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Cycle day 3 measurements of follicle stimulating hormone, luteinizing hormone, estrogen, and the ratio of FSH/LH are indicators of ovarian reserve. Ovarian reserve relates to the ovaries supply of eggs that can develop and fertilize and reduced ovarian reserve is an eventual consequence of aging. Unfortunately, reduced ovarian reserve can occur at any age and signals declining fertility. 
FSH levels above 12 are usually indicative of impending ovarian failure and follow-up care by a infertility specialist,reproductive endocrinologist should be sought. This is critically important in women in their thirties.
Androgen (male hormone) levels will also be measured to rule out conditions like polycystic ovarian syndrome (PCOS). Elevated androgens ultimately lead to a reduction in FSH production. See our PCOS section.
Levels of thyroid hormones will be measured. Elevated thyroid levels Levels of thyroid hormones may be measured. Elevated thyroid hormone levels (hyperthyroidism) or low thyroid hormone levels (hypothyroidism) are associated with irregular ovulation, irregular bleeding, and other conditions.
Human chorionic gonadotropin (hCG) levels will be measured to rule out or document pregnancy. hCG is produced by the placenta and levels increase during pregnancy.
The level of the hormone prolactin will be measured to rule out hyperprolactinemia (elevated prolactin levels) that can cause irregular ovulation. Prolactin levels normally rise in pregnant women to stimulate the production of breast milk. Elevated levels in non-pregnant women are often due to a small benign tumor on the pituitary gland. Depending upon the size and location of the tumor, and other factors, it may be removed by a neurosurgeon. Orally administered Parlodel or Cabergoline may reverse hyperprolactinemia and establish normal ovulation.
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