Hormonal testing

Hormonal testing in blood is often used to investigate the possible hormonal causes of irregular menstrual cycles: polycystic ovarian syndrome (PCOS), secondary amenorrhea, low ovarian reserve, perimenopause/menopause, premature ovarian failure (FSH, LH, E2, PRL), to evaluate the ovarian reserve (AMH), detection of thyroid anomalies (TSH, fT4, fT3, anti-TPO) or polycystic ovarian syndrome.

Follicle stimulating hormone (FSH)

Follicle stimulating hormone is a glycoprotein hormone secreted by the anterior pituitary gland. In women, it plays a fundamental role in the growth and maturation of the ovarian follicle and hormone production. In everyday clinical practice we use the measurement basal FSH levels (usually scheduled at the beginning of a menstrual cycle between days 2-5) to investigate low ovarian reserve or diagnose perimenopause/menopause, premature ovarian failure in case of irregular or absent menstrual cycles.

Luteinizing hormone (LH)

Luteinizing stimulating hormone is a glycoprotein hormone secreted by the anterior pituitary gland. In women, it plays a fundamental role in the growth and maturation of the ovarian follicle, the triggering of ovulation and maintaining the hormone production during the luteal phase. In everyday clinical practice we use LH measurements to investigate polycystic ovarian syndrome (PCOS) or to monitor the risk of premature ovulation during different fertility treatments (ovulation induction, intrauterine insemination or IVF cycles).

Estradiol (E2)

Estradiol is the main female steroid hormone produced mainly by the ovarian follicles and is responsible for female secondary sexual characteristics and the maintenance of the female genital tract. In everyday clinical practice we use E2 measurements to check that their levels are sufficient (when investigating perimenopause/menopause, premature ovarian failure) or to closely monitor the progress of different fertility treatments (ovulation induction, intrauterine insemination or IVF cycles).

Progesterone (P4)

Progesterone is the dominant female steroid hormone produced in the luteal phase after ovulation and in case of a pregnancy and has a pivotal role in preparing the endometrial lining for implantation and maintain a pregnancy. In everyday clinical practice we use P4 measurements to check indirectly that ovulation has happened or more often to monitor adequate progesterone levels at embryo transfer or in early pregnancy.

Prolactin (PRL)

Prolactin is a protein hormone secreted by the pituitary and involved in regulating milk production and breast feeding. In everyday clinical practice we test PRL levels when investigating secondary amenorrhea or polycystic ovarian syndrome (PCOS).

Anti-Müllerian hormone (AMH)

Anti-Müllerian hormone (AMH) is a glycoprotein hormone secreted by small preantral follicles in the ovaries. In everyday clinical practice we use AMH measurements very often to evaluate a patient’s ovarian reserve and to predict potential response to ovarian stimulation during IVF treatment.

Thyroid hormones (TSH, fT4, fT3, anti-TPO)

A thyroid hormone profile is routinely evaluated as part of an initial infertility workup. Relatively common thyroid disturbances like hyper- and hypothyroidism, and Hashimoto autoimmune disease could be diagnosed and monitored during fertility treatment and a pregnancy.