Blood Tests
Your doctor will order blood tests to get a better understanding of your overall health before starting treatment. These tests reveal blood type, check for possible hormonal imbalances and determine whether you (or your partner) carry any genetic or infectious diseases or antibodies - all of which can affect the health and outcome of a pregnancy.
Hormones That Affect Fertility in Women
Hormones control every step in achieving pregnancy, from stimulating the development of an egg, to ovulation and implantation of a fertilized egg in the uterus. Each hormone that plays a role in conception must be produced in a specific amount at a precise time in a menstrual cycle. Hormonal studies measure the levels of certain hormones produced during a cycle. Blood test results, along with other testing, will help determine the best treatment options.
Hormones that control ovulation and implantation of the egg are:
Estradiol stimulates the growth of your follicles and the production of fertile mucus from the cervix, and prepares your uterine lining for implantation of a fertilized egg.
The level of Anti-Mullerian Hormone (AMH) in your blood is generally a good indicator of ovarian reserve, or the number of eggs in your ovaries.
Follicle-stimulating Hormone (FSH) stimulates the development of the e
Luteinizing Hormone (LH) stimulates the release of the egg from the follicle (ovulation).
Progesterone stabilizes your uterine lining for implantation of a fertilized egg and supports early pregnancy.
Normally, small amounts of androgens — testosterone and DHEAS (dehydroepiandrosterone sulfate) — are produced in women. Excess production may interfere with development of the follicles, ovulation, and cervical mucus production.
Prolactin stimulates milk production. Blood levels may be higher than normal in certain disorders or if you are taking certain medications.
An under-active thyroid (hypothyroidism) can result in high prolactin levels.
What to Expect
During an initial visit, your doctor will review your health history and order blood work before treatment begins. If you had any related blood work within the previous 6-12 months, you should make the results available to your care team. Due to their nature, we may need to do certain tests in-house as opposed to a third party.
Interpreting Results
If any of the above tests reveal abnormalities, your doctor will recommend the best options for going forward. Regarding hormone levels, there are some inconsistencies to consider when interpreting AMH levels. Since the AMH test has not been in routine use for many years, the levels considered to be “normal” are not yet clarified and agreed upon by the experts.
The table below has AMH interpretation guidelines from fertility literature. It is important not to get caught up in the cutoff values shown. For example, the difference between a 0.6 and a 0.7 ng/ml test result puts a woman in a “different box” in this table, but there is little difference in fertility potential. In reality, it is a continuum and not something that categorizes well.