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What Hormones Are Tested For Infertility

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2 Important Hormone Tests for Male and Female Fertility

I would consider at-home testing a potential supplement, rather than a replacement, for testing and evaluation in a clinic, Kallen says.

Petrini agrees, noting that measuring hormone levels alone isnt the best way to evaluate whether a woman will conceive without assistance.

There are many factors that may cause infertility in addition to hormones, including uterine abnormalities, endometriosis, problems with fallopian tubes, or even male factors, Petrini explains.

While these types of at-home tests have encouraged more women to talk and think about fertility , its best not to derive any conclusions from them, Petrini concludes.

What Are The Benefits Of Infertility Tests

Infertility tests may find what is causing the problem and you can sometimes be treated during the tests. For example, a blocked fallopian tube may be opened during a hysterosalpingogram.

Sometimes tests cannot find the cause of infertility. And not all infertility problems can be treated. Infertility in men is often less successfully treated than infertility in women. But you may still be able to become pregnant using assisted reproductive technology, which can treat male or female problems.

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The only test of any value where the diagnosis is uncertain is serum FSH. The concentration may be raised above 20-30 IU/L, but this test should be repeated on several occasions as the condition of ovarian failure fluctuates remarkably. There is no place for measuring oestradiol or LH in this situation.

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A Quick Summary Of Hormones

Hormones serve as chemical messengers in your body, carrying signals to different areas of your body and affecting vital functions like metabolism and growth. These chemicals are produced by the endocrine system and contain information that helps instruct different organs and tissues throughout your body about how to function.

When these chemicals are out of balance, it can lead to:

While this sounds like a bunch of medical jargon, each hormone has an important purpose in the reproductive system.

AMH is released by cells around your follicles and is the best predictor of your ovarian reserve or egg count. FSH is responsible for starting ovulation, while estradiol is a sex hormone produced by your ovaries. LH is the hormone that keeps your cycle regular and is produced by your pituitary gland.

Testing for thyroid health is also necessary since the gland can often be the root of pregnancy issues. Low levels of TSH and untreated hypothyroidism can interfere with ovulation, impairing fertility. Thankfully, TSH and fT4 can be adjusted with medication when thyroid disease is present.

Can You Test Day 3 Hormones If Youre On Birth Control And Get A Period

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Some people who use a continuous form of contraception, like the minipill or hormonal IUD, get regular periods. In these cases, day 3 hormones will be included in your test.

Not all periods are created equal in fact, for some birth control methods, the periods you experience arent actually periods. If you are using the regular pill , the vaginal ring, or the birth control patch, the bleeding you experience during the placebo days/week is actually withdrawal bleeding your bodys response to the sudden drop in hormones. And because this withdrawal bleeding is caused by the changes in hormones of your birth control, its not a reflection of your bodys hormones during a natural period. If youre looking to test your day 3 hormones, we recommend waiting three months after going off these birth control methods for your levels to return to non-birth control levels.

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Hormone Testing For Male Fertility

When talking about male fertility, most people think of the sex hormone testosterone. But there are actually a number of hormones that drive the male reproductive process. When these hormones are out of balance, it can affect fertility, which is why testing for hormonal imbalance can be helpful if youre trying to conceive.

Over one-third of infertility cases are caused by male reproductive issues. Hormonal testing for male fertility can provide crucial clues about whether or not hormonal imbalances are contributing to difficulty conceiving. This article will explain what male fertility hormonal testing entails, which hormones are tested, and how hormone testing can provide a roadmap to improving your fertility, including testing for hormonal imbalance.

How Do Hormones Affect Fertility

Hormones play a pivotal role in female reproduction, particularly those hormones that control the menstrual cycle. In order for a pregnancy to occur, hormones in the body must signal and regulate the growth of an egg within an ovary, the release of the newly formed egg into the fallopian tube and the thickening of the uterine lining for implantation. If the newly released egg is fertilized by sperm , the resulting embryo will then travel to the uterus for implantation.

An absence or irregular quantity of one or more hormones can delay or prevent any of the above processes from occurring, making pregnancy difficult to achieve.

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Repeat Testing For Abnormal Initial Results

Many fertility experts will repeat blood hormone testing such as testosterone levels if the results are abnormal initially. They do this for a good reason, since blood hormone levels are known to fluctuate to some degree on a day-to-day basis. For example, testosterone levels generally vary by 10 percent in the same individual over the course of a week. LH levels have much higher levels of variation, while FSH tends to show much less variation over time.

