Hormone and endocrine investigations
We perform hormone and endocrine investigations to evaluate and find the cause of your infertility. These investigations are often part of your baseline investigations and are a very important parameter for diagnosing the nature of your infertility.
Which are the hormone and endocrine investigations that we perform in AAFC?
The hormone levels that we routinely check include Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), anti-Müllerian hormone (AMH), progesterone, estradiol, prolactin and thyroid stimulating hormone (TSH). These reflect a normal endocrine function and detecting their levels, in conjunction with a physical examination (transvaginal scan, for instance) can determine the reason behind infertility. The functions of these hormones are:
- Follicle-stimulating hormone (FSH) plays a very important role in the control of a woman's menstrual cycle and production of eggs. In men, FSH helps the production and transportation of sperms.
- Luteinizing Hormone (LH) is responsible for overall ovarian hormone production and egg maturation. LH is a very well-established marker of ovulation, and often, it is the hormone detected by the home ovulation-predictor kits. In men, LH is responsible for the stimulation of the hormone testosterone, which in turn affects sperm production.
- Anti-Müllerian hormone (AMH) is produced with the development of egg sacks, or follicles in the ovaries. With increasing age in women, the number of follicles that mature per month decreases, and therefore measuring levels of AMH is a good indicator of your ovarian reserve (egg supply).
- Estradiol is produced by the growing follicles in the ovaries during the follicular phase of the menstrual cycle (from the end of the menstruation until the ovulation day). Is the hormone that stimulates the endometrial lining of the uterus to grow thicker and is one of the main estrogens in women. We also detect estradiol levels as a measure of ovarian function and egg quality.
- Progesterone is produced by the ovaries after the time of ovulation. It is the hormone that makes the endometrial lining receptive of the very early embryo. In addition, testing for progesterone presence in the blood just before the start of the menstrual period (luteal phase) can determine that your ovulation has being occurred.
- Prolactin is made in the pituitary gland and is responsible for stimulating milk production in the prospective mother. Women that produce prolactin unrelated to a pregnancy do not menstruate or have very irregular periods, experience infertility and have abnormal discharge of milk. In men, detection of prolactin is linked to a problem with their pituitary gland and explains erectile dysfunction and lack of sex drive.
- Thryroid-stimulating hormone (TSH), which is produced in the pituitary gland and stimulates the thyroid gland in producing the thyroid hormones. Elevated or low levels of the thyroid hormones can affect the menstrual cycle in women, and sperm quality and quantity in men. High TSH also reduces the sex drive in both men and women.
A range of other, more specialized hormones can also be checked, depending on your individual circumstances, and if all other routine checks have not indicated any problems. These may include testosterone and others androgenic hormones. Testosterone is the major male hormone and abnormal levels of this hormone, either in men and women, affects their sex drive. Additionally, in men, it causes erectile dysfunction, and in women, irregularity of the menstrual cycle.
Who may benefit from hormone and endocrine investigations?
These investigations are appropriate for couples that have not been able to achieve a pregnancy after 6 months to a year of unprotected intercourse.
Additionally, these investigations are regularly performed for observing your progress, if you have a condition (for instance hypothyroidism, diabetes or polycystic ovary syndrome) that may affect your reproductive hormones.
Further, if you are a woman of over 35 years of age, and you would like to make sure that your reproductive system is functioning well.
How and when are hormone and endocrine investigations done?
A hormone and reproductive investigation can be done through blood testing between the 2nd and 5th day of your menstrual cycle. For men, hormone and endocrine investigations may be ordered following your basic semen analysis / seminogram.
Additionally, hormone and endocrine investigations are also performed during your In-Vitro Fertilization (IVF) cycle to see whether the hormonal treatments administered are effective.
For endocrine functions that control the changes occurring in your ovaries, such as follicular development, a series of transvaginal scans will also be scheduled around the 2nd to 5th day and during ovulation (9th to 16th day) of your menstrual cycle.
These tests can be performed here in AAFC, in our day clinic. Your doctor will provide you with information and give you specific instructions during your initial consultation. If you have performed a recent comprehensive blood analyses prior coming to AAFC, please bring these along in your first visit.
If you require any further help, about the days that these investigations must be performed, please contact your personal patient’s assistant (a telephone number will be given to you on your first visit).