Blood Tests for Infertility
When you are not able to conceive for 6 months or a year despite unprotected sex, it is termed infertility. It can be because of various reasons in both men and women. So before beginning any treatment, your doctor will first recommend a certain blood tests for infertility for both partners to find the exact cause of infertility.
Only some tests are recommended for all patients. Depending on their condition, your fertility specialist may recommend some of the following blood tests.
Table of Contents
FSH Testing
Follicle-stimulating hormone test is done to determine the condition of women’s egg supply. This FSH hormone helps control a woman’s menstrual cycle, egg production, and ovarian function. The blood test is done on the second and third day of the menstrual cycle to find the cause of the problem.
| Topic | Information |
|---|---|
| FSH | A hormone produced by the pituitary gland in the brain |
| FSH Testing | A blood test that can be done at any time during the menstrual cycle |
| Normal FSH Levels | Below 10 IU/L on day 3 of the menstrual cycle |
| Elevated FSH Levels | May indicate a decrease in ovarian reserve or other hormonal imbalances such as PCOS |
| Low FSH Levels | May indicate anovulation or premature ovarian failure |
In Males, the production and transportation of sperm are controlled by the FSH hormone. So this FSH test in males is done to determine the sperm count.
One hormone that is often evaluated in women with infertility is follicle-stimulating hormone (FSH). Here, we will discuss what FSH is, how it is tested, and what the results mean for diagnosing female infertility.
What is FSH?
Follicle-stimulating hormone (FSH) is a hormone that is produced by the pituitary gland in the brain. In women, FSH is responsible for stimulating the growth of ovarian follicles, which contain the eggs that will be released during ovulation.
FSH is produced in a cyclic pattern, with levels increasing in the first half of the menstrual cycle to stimulate the growth of ovarian follicles. In men, FSH plays a role in the production of sperm.
How is FSH Tested?
FSH testing is a simple blood test that can be done at any time during the menstrual cycle. However, the timing of the test may be important for interpreting the results.
In general, FSH levels should be tested on day 3 of the menstrual cycle. This is because FSH levels are at their lowest during this time and can provide an accurate assessment of ovarian reserve, which is a measure of a woman’s fertility potential.
What are Normal FSH Levels?
The normal range for FSH levels varies depending on the age of the woman. In general, FSH levels should be below 10 IU/L on day 3 of the menstrual cycle. However, as women age, FSH levels may increase due to a decline in ovarian reserve. Women who are over the age of 40 may have FSH levels above 10 IU/L and still be within the normal range.
What do Elevated FSH Levels Mean?
Elevated FSH levels on day 3 of the menstrual cycle may indicate a decrease in ovarian reserve. This means that the ovaries may not be producing as many viable eggs as they did in the past. Elevated FSH levels can also indicate other hormonal imbalances, such as polycystic ovary syndrome (PCOS). Women with elevated FSH levels may have difficulty conceiving naturally and may require fertility treatments such as in vitro fertilization (IVF).
What do Low FSH Levels Mean?
Low FSH levels on day 3 of the menstrual cycle may indicate anovulation, which is the absence of ovulation. This can be caused by hormonal imbalances such as hypothyroidism or hyperprolactinemia. Low FSH levels can also indicate premature ovarian failure, which is the loss of ovarian function before the age of 40. Women with low FSH levels may also have difficulty conceiving and may require fertility treatments.
Estradiol Test
Estradiol is a form of estrogen hormone. This hormone is responsible for sexual development and is required for estrogen production. Doctors may perform this test to know the cause of infertility. This estradiol blood test is recommended to measure ovarian function and evaluate egg quality.
This test is also recommended for missing periods, abnormal bleeding, and damage to the adrenal glands, Ovaries or testes in men.
| Estradiol Test | Information |
|---|---|
| Hormone | Estradiol |
| Function | Involved in the development and maturation of ovarian follicles |
| Diagnostic Tool | Used to diagnose female infertility |
| Ovarian Function | Monitored using estradiol levels during fertility treatment |
| Ovarian Reserve | Assessed using estradiol levels to determine remaining follicles |
| Hormonal Imbalances | Estradiol levels used to assess hormonal imbalances |
| Ovulation Timing | Estradiol levels are used to time ovulation |
| Test Method | Simple blood test |
| Timing of Test | Typically performed on the third day of the menstrual cycle |
| Test Results | High levels of estradiol can indicate a problem with the ovaries |
| Statutory Limitations | None known in the context of estradiol testing |
What is Estradiol?
