A range of blood tests may be ordered.
Anti-Müllerian Hormone (AMH)
AMH is secreted by cells in the follicles of an ovary and is used to indicate ovarian reserve – reflecting egg quantity. Though the AMH test does not give any indication of the quality of eggs it will aid in personalising your fertility treatment. The test can be conducted with a blood sample at any time in your cycle.
Follicle-stimulating Hormone (FSH)
Follicle-stimulating hormone (FSH) helps control a woman’s menstrual cycle and the production of eggs. Testing FSH levels can also help your Fertility Specialist evaluate your ovarian reserve, particularly when there is a significant problem. The test will most likely be done on the third day of your menstrual cycle.
Luteinizing Hormone (LH)
Luteinizing Hormone (LH) is linked to ovarian hormone production and egg maturation, your Fertility Specialist can test to see if and when you are ovulating.
Oestradiol (estrogen) is an important form of oestrogen (the primary female sex hormone). Oestradiol is produced by ovarian follicles as they grow and develops/thickens the lining of your uterus. Your Fertility Specialist will use an Oestradiol Test as part of an assessment of ovarian function. It’s likley to be conducted on the third day of your menstrual cycle and is also an important part of monitoring of fertility treatments.
A week after expected ovulation, your Fertility Specialist might test your progesterone level. Progesterone is the hormone which is produced by your ovary after you ovulate. It helps maintain the endometrial lining making it a receptive environment for a fertilised egg.
Probably best known for its role in human milk production, an elevated level of prolactin at other times can be associated with poor or absent ovulation. Your Fertility Specialist may use a prolactin test to help understand why you’re not menstruating or ovulating regularly.
Your thyroid gland, located in your neck, produces thyroid hormone that regulates your metabolism. An over- or underactive thyroid function can lead to widespread medical issues and problems with ovulation. But more commonly, very subtle change in thyroid function, especially mild underactivity often as a result of thyroid antibodies, can lead to fertility problems and a higher risk of miscarriage. Your Fertility Specialist will often measure your thyroid gland’s controlling hormone (TSH) and look for thyroid antibodies.
For patients who have had recurrent miscarriage or have a genetic condition in their family, a Fertility Specialist may review both partners for chromosome abnormalities (karyotypes).
Even without any obvious family history, all couples planning pregnancy should consider having testing to ensure that they both don’t carry the same quiet genetic (recessive) condition. Many of us carry one recessive condition which in itself doesn’t cause disease, however if both partners carry the same recessive gene (examples include cystic fibrosis and spinal muscular atrophy) – then that couple have a 1 in 4 chance of having a baby with a serious medical disorder. Your Fertility Specialist will usually offer this testing which is undertaken by an external pathology company.
An ultrasound helps your Fertility Specialist to check the health of the lining of your uterus (called the endometrium) as well as check for fibroids, polyps or ovarian cysts and conditions such as endometriosis
and polycystic ovarian syndrome (PCOS)
. When combined with hysterosalpingo-contrast-sonography (HyCoSy), an ultrasound will check that your fallopian tubes are open and not blocked.