If you’re a woman who is 35 years old or younger and have been unable to conceive after one year of unprotected intercourse, or after six months if you’re over 35, you and your partner should have a full physical and medical evaluation with a Reproductive Endocrinologist, a doctor who specializes in infertility diagnosis and treatment.
Several blood tests are available to determine if you, your partner, or both of you have a problem that is causing infertility.
Follicle-stimulating hormone (FSH) helps control a woman’s menstrual cycle and the growth of follicles, which contain eggs, in the ovaries. The blood test is done on the second or third day of your menstrual cycle, and is used to evaluate egg supply and ovarian function.
In men, FSH regulates the production and transportation of sperm. The test is used to determine sperm count.
Estradiol is an important form of estrogen. An estradiol test is used to measure your ovarian function and to evaluate the quality of your eggs. Like FSH, it is done on the second or third day of your menstrual cycle.
Luteinizing Hormone (LH) Level
In women, luteinizing hormone (LH) is linked to ovarian hormone production and egg maturation. A luteinizing hormone test performed at the beginning of your cycle may help diagnosis hormonal imbalances, like PCOS. When LH testing is performed midway through your menstrual cycle (day 14 of a 28-day cycle), the level may assist in determining when you’re ovulating.
In men, LH stimulates the hormone testosterone which affects sperm production. An LH test may be useful in evaluating male-factor infertility.
Anti-Müllerian Hormone (AMH)
AMH has quickly become the ‘gold standard’ in fertility blood tests. Secreted by the small antral follicles in the ovary, AMH is present until a woman reaches menopause. Testing AMH gives a physician a good understanding of your ovarian function and egg reserve. Lower AMH levels can predict a lower egg yield and thus, a lower chance of success in patients undergoing IVF.
AMH can be tested at any point in your menstrual cycle, and can also be done if you’re taking oral contraception.
Progesterone is a female hormone produced by the ovaries during ovulation. It prepares the endometrial lining of the uterus and makes it receptive to fertilized eggs. A serum progesterone test is used to determine if ovulation is occurring.
Since progesterone levels increase towards the end of a woman’s cycle, the test is done during the luteal phase of your menstrual cycle (just before your period starts).
The hormone prolactin is made by the pituitary gland, and causes milk production.
In women, a prolactin test may be performed:
- In the evaluation of infertility.
- To determine why a woman is not ovulating.
- When a woman has symptoms, such as nipple discharge.
In men, a prolactin test is done:
- When there is a lack of sexual desire.
- When there is difficulty getting an erection.
- If there might be a problem with the pituitary gland.
Affecting the sexual functioning of both men and women, testosterone is probably the most well-known androgen.
In women, an androgen test is used in the evaluation of conditions including polycystic ovarian syndrome (PCOS).
In men, an androgen test is used to find the cause of a low sex drive, the inability to get an erection, or infertility.
Dr. Alan Copperman is a board-certified reproductive endocrinologist and infertility specialist with a long history of success in treating infertility and applying fertility preservation technologies. He serves as Medical Director of Progyny, a leading fertility benefits management company, and co-founded and serves as Medical Director of RMA of New York, one of the largest and most prestigious IVF centers in the country. Dr. Copperman is also the Vice Chairman and Director of Infertility for the Icahn School of Medicine at Mount Sinai, and Chief Medical Officer of Sema4, a health information company. Dr. Copperman has been named to New York magazine’s list of Best Doctors 17 years in a row. He has been recognized by his peers and patient advocacy organizations for his commitment to patient-focused and data-driven care. He has published more than 100 original manuscripts and book chapters on reproductive medicine and has co-authored over 300 scientific abstracts on infertility, in vitro fertilization, egg freezing, ovum donation, and reproductive genetics.