Estradiol is a type of estrogen hormone that is produced by the ovaries. It is involved in the development and maturation of the ovarian follicles, which eventually release an egg during ovulation. Estradiol also plays a crucial role in the thickening of the uterine lining, preparing it for pregnancy.
How is Estradiol Testing Used to Diagnose Female Infertility?
Estradiol testing is a vital diagnostic tool for female infertility. Here are some ways in which it is used:
- Monitoring Ovarian Function: Estradiol levels are used to monitor ovarian function during fertility treatment, such as in-vitro fertilization (IVF). High estradiol levels can indicate the presence of a dominant follicle, which can be an indication of ovulation.
- Assessing Ovarian Reserve: Estradiol levels can also be used to assess ovarian reserve, or the number of follicles remaining in the ovaries. As women age, the number of follicles decreases, leading to a decline in fertility. Low estradiol levels can be an indication of diminished ovarian reserve.
- Assessing Hormonal Imbalances: Estradiol levels are also used to assess hormonal imbalances that can contribute to infertility. High levels of estradiol, for example, can indicate a problem with the ovaries, such as polycystic ovary syndrome (PCOS).
- Timing Ovulation: Estradiol levels are also used to time ovulation. As the follicles mature, estradiol levels increase. When the levels reach a certain point, ovulation occurs, and the egg is released.
What Does the Estradiol Test Involve?
The estradiol test is a simple blood test. A small amount of blood is taken from a vein in the arm, and the estradiol level is measured. The test is typically performed on the third day of the menstrual cycle, as estradiol levels are at their lowest point at this time. If estradiol levels are measured at other times during the cycle, the results may be less reliable.
Luteinizing Hormone Level
Pituitary gland secretes this hormone. This pituitary gland stimulates ovulation in women and the fusion of androgen in men. This hormone is essential for the functioning of ovaries in women and stimulates the testosterone hormone that affects sperm production in men.
This blood test can determine whether infertility is caused due to the failure of the ovaries or the pituitary gland.
| Aspect | Information |
|---|---|
| What is luteinizing hormone? | A hormone produced by the pituitary gland that helps regulate ovulation and the menstrual cycle. |
| Why is the test performed? | To measure the level of LH in a woman’s body, which can help diagnose infertility and other reproductive disorders. |
| Preparing for the test | Talk to your doctor about any medications or supplements you’re taking. Follow any instructions provided by your doctor to ensure accurate results. |
| How is the test performed? | A simple blood test that can be performed in a doctor’s office or clinic. A small sample of blood is taken from a vein in the arm and sent to a laboratory for analysis. |
| Interpreting the results | LH levels vary depending on the stage of the menstrual cycle. Abnormal results may indicate a problem with ovulation, and further testing may be necessary to determine the cause. |
What is Luteinizing Hormone?
Luteinizing hormone is a hormone that plays a key role in the female reproductive system. It is produced by the pituitary gland and helps to regulate ovulation and the menstrual cycle. LH stimulates the ovaries to release eggs, and it also plays a role in the production of progesterone.
Why is the Luteinizing Hormone Level Test Performed?
The Luteinizing Hormone Level Test is performed to measure the level of LH in a woman’s body. This test is often used to diagnose infertility and other reproductive disorders, as it can help identify problems with ovulation. In addition, the Luteinizing Hormone Level Test can be used to monitor women who are undergoing fertility treatments, such as ovulation induction and in vitro fertilization (IVF).
Preparing for the Luteinizing Hormone Level Test
Before having a Luteinizing Hormone Level Test, it is important to talk to your doctor about any medications or supplements that you are taking. Certain medications and supplements can affect LH levels, so your doctor may ask you to stop taking them before the test.
The Luteinizing Hormone Level Test is usually performed on the third day of a woman’s menstrual cycle. It is important to follow any instructions provided by your doctor, as this will ensure that the test is accurate.
How is the Luteinizing Hormone Level Test Performed?
The Luteinizing Hormone Level Test is a simple blood test that can be performed in a doctor’s office or clinic. The test involves taking a small sample of blood from a vein in the arm. The blood sample is then sent to a laboratory for analysis.
Interpreting the Results of the Luteinizing Hormone Level Test
| LH level | Menstrual cycle stage | Interpretation |
|---|---|---|
| Low (1.5-15.0 mIU/mL) | Follicular phase (first half of cycle) | Normal LH levels during this phase help follicle development in the ovary |
| High (0.5-10.0 mIU/mL) | Luteal phase (second half of cycle) | LH surge triggers ovulation; normal LH levels during this phase maintain corpus luteum |
| Too low | Any cycle stage | Pituitary gland dysfunction or premature ovarian failure |
| Too high | Any cycle stage | Polycystic ovary syndrome (PCOS), primary ovarian failure, or other hormonal imbalances that can affect ovulation |
The results of the Luteinizing Hormone Level Test are usually reported in milli-international units per milliliter (mIU/mL). The normal range for LH levels varies depending on the stage of the menstrual cycle.
