Hormone Level Check
Performed on cycle days 1-3, the baseline laboratory assessment includes testing for hormone levels AMH, FSH, LH, estradiol, progesterone, TSH and prolactin. Abnormalities in these hormones can affect ovulation or implantation. Assessment of these hormone levels can be important in determining an appropriate medical treatment to normalize and stimulate ovulation and treat infertility.
Thyroid stimulating hormone (TSH), is the main hormone involved in metabolism.
Women with hyper- or hypothyroidism may have menstrual irregularities and stop ovulating. By identifying and treating a thyroid abnormality, ovulation can be restored so a pregnancy can occur. Prolactin, when elevated, may interfere with ovulation and can cause miscarriage.
Some women have symptoms (milky breast discharge), but others do not.
Follicle-stimulating hormone (FSH) along with estradiol is a marker of ovarian reserve. Checking the FSH hormone levels is especially important for women 35 and older. This hormone level is a rough guide to a woman’s egg quantity and quality. It can predict the likeliness of a woman in responding to fertility medication in an effort to try to conceive.
Hydroxyprogesterone Test
Besides testosterone, DHEAS and 17 hydroxyprogesterone may be recommended to test, it will show if there is a production of excess male hormones that are interfering with ovulation. This is most commonly seen in women with the polycystic ovarian syndrome (PCOS) and late-onset adrenal hyperplasia. In this case, with a correct treatment, ovulation can be restored.
In selected patients with signs of PCOS or obesity, screening for diabetes may be recommended. Diabetes can be checked either by checking the fasting sugar and insulin levels or performing a two-hour glucose tolerance test. Egg quality may be adversely affected by elevated insulin levels and, therefore, medication may be recommended to normalize its levels. This treatment can significantly improve a woman’s chances of conceiving, sometimes without the need for fertility medication.
Pregnancy Ultrasound Exam
The baby ultrasound exam is an opportunity to assess the uterus and ovaries in detail. Follicle monitoring is performed to track the ovulation. Uterine fibroids, endometriomas, and hydrosalpinges are some of the abnormalities that can be identified with an ultrasound exam as well. To further assess ovarian reserve, the antral follicle count is checked.
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