Tests -Hormonal Assessment
follicles produce estrogen which signals the hypothalamus
to increase or reduce the amount of FSH produced by the
pituitary gland. When "good" follicles are not
developing, estrogen levels are lower and more FSH is
produced. This leads to higher levels of FSH on day 3.
3 FSH fertility test is not the only parameter used
to assess ovarian reserve. Poor ovarian reserve is indicated
by an FSH of >9, a high FSH/LH ratio (>2.5) even
in the presence of a normal FSH or a high E2 level (>60
pg./ml). We also use the clomiphene citrate challenge
test to help determine ovarian reserve.
woman who has poor day 3 hormonal results, especially
if she is older, should consider using an egg donor.
Success rates are high and match the donor's age group.
For example, embryos from a healthy 23 year old that
are placed in a 45 year old will retain the pregnancy
rate of the younger female.
chorionic gonadotropin (b-hCG) is produced by the placenta
and elevated levels indicate that pregnancy has occurred.
hormones are produced by the thyroid gland and levels
are measured with blood tests. Hypothyroidism (low levels)
can cause anovulation and early pregnancy loss. Hyperthyroidism
(high levels) is associated with many abnormal conditions
including irregular ovulation, fetal abnormalities,
and premature labor.
androgen levels (male hormones) can case irregular or
absent ovulation and are seen in conditions such as
polycystic ovarian disease. Elevated androgen levels
are also associated with obesity. Women with excess
androgen usually have excess body hair and oftentimes
a characteristic pear shaped body appearance.
Citrate Challenge Test (CCCT)-Each
month one follicle will become dominant, develop under
the influence of FSH, and be ovulated. Ovarian reserve
is an indication of the "quality" of the eggs
remaining in a woman's ovaries. Egg quality, and ovarian
reserve, naturally decline as women age and approach
menopause. Some women experience this decline earlier
in life (for unknown reasons) and this is a common cause
of sub fertility.