- During the follicular phase (the first half of the menstrual cycle), LH levels are typically low, ranging from 1.5 to 15.0 mIU/mL.
- During the luteal phase (the second half of the menstrual cycle), LH levels are typically higher, ranging from 0.5 to 10.0 mIU/mL.
Abnormal results from the Luteinizing Hormone Level Test may indicate a problem with ovulation. If LH levels are too low, it may indicate a problem with the pituitary gland, which can affect ovulation. If LH levels are too high, it may indicate polycystic ovary syndrome (PCOS) or other hormonal imbalances that can affect ovulation.
In some cases, further testing may be necessary to determine the cause of abnormal LH levels. This may include other blood tests, ultrasounds, or other diagnostic procedures.
Prolactin Levels Test
This prolactin hormone plays an important role in milk production and is a hormone made by the pituitary gland. During pregnancy, the level of this hormone increases and inhibits ovulation after the delivery, which is why women do not get periods after delivery or when they become pregnant. But if the prolactin level increases without a pregnancy or delivery, it leads to infertility.
| Topic | Information |
|---|---|
| Hormone | Prolactin |
| Produced by | Pituitary gland |
| Role in female fertility | Regulates menstrual cycle and ovulation |
| Effect on fertility | High levels can interfere with ovulation, causing infertility |
| Diagnosis | Blood test to determine prolactin levels |
| Causes of high prolactin levels | Stress, medications, tumors in the pituitary gland, thyroid dysfunction |
| Treatment options | Dependent on underlying cause; can include surgery or medications to lower prolactin levels and restore fertility |
Relationship between Prolactin Levels and Infertility:- High levels of prolactin can interfere with the body’s ability to ovulate, leading to infertility. This is because prolactin inhibits the production of other hormones necessary for ovulation, such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
Diagnosing Infertility with Prolactin Levels:- The level of prolactin in the blood can be used to diagnose infertility. A blood test can determine the level of prolactin in the body, and if it is found to be high, further tests may be needed to investigate the cause.
Causes of High Prolactin Levels: -Several factors can contribute to high prolactin levels, including stress, medications, tumors in the pituitary gland, and thyroid dysfunction.
Treatment for High Prolactin Levels:– The treatment for high prolactin levels depends on the underlying cause. For example, if the cause is a tumor in the pituitary gland, surgery may be required. Medications such as dopamine agonists can also be used to lower prolactin levels and restore fertility.
Androgen
Androgen affects the sexual functioning of both men and women. An Androgen test in women is done to test its level because a high level of androgen can cause polycystic ovary syndrome, and women with PCOS do not ovulate, which results in infertility.
Androgens are male sex hormones that are also present in women in smaller quantities. Androgens play a crucial role in female reproductive health, including the development and maintenance of female reproductive organs, sex drive, and menstrual cycles.
How are Androgen Levels Tested?
| Androgen Test | Default Value |
|---|---|
| Total Testosterone | 6 – 86 ng/dL |
| Free Testosterone | 0.1 – 6.4 pg/mL |
| DHEA-S | 35 – 430 ug/dL |
Androgen levels can be tested through a simple blood test. The blood sample is usually taken in the morning, as androgen levels are known to fluctuate throughout the day.
Role of Androgen Testing in Diagnosing Female Infertility
- Identifying Polycystic Ovary Syndrome (PCOS):-One of the most common causes of female infertility is Polycystic Ovary Syndrome (PCOS). Women with PCOS typically have higher than normal androgen levels. An androgen test can help identify the elevated androgen levels in women with PCOS, which can help diagnose the condition and guide treatment.
- Assessing Ovarian Reserve: Androgen levels can be an indicator of a woman’s ovarian reserve, which refers to the number of eggs a woman has available for fertilization. Women with low ovarian reserve may have lower androgen levels.
- Evaluating Fertility Treatment Response:– Androgen testing can be used to assess the effectiveness of certain fertility treatments, such as ovulation induction. If androgen levels increase in response to treatment, it can indicate that the treatment is working.
Anti-Mullerian Hormone (AMH)
The AMH test measures the level of anti-Mullerian hormone in a woman’s blood. This hormone is produced by cells in the ovarian follicles, and its level is directly related to a woman’s ovarian reserve. In other words, the higher the level of AMH, the greater the number of viable eggs a woman has.