I think that repeating low testosterone levels is a completely valid way to approach hormone testing in men. However, when I have a man who has a low testosterone level on initial testing, I typically do not repeat the test before starting treatment. My rationale is that if a man has a low baseline testosterone at initial testing, then even if it is normal on repeat testing, that mans testosterone levels are likely borderline at best, and he may benefit from hormonal therapy. One thing to keep in mind is that every so often lab errors do occur. So if an unexpected result comes back , then I do recommend repeating the blood test before making a definitive decision about treatment.

How Is Hormone Testing Done

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Any abnormalities or imbalance caused in the sex hormones can lead to fertility issues in men. In the hormone testing, the patient will be required to give a blood sample. No other requirement is needed from the patient. The blood sample undergoes a series of tests to obtain a complete hormone profile. The levels of the below-mentioned hormones are evaluated by the doctor that helps in the detection of infertility in men:

Follicle stimulating hormone or FSH is produced by the pituitary gland that is responsible for healthy sperm production in men.

Luteinizing hormone or LH is also produced by the pituitary gland that plays a key role in male infertility. LH stimulates the production of testosterone. Any rise in the level of this hormone could mean that the testicles are not producing enough testosterone.


This male sex hormone is produced by the testicles of a man. Testosterone is responsible for a mans masculine characteristics such as hair growth, bone, and muscle strength. The levels of testosterone can decline with age, but if there is an unusual decrease then it can lead to infertility in men.

In cases of complete testicular failure FSH and LH levels are elevated whereas testosterone may be low or normal.

Low levels of FSH, LH and Testosterone with low sperm count suggest hypogonadotropic hypogonadism.



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Timing Of Hormone Testing

Most hormone testing can be done at any time of day, but blood for testosterone levels should be drawn between 7:00 and 9:00 a.m., as this is when most men have their highest blood levels of testosterone. Men who consistently work night shifts can have their testosterone levels drawn at their normal wake-up times. Men who inconsistently work night shifts should try to get their testosterone levels drawn between 7:00 and 9:00 a.m. on a day off from work. Fasting is not required for standard fertility hormonal testing.

Fertility Hormone Blood Test Panel

A Fertility Hormone Blood Test Panel is made up of the four most commonly ordered tests to evaluate the reproductive abilities in women. Panel includes Follicle-stimulating hormone , Luteinizing hormone , Anti-Mullerian hormone , and Estradiol .

CPT Code: See Individual Tests

Also Known As:

No fasting required. Stop biotin consumption at least 72 hours prior to the collection.

Test Results:

3-6 days. May take longer based on weather, holiday or lab delays.

CPT Code: See Individual Tests

Also Known As:

No fasting required. Stop biotin consumption at least 72 hours prior to the collection.

Test Results:

3-6 days. May take longer based on weather, holiday or lab delays.


This panel is a Female Only Panel

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Other Hormones That Can Interfere With Ovulation:

  • Androgens normally, small amounts of androgens are produced in women excess production may interfere with the development of the follicles, ovulation, and cervical mucus production.
  • Prolactin stimulates milk production blood levels may be higher than normal in certain disorders or if you are taking certain medications
  • Thyroid an under-active thyroid can result in high prolactin levels

Where Are Infertility Tests Done

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Many infertility tests, including the physical examination, medical history, and blood tests, can be done in your doctor’s office or clinic by an obstetrician or reproductive endocrinologist. Your internist or family medicine physician may do some of the first tests. Tests on a man may be done by a urologist. Some medical procedures are done in an operating room.

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What Is Fertility Testing And Infertility Diagnosis For Women

A woman should consider fertility testing if she has been actively trying to get pregnant, by having unprotected intercourse on a regular basis with her partner, for more than one year. If a woman is age 35 or older, she should consider fertility testing after six months of trying to get pregnant. According to the American Society for Reproductive Medicine, infertility affects men and women equally, so both partners should be tested.

Fertility tests for women help identify the cause of infertility so the condition can be properly treated and the couple can have the best chance to conceive. Fertility tests for women often involve:

  • Medical history discussion, especially to check for ovulation or menstrual cycle issues
  • Blood tests to check hormone levels and ovarian reserve .
  • Pelvic examination
  • Minimally invasive procedures, such as ultrasound imaging and surgery, to check for structural causes of infertility
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Interpretation Of Free/bioavailable Testosterone Levels

Just when you thought that things were complicated enough . . . not only can the measurements of usable testosterone be calculated using either the bioavailable or the free testosterone, but in addition the free testosterone can be calculated in two different ways:

1. Direct FT test, which directly measures the amount of free testosterone in the bloodstream.

Normal value: 15 ng/Dl or more.

2. Calculated FT test, which measures the total testosterone, albumin, and SHBG levels and then plugs these values into a mathematical equation that calculates the free testosterone level.

Normal value: 50 ng/Dl or more.

