Fertility Test For Women – Lab Test That Can Detect Infertility In Women

• High FSH Levels
  • Primary Ovarian Insufficiency (POI): If your FSH levels are high, it could mean that your ovaries aren’t reacting properly to FSH stimulation. This could mean that your ovarian reserve is low or that you are going through early menopause.
  • Poor Ovarian Reserve: High FSH is common in women whose ovarian reserve has been reduced, which means they aren’t making as many or as good of eggs for their age.⁵ This can make it hard to get pregnant normally.
  • Menopause: When a woman goes through menopause, her FSH levels stay high, which means her ovaries aren’t working as well.⁶
• Low or Normal FSH Levels
  • Hypothalamic or Pituitary Dysfunction: Low FSH levels can mean that there is a problem with the brain or pituitary gland.⁷ This can make it harder for the body to make and control reproductive hormones, which can cause ovulation to happen irregularly or not at all.
  • Polycystic Ovary Syndrome (PCOS): Women with PCOS usually have normal or slightly higher amounts of FSH, but the ratio of LH to FSH is usually higher, which shows a mismatch that can make it hard to ovulate.

• High LH Levels
  • Polycystic Ovary Syndrome (PCOS): A lot of people with PCOS have high amounts of LH or LH/FSH.⁸ This mismatch of hormones can stop ovulation and follicular growth, which can lead to unpredictable periods and infertility.
  • Premature Ovarian Failure (POF) or Primary Ovarian Insufficiency (POI): A high level of LH can mean that the ovaries aren’t reacting to hormones, which could be a sign of POI or early menopause.
• Low or Normal LH Levels
  • Hypothalamic Amenorrhea: Stress, losing a lot of weight, and doing a lot of intense exercise can lower LH levels. This can make the hypothalamus not work properly, which can stop periods and pregnancy.
  • Pituitary Disorders: Infertility and menstruation can be slowed down by tumors and hypopituitarism, which lowers LH output.

LH levels fluctuate during the menstrual cycle, therefore test timing is critical for proper interpretation.

• Mid-Cycle Surge: LH levels rise 28 to 36 hours before ovulation.⁹ Check your LH levels around this time to find out when you will be most fertile and to prove that you have ovulated.
• Day 3 Test: On the third day of the monthly cycle, LH and FSH levels are checked to get a general idea of how well the ovaries are working and how well the hormones are balanced.¹⁰

• High Estradiol Levels
  • Ovarian Hyperstimulation: Conditions such as ovarian hyperstimulation syndrome (OHSS) can lead to an excess of estradiol in the body.¹¹ This can arise during pregnancy procedures such as in vitro fertilization (IVF).
  • Estrogen-Producing Tumors: In extremely rare circumstances, elevated estradiol levels may indicate that the ovaries contain estrogen-producing tumors.
  • Polycystic Ovary Syndrome (PCOS): Women with PCOS may have higher levels of estradiol.
• Low Estradiol Levels
  • Poor Ovarian Reserve: Low levels of estradiol, particularly on Day 3 of the monthly cycle, might indicate that fewer ovarian follicles are active, implying that the ovarian reserve is reduced.
  • Hypothalamic Amenorrhea: Stress, rapid weight loss, and excessive exercise can all have an impact on the brain and result in low levels of estradiol. This might produce irregular or absent menstruation.
  • Premature Ovarian Insufficiency (POI): Low estrogen levels can indicate that a woman is entering early menopause, which occurs when her ovaries cease to function normally before the age of 40.

Estradiol levels are measured at several points throughout the monthly cycle to get thorough information.

• Day 3 Test: Measure your estrogen levels on the third day of your menstruation to determine your ovarian reserve. When levels are high, the body may be compensating for poor cell quality, lowering ovarian reserve.
• Mid-Cycle (Ovulatory) Phase: Estradiol levels before ovulation show that the dominant follicle is developing and that LH is rising at the proper moment.
• Luteal Phase: Estradiol and progesterone levels are evaluated during the luteal phase to assess corpus luteum function and endometrial implantation readiness.

• Low Progesterone Levels
  • Luteal Phase Defect (LPD): If you don’t have enough progesterone during the luteal phase, it could mean that your endometrium isn’t ready for implantation, which can make pregnancy difficult.
  • Anovulation: Low amounts of progesterone during the period could mean that you haven’t ovulated. Anovulation, which means that no egg is available for fertilization, is a common cause of infertility.
  • Miscarriage: In the early stages of pregnancy, low amounts of progesterone can lead to a miscarriage because the hormone helps the baby grow and keeps the lining of the uterus healthy.
• High Progesterone Levels
  • Corpus Luteum Cyst: A cyst in the corpus luteum might produce an abnormally high amount of progesterone.
  • Hormonal Imbalance: If your progesterone levels are high outside of the luteal phase, your hormones may be out of balance, affecting your fertility.

To obtain trustworthy findings, progesterone levels are frequently measured at specific intervals during the monthly cycle:

• Mid-Luteal Phase (Day 21 Test): Progesterone levels are checked around Day 21 of a 28-day cycle, which is seven days after ovulation. At this point, the corpus luteum makes enough progesterone to support the uterus so that the egg can implant.
• Confirmation of Ovulation: The level of progesterone can determine whether or not ovulation occurred.¹² If the amount of progesterone rises significantly, it indicates that ovulation has occurred and the corpus luteum is active.

• High Prolactin Levels (Hyperprolactinemia)
  • Menstrual Irregularities: High amounts of prolactin stop the hypothalamus from releasing GnRH, which stops the production of sexual hormones like estrogen and progesterone.¹³ This can have an impact on infertility because it can cause irregular periods or amenorrhea.
  • Anovulation: When prolactin levels are high, FSH and LH production goes down, which throws off the ovulatory cycle. When the ovary doesn’t produce an egg, this is called anovulation, and it stops fertilization.
  • Galactorrhea: Hyperprolactinemia can lead to galactorrhea, which is when your body makes too much breast milk. Even though it’s not directly linked to fertility, it often happens with irregular periods and could be a sign of chemical changes that affect fertility.
  • Prolactinomas: Prolactinomas are benign growths of the pituitary gland that can make more prolactin. These tumors can cause headaches, vision issues, irregular periods, and impotence.
• Low Prolactin Levels
  • Rare Conditions: Low prolactin levels may be a sign of hypopituitarism or pituitary gland failure, but impotence is not a common symptom. Fertility may be affected if the body doesn’t make enough of other biological hormones.

You may test your prolactin levels at any time during your period, but to get accurate results, you typically need to follow these steps:

• Fasting Sample: Prolactin levels are often measured in the morning, following a time of not eating or drinking. This is because levels can be influenced by recent food consumption, stress, and physical activity.
• Repeated Measurements: Because prolactin levels vary, testing is routinely repeated to ensure consistency and accuracy.