Role of the AMH Test in Diagnosing Ovarian Reserve
The AMH test is a useful tool in diagnosing ovarian reserve because AMH levels are directly correlated with the number of viable eggs a woman has left. Higher levels of AMH indicate that a woman has a higher number of viable eggs in her ovaries, while lower levels of AMH suggest that a woman has a lower ovarian reserve.
Compared to other tests used to assess ovarian reserve, the AMH test has some advantages. For example,
Interpret AMH Test Results
Interpreting AMH test results requires an understanding of the normal ranges of AMH levels and how they correlate with ovarian reserve. Generally, higher levels of AMH indicate a higher ovarian reserve, while lower levels of AMH suggest a lower ovarian reserve. However, it’s important to keep in mind that other factors, such as age and fertility history, can also affect a woman’s chances of getting pregnant.
Here is a table outlining the typical AMH levels and what they indicate in terms of ovarian reserve:–
| AMH Level (ng/mL) | Ovarian Reserve |
|---|---|
| 0.7 or less | Low |
| 0.7 – 1.1 | Low to Normal |
| 1.2 – 4.0 | Normal |
| 4.1 or higher | High |
It’s important to note that the reference range for AMH levels may vary depending on the laboratory where the test was performed. Therefore, it’s best to consult with a doctor who can interpret the results based on the specific reference range used by the laboratory.
In addition to the AMH level, doctors may also consider other factors when interpreting the AMH test results, such as a woman’s age and fertility history. For example,
- If a woman has a low AMH level but is still relatively young and has not been trying to conceive for very long, her chances of getting pregnant may still be good.
- Conversely, if a woman has a high AMH level but is older and has a history of infertility, her chances of getting pregnant may still be lower.
Other Uses of the AMH Test in Reproductive Medicine
In addition to its role in diagnosing ovarian reserve in the context of female infertility, the AMH (anti-Mullerian hormone) test has several other uses in reproductive medicine. Here are some of them:
- Assessing the response to fertility treatments: The AMH test can be used to predict a woman’s response to fertility treatments, such as in vitro fertilization (IVF). Women with higher AMH levels are more likely to respond well to fertility treatments and produce a higher number of viable eggs.
- Diagnosing polycystic ovary syndrome (PCOS): PCOS is a common hormonal disorder that can cause infertility. Elevated AMH levels are a characteristic feature of PCOS, and the AMH test can be used to aid in its diagnosis.
- Monitoring ovarian function in cancer patients: Some cancer treatments, such as chemotherapy and radiation therapy, can damage the ovaries and cause infertility. The AMH test can be used to monitor ovarian function in cancer patients and predict their chances of fertility after treatment.
- Predicting the onset of menopause: As women age, their ovarian reserve declines, eventually leading to menopause. The AMH test can be used to predict the onset of menopause and help women make informed decisions about family planning.
Overall, the AMH test is a versatile tool in reproductive medicine that can provide valuable information for both patients and doctors. By measuring AMH levels, doctors can better understand a woman’s fertility potential and make informed decisions about the best course of treatment.
Limitations of the AMH Test in Diagnosing Female Infertility
While the AMH (anti-Mullerian hormone) test is a valuable tool in diagnosing female infertility, it does have some limitations that should be considered. Here are some of the main limitations of the AMH test:–
- It does not provide a complete picture of fertility: While AMH levels are correlated with ovarian reserve, they do not provide a complete picture of fertility. Other factors, such as a woman’s age, the quality of her eggs, and the health of her uterus and fallopian tubes, also play a role in fertility.
- It does not predict pregnancy success: While the AMH test can provide information about a woman’s ovarian reserve, it cannot predict whether a woman will become pregnant. Many other factors, such as the quality of a woman’s partner’s sperm and the timing of intercourse, also play a role in pregnancy success.
- It has limitations in women with certain medical conditions: The AMH test may not be as accurate in women with certain medical conditions, such as polycystic ovary syndrome (PCOS) or premature ovarian failure (POF).
- It has limitations in women using hormonal contraceptives: The AMH test may not be accurate in women who are using hormonal contraceptives, as these can affect AMH levels.
- It may have different reference ranges: The reference ranges for AMH levels may differ depending on the laboratory where the test was performed, which can make it difficult to compare results across different labs.
In summary, while the AMH test is a useful tool in diagnosing female infertility, it is important to keep in mind its limitations. Doctors should use the test in conjunction with other diagnostic tools and take into account a woman’s age, fertility history, and other factors when assessing fertility potential.
