Ovarian Reserve Testing
The main reason for evaluating your hormone levels is to assess your egg quantity and quality. This is done by measuring your FSH (Follicle Stimulating Hormone) and AMH (Anti-Mullerian Hormone) levels. These two hormone levels can provide more information about what your “ovarian age” is compared to your actual or biological age. For some women, advanced ovarian aging can be the main reason for infertility or recurrent pregnancy losses.
Follicle Stimulating Hormone (FSH)
FSH is a hormone produced in the pituitary gland in the brain and a normal level is 4-10 mIU/mL. Elevated FSH levels between 10-25 mIU/mL suggest advanced ovarian aging and can make success with fertility treatments more challenging. Levels above 25 mIU/mL are menopausal and patients with levels above 25 mIU/mL may benefit from fertility treatments with donor eggs (oocytes). In vitro fertilization with an FSH level above 18 mIU/mL is typically not successful.
Anti-Mullerian Hormone (AMH)
AMH is a hormone produced in the ovary and a normal level is 1-3 ng/mL. Levels below 1.0 ng/mL indicate a lower egg count and quality, and the need for higher medication doses during treatment. The lowest measurable level is 0.16 ng/mL and may indicate difficulty getting pregnant with intercourse, IUI or IVF. Levels above 3.0 ng/mL suggest a woman is not ovulating regularly and may have PCOS.
Testing for Ovulation & Irregular cycles
The second reason to evaluate your hormone levels is to determine if there are any abnormal hormone levels which are interfering with ovulation, which is the monthly release of an egg from your ovary. Problems with high or low thyroid function, elevated prolactin levels and elevated testosterone levels in PCOS (Polycystic Ovarian Syndrome) can prevent you from getting pregnant naturally and cause also interfere with fertility treatments. Treatment of abnormal hormone levels can also help you ovulate more regularly and make your cycles normal again.
By detecting abnormal hormone levels and treating them early, we can also improve your chances of getting pregnant regardless of the type of treatment chosen.
The thyroid hormone controls the “metabolic rate” in the body. Low or high thyroid levels can prevent ovulation and lead to irregular or heavy cycles, miscarriage and preterm labor.
Prolactin is the “feel good hormone” associated with bonding between a mother and her baby. It is also responsible for allowing the breast to produce milk during nursing. Occasionally prolactin levels can be elevated outside of nursing or pregnancy and prevent ovulation. Elevated prolactin levels can be treated with medication.
Testosterone & Male Hormone (Androgen) Levels
Elevated testosterone or androgen levels in women can prevent ovulation and are typically associated with PCOS, ovarian or adrenal gland problems. Elevated testosterone and androgen levels can often be treated with medication.
Home Ovulation Kits
Women can test for ovulation at home using an ovulation (LH) kit purchased at the pharmacy. If a woman has regular cycles, testing should begin 10-12 days after a woman’s cycle begins and continued for 7-10 days, or until a positive result is achieved. Women with irregular cycles, less frequent than every 35 days may need to test for longer periods of time.
Basal Body Temperature Measurements
Measuring your temperature daily in the morning is typically not recommended since it can be difficult to determine when temperature changes occur and therefore when ovulation occurs.