Your Hormones are determining factors in human reproduction as they are responsible for the control of your menstrual cycle and sexual development. They also play a vital role in your fertility and if they are not functioning as expected fertility problems can occur. The hormones that determine fertility also called reproductive hormones, are
- Follicle-stimulating hormone (FSH), that causes maturation of the egg in the ovary,
- Luteinising hormone (LH) that stimulates the release of the egg,
- Anti-mullerian Hormone(AMH) is the ovaries' ability to produce good-quality eggs and
- Estradiol (E2) is an eastogen, one of the major sex hormones, that define your ovaries’ ability to produce eggs.
Getting a better understanding of hormones and the impact on your reproductive health will help you choose the right infertility treatment.
Which hormones are tested for infertility?
Fertility changes with age and consequently age affects the levels of the reproductive hormones. Further below you will find a brief explanation of fertility hormones and which are the optimal levels when you are trying to conceive.
FSH - Follicle-stimulating hormone
Meaning: Is one of the hormones responsible for the optimal development and function of women’s ovaries. This hormone stimulates the growth of ovarian follicles in the ovary before the release of an egg from one follicle at ovulation.
Significance: As we age the levels of this hormone change and usually high follicle-stimulating hormone (FSH) levels are measured to confirm menopause.
Optimal levels: Women who are still menstruating - 4.7 to 21.5 mIU/mL (4.5 to 21.5 IU/L) After menopause - 25.8 to 134.8 mIU/mL (25.8 to 134.8 IU/L) .
LH - Luteinizing hormone
Meaning: Is an important hormone known as a gonadotropin and it affects the sex organs and plays a significant role in puberty, menstruation and fertility. LH is an important part of your menstrual cycle as it works with follicle-stimulating hormone (FSH) and it's causing an egg to grow. It also triggers the production of estrogen in the follicle.
Significance: LH levels can indicate a problem with the supply of eggs in a woman’s ovaries that can affect fertility.
Optimal levels: Most of the time, blood concentration of LH is between 5 – 20 mIU/mL. But 24 – 36 hours before ovulation, LH levels begin to surge to a peak of 25 – 40 mIU/ml.
AMH - Anti-Mullerian Hormone
Meaning: AMH is made in the reproductive tissues of both males and females. An AMH test is often used to check a woman's ability to produce eggs that can be fertilized for pregnancy. A woman's ovaries can make thousands of eggs but the number declines as you get older.
Significance: AMH levels show how many potential egg cells a woman has left and that's the reason why an AMH test will help you determine what are the chances of conceiving and also when would be the best time to try to get pregnant.
Optimal levels: A typical AMH level for a fertile woman is 1.0–4.0 ng/ml; under 1.0 ng/ml is considered low and indicative of diminished ovarian reserve. Low AMH does not mean that you cannot get pregnant but possibly a long road to motherhood.
E2 - Estradiol (or oestradiol)
Meaning: is a female sex hormone produced by the ovaries and also the placenta during pregnancy. Estradiol is needed to maintain the eggs inside a female’s ovaries.
Significance: One reason to have your estradiol levels checked is to determine your ovaries' ability to produce eggs.
High levels of estradiol indicate that you might have a problem with your ovarian reserve. It could also mean that the estradiol is suppressing FSH. Either of these things could mean that you will have more trouble getting pregnant, more trouble ovulating and reduced success with IVF.
Optimal levels: 200 pg/ml (maximum) during follicular development. 400 pg/ml (maximum) just before ovulation. The level dips briefly during the release of the ovum (ovulation) and peaks again during the luteal phase. In the absence of pregnancy, the level falls to its lowest or menstrual level at the end of the luteal phase.
Can I get Pregnant with high FSH levels?
When FSH is elevated is an indication of Diminished Ovarian Reserve (DOR) or premature ovarian aging (POA), both of which are conditions that lessen the chances of getting pregnant naturally. Decreased ovarian reserve is associated with a reduced number of follicles or eggs.
Usually women with high FSH respond poorly to infertility medication and IVF due to poor quality of eggs. Don't be discouraged as this is not the end of the road. IVF with Egg Donation can bring you a step closer to motherhood and diminish the fear of infertility with great success.
Low AMH, what are my options to get pregnant?
Low Anti Mullerian level is considered 0.3 – 0.6 ng/ml , this can indicate low ovarian reserve.On one hand is something totally normal for a woman on a later fertility age but on the other hand it might be a sign of premature fertility loss in younger women.
That doesn't mean that you cannot conceive naturally but you might need to take a longer path to motherhood. Treatments like IVF and Ovarian Rejuvenation therapy have shown that can help you achieve pregnancy when you have Low AMH and get a step closer to the dream of giving birth to your own child.
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