Thyroid-Stimulating Hormone (TSH)
The thyroid gland produces hormones that regulate metabolism, growth, and development, and if there is a dysfunction in this gland, it can lead to a range of health problems, including infertility. Here, we will discuss the importance of the Thyroid-Stimulating Hormone (TSH) test in diagnosing female infertility.
This test is done to check for thyroid disease among women. It can be either hypothyroidism or hyperthyroidism. Either of the conditions can cause infertility problems because of hormone imbalances.
What is TSH Test?
Thyroid-Stimulating Hormone (TSH) is a hormone produced by the pituitary gland in the brain, and it plays a crucial role in regulating thyroid hormone production. The TSH test measures the level of this hormone in the blood, and it is one of the most common tests used to diagnose thyroid disorders.
How is TSH Test Related to Female Infertility?
The thyroid hormones play a crucial role in regulating the menstrual cycle and fertility. An underactive thyroid gland (hypothyroidism) can lead to irregular periods, anovulation (lack of ovulation), and infertility. On the other hand, an overactive thyroid gland (hyperthyroidism) can also cause menstrual irregularities and reduce fertility.
Importance of TSH Test in Diagnosing Female Infertility
The TSH test is essential in diagnosing female infertility because it helps identify any underlying thyroid disorders that may be affecting fertility.
| TSH Test Result | Interpretation |
|---|---|
| Less than 0.4 mIU/L | Hyperthyroidism |
| 0.4 – 4.0 mIU/L | Normal Range |
| 4.0 – 10.0 mIU/L | Borderline High |
| Greater than 10.0 mIU/L | Hypothyroidism |
- A high TSH level indicates hypothyroidism, which can be treated with thyroid hormone replacement therapy to restore normal thyroid function and improve fertility.
- In contrast, a low TSH level indicates hyperthyroidism, which can be treated with medications or surgery to regulate thyroid function and improve fertility.
Note that the reference ranges for TSH levels may vary slightly depending on the laboratory performing the test, and some labs may have slightly different cutoffs for what is considered normal or abnormal. It is important to consult with a healthcare provider to interpret TSH test results in the context of an individual’s medical history and symptoms.
When to Get TSH Test?
The TSH test should be a part of the routine fertility evaluation for all women who are struggling to conceive. Additionally, women with irregular menstrual cycles, recurrent miscarriages, or a family history of thyroid disorders should also get the TSH test done to rule out any thyroid-related fertility problems.
Progesterone
Progesterone is a hormone that plays a crucial role in the menstrual cycle and pregnancy. It is produced by the ovaries after ovulation and prepares the uterus for implantation of a fertilized egg. In diagnosing female infertility, progesterone levels can provide valuable information about the function of the ovary and the timing of ovulation.
Progesterone levels can be measured through a blood test, typically on day 21 of a 28-day menstrual cycle, to determine if ovulation has occurred. This is because progesterone levels rise after ovulation and remain elevated during the luteal phase of the menstrual cycle. A progesterone level of at least 10 ng/mL on day 21 is considered to be a reliable indicator of ovulation.
| Menstrual Cycle Day | Progesterone Level |
|---|---|
| Day 1-14 | Less than 1 ng/mL |
| Day 15 | 1-5 ng/mL |
| Day 16 | 2-10 ng/mL |
| Day 17 | 5-20 ng/mL |
| Day 18 | 10-30 ng/mL |
| Day 19 | 15-40 ng/mL |
| Day 20 | 20-50 ng/mL |
| Day 21 | 30-100 ng/mL |
| Day 22 | 30-90 ng/mL |
| Day 23 | 20-80 ng/mL |
| Day 24 | 10-60 ng/mL |
| Day 25 | 1-30 ng/mL |
| Day 26-28 | Less than 1 ng/mL |
It’s important to note that these levels can vary between individuals and from cycle to cycle, so a single measurement may not always be indicative of a problem.
Additionally, these ranges are for illustrative purposes only and may vary depending on the specific laboratory and testing method used. A healthcare provider should be consulted to interpret progesterone test results in the context of an individual’s unique situation.
Progesterone levels can also be measured in early pregnancy to monitor the health of the pregnancy. Low progesterone levels in early pregnancy can be a sign of a miscarriage or ectopic pregnancy. Progesterone supplementation may be prescribed to support the pregnancy in these cases.
Conclusion
These blood tests are done to know the cause of infertility in both men and women. A doctor may suggest some of the tests per your condition to know the cause of infertility, provide treatment accordingly, and improve your fertility health.