Hormone Evaluations

Day 3 hormone evaluation
Reproductive hormones such as FSH, LH, and estradiol are typically measured on day 3 of the menstrual cycle. These measures allow the doctor to access the ovarian reserve of the patient or the ability of a patient to produce quality ovules

Healthy developing follicles produce estrogen, which is controlled by a small gland at the base of the brain called the hypothalamus. Young ovaries with an adequate ovarian reserve require a minimum amount of FSH to be stimulated, and early follicular FSH will be relatively low. On the other hand, ovaries with a compromised reserve will require more FSH from the pituitary gland to develop a follicle. Elevated FSH levels (> 10 mIU / ml) on day 3 are an indication of decreased ovarian limit or reserve. An abnormally high estrogen level or a high FSH / LH ratio may also indicate a decrease in ovarian reserve.

We use the clomiphene citrate challenge test (CCCT) as a predictor of the ovarian response to fertility drugs. This allows us to measure the chances of success to achieve pregnancy. Women with abnormal CCCT results may have little chance of becoming pregnant using their own eggs. They may have to consider IVF with donated eggs for a higher pregnancy success rate.

Thyroid hormones
Thyroid hormones are produced by the thyroid gland and are often measured during a fertility evaluation. Although thyroid function is a key regulator of metabolic rate, even subtle abnormalities can affect fertility. Too low levels (hypothyroidism) can cause a miscarriage and irregular ovulation. Levels that are too high (hyperthyroidism) can also cause irregular ovulation, fetal abnormalities, and premature delivery.

Androgens are male hormones produced by the ovaries and adrenal glands. Elevated androgen levels may be associated with the presence of polycystic ovary syndrome (PCOS). In this condition, elevated levels of LH and insulin stimulate the ovary to produce abnormal amounts of male hormones, which prevent normal growth and ovulation of the follicle. Rarely, a tumor in the ovary or adrenal gland can lead to an excess of androgens.

Clomiphene Citrate Challenge Test
The clomiphene citrate challenge test (CCCT) is an effective measure of the ovarian reserve and is often performed if there is suspicion of a reduction in the ovarian reserve. It is usually done in older women, regardless of the results of the hormonal evaluation on day 3. Women with poor CCCT results may be candidates for our egg donation program.