Top 10 Fertility Lab Tests You Should Request from Your Doctor
Whether you’re trying to conceive, thinking about it, or have been struggling to get pregnant, it’s important that you get the appropriate lab work done to help rule out underlying conditions and/or hormonal imbalances that may be affecting your chances of conceiving. Working with so many couples in their fertility journey, I have developed a checklist of tests that give us the information necessary so that I can provide you with a targeted fertility support plan to help you grow your family.
Follicle stimulating hormone (FSH): Hormone that stimulates follicles to develop so that they’re mature and can release an egg at the time of ovulation. FSH can tell us a lot about your egg quality.
Lutenizing hormone (LH): Essential for inducing ovulation. No ovulation = no egg that can get fertilized = no pregnancy. In my practice, I see a lot of cases of polycystic ovarian syndrome (PCOS)- a condition that is often missed and undiagnosed- and these women often have higher levels of LH. This can contribute to higher levels of androgens (“male” hormones) that can further impede regular ovulation.
Estradiol (estrogen): This is often tested during Day 2 or 3 of your cycle (2-3 days into your period) to assess your ovarian reserve (= number and quality of eggs).
Progesterone: This hormone is only produced in significant amounts after ovulation and is responsible for thickening the uterine lining so that a fertilized egg can be implanted and allowed to develop. Progesterone is often tested 7 days before your next expected period to assess whether ovulation has occurred during your cycle.
Testosterone: Typically considered the “male” hormone, elevated levels of testosterone can stop ovulation from occurring and contribute to acne and unwanted hair growth (hallmark symptoms in PCOS).
Anti-Mullerian hormone (AMH): This hormone is often measured by fertility clinics to assess your ovarian reserve. However, your result should always be interpreted within the context of your other hormone levels.
Prolactin: High prolactin levels can impair follicle development and thus, ovulation. It may contribute to irregular periods and a deficiency in progesterone.
Fasting glucose: Gives us an idea of how well your body is regulating your blood sugar levels. Dysregulated blood sugar can affect your hormonal balance and create challenges for your fertility.
Fasting insulin: This value is used in conjunction with your fasting glucose to determine if there’s any underlying insulin resistance that may be impairing ovulation. Unregulated blood sugar, and high amounts of circulating insulin can also increase testosterone, which can contribute to hormonal imbalances that can further affect your fertility.
Full thyroid panel (TSH, T3, T4, rT3, anti-TPO and anti-thyroglobulin antibodies): So many women I’ve seen have an undiagnosed thyroid condition that results in an under-functioning thyroid gland. It’s not enough to just get your thyroid stimulating hormone (TSH) tested. We need to look at the actual thyroid hormones that your body is producing (T3, T4), any antibodies that are limiting your thyroid function (anti-thyroperoxidase and anti-thyroglobulin antibodies), as well as reverse-T3 (rT3) which is an inactive form of thyroid hormone that is produced when your body is undergoing periods of stress.
You can request these tests from your doctor, or your health care practitioner who is supporting you with your fertility. Never be afraid to advocate for your own health and surround yourself with a supportive team that can help you navigate the challenges of troubleshooting your hormones and restoring hormonal balance.
