, a sweet, orange-flavored drink. Two (2) hours later, hormone levels are again determined.

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