Hormone dosages, what are to be done when pregnancy does not arrive?

To understand if our ovaries are working properly, there are some blood tests to be carried out on the third day of the menstrual cycle. To then verify if ovulation has occurred, on the 21st day (of the same cycle) another analysis can be done to evaluate progesterone levels.

The most common tests that are prescribed are the following:

LH hormone

when the LH hormone and the FSH hormone reach their maximum values, usually in the middle of the cycle, they determine the release of the egg cell from the right or left ovary (and this event is called ovulation ) .

The rapid rise in LH (the peak that is monitored with ovulation sticks ) also stimulates the ovaries to produce other hormones that help support pregnancy, including progesterone.

FSH Hormone (Follicle Stimulating)

The FSH hormone stimulates the growth and development of ovarian follicles (and therefore egg cells) during the first phase of the menstrual cycle (follicular phase), which runs from menstruation to ovulation.

If an analysis is done on the third day of the menstrual cycle, the ovarian reserve and the quality of the egg cells will be evaluated. In general, a FSH value of less than 10 is fine, 10 to 15 is borderline, greater than 15 is high.

However, a single dosage of FSH cannot be decisive: it is better to do further dosages when the results are not satisfactory because the levels of FSH in the blood vary from cycle to cycle.

It could be that in these cases the FSH values ​​are requested over three months to get a complete picture of the situation.

Too high or too low levels of LH or FSH are an indication that the reproductive system is not working as it should.

For example, 40% of women with PCOS have increased LH levels which interfere with the normal development of egg cells within the ovarian follicles.

If your levels are borderline or high, your specialist may also prescribe you clomiphene and check the drug’s effect on FSH levels.

For example, FSH and estradiol are measured on the third day of the cycle, then clomiphene is administered from the fifth to the ninth day, and subsequently the FSH values ​​are checked on the tenth day. If the values ​​are high on the third day and also on the tenth day, this suggests a reduced ovarian reserve.

Studies show that women under 40 with high FSH levels produce fewer eggs in IVF treatment, but this does not affect the likelihood of becoming pregnant. Women over the age of 40, on the other hand, experience a reduced ovarian response, lower egg cell production, and reduced implantation and pregnancy rates.

Estradiolo (E2)

Estradiol determines the thickening of the endometrium necessary for implantation. Its value decreases towards menopause. A normal value is between 25 and 75 pg/ml.

Prolactin

Prolactin induces and maintains milk production after delivery. It also stimulates the production of progesterone. It is evaluated in case of irregular dicli and when the man has a reduced sexual drive.

See also hyperprolactinaemia and infertility.

Progesterone:

Together with other hormones, progesterone prepares the female body for pregnancy.

Progesterone levels begin to rise when the egg cell is released from the ovary and continue to rise for several days. If the egg cell is not fertilized, progesterone levels drop and menstruation begins.

However, if the levels continue to rise, pregnancy has occurred.

The progesterone analysis on the 21st day of the cycle is used to understand whether or not ovulation has occurred. Progesterone tests are also used to understand if an ectopic pregnancy is in progress or if a miscarriage is threatened. In these two cases, in fact, the progesterone levels do not increase in the correct way as the pregnancy proceeds.

AMH (Anti-Müllerian Hormone)

It can be done at any time of the cycle unlike the others, and it is an index of the ovarian reserve. For all references read here.