FSH/LH/E2

A cornerstone of the female fertility evaluation is the measurement of day three hormone levels including FSH, LH, estrogen, androgens, thyroid hormone, etc.   The FSH level will be elevated in women who have reduced ovarian reserve and the degree of elevation correlates with “egg quality” and the chances of conception.

An abnormally high FSH level, above 15 mIU/mL signifies ovarian failure and an egg donor will be required.  An FSH level above 10 miu/ml is an indication of diminishing ovarian reserve and reduced probability of conception. If the ratio of FSH/LH is above 2.5 it is a similarly poor prognosis for pregnancy. Oftentimes, the Clomid Challenge Test is used to further evaluate ovarian reserve and predict the probability of success using FSH ovulation induction for IVF.

Women with elevated FSH levels, especially if they are older, are often candidates for our donor egg program. IVF success rates using an egg donor match the donor’s age group and are typically high.

Androgens

Androgens are male hormones normally present in the milieu of female hormones. When androgen levels are abnormally high, it can lead to irregular or no ovulation and the expression of “male characteristics”.

Excessive androgen hormones are seen in women with polycystic ovarian syndrome (PCOS), a relatively common cause of infertility. They are a result of the chronically elevated insulin levels (hyperinsulinemia) seen in women with PCOS. These women often express other male characteristics such as excess body hair, male pattern baldness, lowering of the voice, and others. Current treatments aim at normalizing insulin levels which reduces androgens allowing normal ovulation to resume.

Thyroid Hormones

Thyroid hormones, produced by the thyroid gland, can influence ovulation, miscarriage and other fertility processes.  Thyroid hormone levels are measured with blood tests and hypothyroidism (low levels) can cause anovulation, early pregnancy loss, and other conditions. Similarly hyperthyroidism (high levels) is associated with irregular ovulation, fetal abnormalities, and premature labor. Treatment aims to normalize thyroid hormone levels.

Fertility Tests