There is no general consensus regarding which of these is more accurate, but individual fertility experts may prefer one or the other. Note that the levels for what is considered normal are different for each.

When you get back a blood test result for a free testosterone level, the report typically is not going to tell you whether the direct or calculated technique was used. However, if on the lab report you see results for albumin and SHBG, then you can presume that the calculated technique was used. If not, then the direct technique was likely used.

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What Effects Do Hormones Have On Male Fertility

Generally, hormonal analysis in men to study their fertility consists of determining the levels of testosterone, FSH and LH .

FSH is involved in spermatogenesis, that is, in the formation of spermatozoa in the seminiferous tubules.

On the other hand, LH acts on the Leydig cells and secretes testosterone, the male sex hormone par excellence.

Finally, testosterone is involved in the development of male sexual characteristics. Thus, testosterone is responsible for the growth of muscle mass, beards and body hair.

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The most accurate way to determine testosterone levels would be to include total testosterone and either free or bioavailable testosterone, and to have the blood for these tests drawn between 7:00 and 9:00 a.m. If you are not working with a male fertility expert and want to keep things simple, just measuring total testosterone is sufficient for 80 percent of men the goal is to have total testosterone 500600 ng/dL or above.

If you want to measure the measure the amount of usable testosterone in the bloodstream, as well to determine whether you might be in the 20 percent of men who have hypogonadism despite having normal total testosterone levels, you might want to consider having a test done for bioavailable testosterone if you have a choice. However, if the health care practitioner or lab that you use prefers free testosterone, then you can use the information above to help figure out if the direct or calculated method was used and if the results are normal.

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Does It Really Matter If You Test E2 Fsh And Lh On Day 3

Since E2, FSH, and LH fluctuate quite a bit throughout the menstrual cycle, youd likely get a totally different value for the same hormone if you tested on any other day. Doctors call day 3 the baseline because thats when E2, FSH, and LH are most stable, before they begin to rise. Aiming to test on day 3 puts you right at the beginning of the follicular phase and is the best time to get a clear read of these baseline levels.

We hear from customers that it can be a bummer to have to wait for your period to test, and we totally get that feeling. It can be hard to wait for this info! While its true that you can technically measure these hormones on any day of your cycle, it wont be clinically meaningful.

Imagine youre checking in with your cardiovascular health and measuring your resting heart rate. If you were just moving around a lot or feeling anxious for any reason, you might expect a higher-than-average heart rate. The heart rate measured at that time wouldnt necessarily be representative of your actual resting heart rate, unaffected by movement or nerves and it might not be the same the next time you measured it.

Another reason why testing your fertility hormones on day 3 is important comes down to reference ranges, which well explain in the next section.

How Is Hormone Testing Done To Detect Infertility In Men

Infertility or unable to conceive a baby can make you feel mentally as well as physically drained. To diagnose the cause is usually not easy, in other words, detection of infertility in men is not at all an easy task. It involves a series of tests that both the partners need to undergo. In fact, up to half of all the cases of infertility involve the male partner.

To determine the root cause of male infertility, there are many tests available these days. One of which is the hormone testing. The hormones produced by the pituitary gland, hypothalamus and testicles are crucial for the development of the male reproductive parts and most importantly for sperm production.

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Testing For Tubal Patency And Normalcy Of The Uterine Cavity With A Hysterosalpingogram

The hysterosalpingogram, or HSG is done in order to assess the anatomy of the endometrial cavity of the uterus and the fallopian tubes. The HSG is usually scheduled between days 6 and 13 of the cycle after bleeding and before ovulation.

  • This test is usually performed in a radiology facility
  • About 25% of all infertility is due to a tubal factor

Luteinizing Hormone Lh Test

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If your LH Test report shows normal levels, which is between 0.7 and 7.9 IU/L for those between the ages of 20 and 70 and, between 3.1 and 34.0 for men above the age of 70 years, it depicts that you LH hormone if functioning completely fine and you are not in the fault of any male infertility.

Low levels of LH in men can be a cause of

  • Low testosterone levels,

Read more about LH testing here.

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What Is A Sperm Count

Over the past 40 years, the average mans sperm count has dropped almost 60%, which is an alarming statistic. But what exactly is a sperm count? There are a couple of things that are measured medically to determine it.

Theyre also analysing the sperm size, shape, tail length and if they swim well, all of this data ultimately builds up what is known as a sperm count.

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Length Of Time Trying To Conceive

The GP will ask how long you’ve been trying to conceive.

About 84% of people will conceive within 1 year if they have regular unprotected sex .

Of those who do not conceive in the first year, about half will conceive in the second year.

If you’re under 40 and have not been trying for a baby for very long, you may be advised to keep trying for a little longer.

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