Rather than doing series of unnecessary and expensive hormone tests we plan them specifically so that it tells us exactly what we need to know and not waste your time and money. We are guided by the latest (2013) NICE guidelines and ofcourse our own experience.
Estrogen, progesterone, AMH (Anti Mullirian hormone) and some androgens are the most commonly done ovarian hormones.
This hormone is essentially the hormone of femininity and is responsible for most female physical attributes (“secondary sexual characteristics”). Until puberty the ovary of a young girl (upto 7-8 years of age) is immature and doesn’t make oestrogen. From the age of 8 or 9 on wards, the estrogen from the ovary changes the appearance of the young girl bringing on the changes of puberty.
When do we check this hormone ?
During an IVF cycle wherein we want to check “down regulation” or at other points in the cycle, checking the Estrogen levels can be helpful.
This hormone is released by the ovarian follicle only after ovulation. The level of Progesterone is typically checked on the 21st day of the menstrual cycle because it is not found in the blood until after ovulation.
If done in the first half of the menstrual cycle, low levels of Progesterone does not mean much.
We use this test in selected situations, generally to corroborate findings of ovulation tracking.
AMH is secreted by the antral follicles (follicles that are yet to start developing in) and thus predicts the overall stores of eggs in the ovary. His test has been branded as the “fertility reserve” test. But considering the very little time that the test has been in the market, we should use it judiciously. The risk is as much about wrongly predicting early menopause (and causing un-necessary worry) but also on the other hand giving a woman false assurance that menopause is not very near. Details about its value in ovarian reserve testing have been discussed elsewhere.
AMH also has a role when it comes to starting an IVF cycles, deciding on doses of FSH.
Serum Anti Mullerian hormone being a newly discovered test, costs far more than other hormone tests.
The most common pituitary hormones that we look during fertility investigations will be FSH (Follicle Stimulating Hormone), LH (Luteinizing Hormone) and Prolactin.
FSH (Follicle Stimulating horomone) is probably most helpful. Since the pituitary controls the ovary by secreting FSH, high ambient levels of FSH suggests that the ovarian functions is on the decline.
The level of FSH changes in various stages of the menstrual cycle, it is important to check the lowest level of FSH and for that it has to be done on 3rd or 4th day of the period.
Our centre is open six days in a week and we are happy to do your bloods on Saturdays as well for no extra costs.
LH (Luteinizing Hormone)
This hormone urges mid cycle and that triggers ovulation. In cases of polycystic ovarian syndrome the LH level rises causing excessive androgens from the ovary. In the past doing, the LH levels were important mainly for diagnosing PCOS. Today these diagnoses are mainly done by ultrasound scan and thus LH is done less frequently.