Preconception and Fertility Hormone Testing: A Comprehensive Guide

When preparing for a pregnancy, hormone testing plays a vital role in a comprehensive fertility assessment for the female partner. In my naturopathic practice, I will often recommend hormone testing for those trying to conceive so we can understand baseline numbers, and provide early intervention, guidance and referrals when needed. In this article, we will discuss various hormones relevant to fertility and the significance of testing them. Let's dive in!

Hormones in the Fertility Context

1. Day 3 Estradiol

Estradiol is the primary form of estrogen in women. Testing estradiol levels on day 3 of the menstrual cycle assesses ovarian reserve (ie. how many eggs the ovaries have), and determines whether your FSH test was accurate or not. Abnormal levels may indicate a diminished ovarian reserve or potential fertility issues.

2. Day 3 FSH (Follicle-Stimulating Hormone)

FSH is responsible for stimulating the growth of ovarian follicles in women. Elevated levels of FSH on day 3 of the menstrual cycle may indicate diminished or poor ovarian reserve.

3. Day 3 LH (Luteinizing Hormone)

LH surges during the menstrual cycle, triggering ovulation in women. Measuring LH on day 3 of the menstrual cycle, helps in the diagnosis of ovulatory disorders. For instance, a day 3 LH that is higher than FSH may indicate polycystic ovary syndrome (PCOS).

4. Day 21 Progesterone

Measuring progesterone levels on day 21 of the menstrual cycle (or 7 days before your expected period) assesses the adequacy of the luteal phase, and confirms whether or not ovulation has occurred. Low progesterone levels indicate anovulation, and suboptimal progesterone may indicate luteal phase defects or a potential risk of miscarriage.

5. AMH (Anti-Mullerian Hormone)

AMH is a hormone secreted by developing ovarian follicles. Testing AMH levels provides insight into ovarian reserve and the number of eggs remaining. Lower AMH levels may suggest reduced fertility or early onset of menopause.

6. Testosterone

Testosterone is commonly associated with male fertility, but it plays a crucial role in women as well. Elevated testosterone in women may indicate conditions like polycystic ovary syndrome (PCOS), which can affect fertility.

7. Prolactin

Prolactin is involved in milk production after childbirth but can also impact fertility. Elevated prolactin levels may interfere with ovulation and menstrual regularity, making conception more difficult.

8. TSH (Thyroid-Stimulating Hormone)

TSH regulates thyroid function and metabolic rate. An imbalance in TSH levels can affect menstrual regularity and ovulation, potentially leading to infertility or miscarriage.

9. TPO (Thyroid Peroxidase Antibodies)

Testing for thyroid peroxidase antibodies assesses autoimmune thyroid disorders like Hashimoto's disease. These disorders can affect fertility by interfering with thyroid function and hormone production.

Conclusion

Understanding the role of hormones in fertility is essential for anyone planning to conceive. Fertility hormone testing, including day 3 estradiol, day 3 FSH, day 3 LH, day 21 progesterone, AMH, testosterone, prolactin, TSH, and thyroid peroxidase antibodies, helps identify potential fertility issues and guides appropriate medical interventions. Remember, consulting with a healthcare professional is highly recommended to interpret hormone test results accurately and develop an individualized fertility plan. If you would like to learn more about your reproductive health, please don’t hesitate to contact Juniper Family Health. We are here to help!

In health and happiness,

Dr. Meghan van Drimmelen | Naturopath Victoria BC