Getting to Know Your
Fertility

There are several tests that women and men should be aware of that could offer insight into their fertility health. 

 

These tests are recommended after a couple has been trying to conceive for at least one year (6 months if the woman is over 35 years old).

 

Fertility Blood Tests for Women

 

FSH (follicle stimulating hormone)- Often used as a gauge of ovarian reserve.

 

E2 (Estrodiol)- Essential for the development and maintenance of female reproductive tissues. Usually compared to FSH. An elevated E2 can indicate low ovarian reserve. 

 

Progesterone (P4)- A steroid hormone whose main role is to maintain pregnancy and to regulate the menstrual cycle. Often tested days after ovulation to see if ovulation has occurred. 

 

LH (Luteinizing hormone) –This test will also see if ovulation is occurring. Often compared to FSH to rule out PCOS.

 

AMH (Anti-Mullerian Hormone) – produced in small ovarian follicles and used to measure the size of the pool of growing follicles. AMH levels are thought to reflect the size of the remaining egg supply/ovarian reserve. 

 

TSH (Thyroid Stimulating Hormone) – Will measure an overactive or underactive thyroid, which can impact fertility in men and women. 

 

T4 and T3 (Thyroxine and Triiodothyronine)- High or low levels can create fertility issues including an increased rate of early miscarriage, ovulatory disorders, irregular periods and preterm labor. 


Prolactin (luteotropic hormone)- elevated levels can interfere with ovulation. Also associated with the production of breast milk. High levels of stress can impact levels. 

 

Vitamin D – Low levels can affect fertility hormones. An IVF study showed pregnancy rates were 50% higher with adequate levels of Vitamin D. 

 

Testosterone – Elevated levels are often found in females with PCOS. 

 

DHEA (Dehydroepiandrosterone Sulfate) – A low level can indicate PCOS as well as low ovarian reserve. 

 

Inhibin B Test (Protein Hormone) – Produced by antral follicles thus correlating with the number of eggs left in the ovaries. If there are fewer antral follicles then the inhibin B level will be lower. The higher the inhibin level, the better the ovarian reserve. Levels of Inhibin B decrease with age. 

 

Semen Analysis- According to the ASRM (American Society for Reproductive Medicine) in 40% of infertile couples, the male partner is either the sole cause or a contributing cause of infertility. Thus, it is a good idea for the male partner to get a semen analysis while his partner is undergoing blood work. 

 

Additional Testing

 

HSG (Hysterosalpinogram) – This is a test used to examine a woman’s uterus and fallopian tubes. It is essentially an x-ray procedure in which a radio-opaque dye is injected through the cervix into the uterus and fallopian tubes. The procedure will show any abnormalities such as an unusually shaped uterus, tumors, scar tissue or blockages in the fallopian tubes.

 

Hysteroscopy –  Usually performed after a uterine abnormality is suspected after the HSG. A hysteroscope is inserted through the cervix into the uterus and enables the doctor to see any uterine abnormalities or growths.  

 

Laparoscopy – a narrow fiber optic telescope is inserted through a woman’s abdomen to look at the uterus, fallopian tubes and ovaries to discern endometriosis or pelvic adhesions

 

Ultrasound- an ultrasound of the ovaries is useful to determine the amount of antral follicles that can be seen. This is another tool to determine ovarian reserve. Ultrasound is also useful to determine the thickness of the uterine lining and to see if there is any sign of PCOS (polycystic ovarian syndrome).