Hor­mone and fer­ti­lity tests

Fer­ti­lity tests can be done both by women whose de­sire to have children and by women who want to have cla­rity about their own fer­ti­lity. It is a blood test that de­ter­mines the hor­mones re­spon­sible for fer­ti­lity.

Each woman has only a li­mited number of eggs available. With ad­van­cing age, the con­tin­gent of fer­tile eggs be­comes in­cre­asingly de­pleted. The pro­ba­bi­lity of be­co­ming pregnant the­r­e­fore de­creases ra­pidly with ad­van­cing age. [1] Young women can also reach me­no­pause early due to va­rious re­asons, such as en­do­me­triosis en­do­me­triosis. For this re­ason, it is im­portant to know about one’s fer­ti­lity in time.

The anti-mulle­rian hor­mone as a me­a­sure of fer­ti­lity

In­for­ma­tion about the egg cell re­serve is pro­vided by the so-called anti-Mül­le­rian hor­mone egg cell re­serve, which roughly in­di­cates how many eggs are still available in the wo­man’s body [2]. From this, it can be de­duced how much time the woman has left to ful­fill her de­sire to have a child. The value also al­lows a pro­gnosis for the suc­cess of as­sisted re­pro­duc­tion. The AMH normal value in women is bet­ween 1 and 5ng/ml blood. From the age of 30 on­wards, the con­cen­tra­tion of AMH in the blood con­ti­nuously de­creases. Va­lues below 1 in­di­cate that ova­rian func­tion is im­paired.

The Ovars­core test

A re­lated test is the Ovars­core test, which is de­si­gned to show a woman how many fer­tile years she has left. Using an ul­tra­sound exam, your doctor will as­sess your ova­rian re­serve. Ho­wever, your doctor will only see the fol­licles that are available in the cur­rent cycle. A long-term pro­gnosis for a wo­man’s fer­ti­lity is not pos­sible with this test.

In most cases, the fer­ti­lity test is per­formed in the course of a wanted pregnancy. If the longed-for baby luck does not ma­te­ria­lize after six to twelve months, it is ad­vi­sable to con­sult a gyneco­lo­gist or a fer­ti­lity center. First, a check-up or ana­mnesis is first car­ried out. The doctor will ask you about the fol­lo­wing points:

• Phy­sical con­di­tion
• Re­gu­la­rity of the cycle
• Chronic di­se­ases and tem­po­rary in­fec­tions
• At­tempt pe­riod
• Pre­vious pregnan­cies

The fer­ti­lity test for women is com­posed of a blood test and ul­tra­sound scans. While the ul­tra­sound images check the quan­tity of fol­licles, the blood test mainly deals with hor­mones. An ad­di­tional di­stinc­tion is made bet­ween the AMH basic check egg re­serve and a com­pre­hen­sive fer­ti­lity test.

Which hor­mones are ex­amined in a fer­ti­lity test?

While the AMH Basis Check fo­cuses only on the anti-Mül­le­rian hor­mone, the fer­ti­lity test or­ders a com­plete ana­lysis of the fol­lo­wing hor­mones:

• TSH: Al­lows con­clu­sions to be drawn about thy­roid func­tion. Hy­po­thy­ro­idism or hy­per­thy­ro­idism can af­fect the fe­male cycle and hinder con­cep­tion. [3]
• FSH: A low FSH level is an in­di­cator of im­paired fer­ti­lity. Since FSH pro­motes ma­tu­ra­tion and de­ve­lo­p­ment of the egg, ir­re­gu­la­ri­ties can af­fect fer­ti­lity. [4]
• Es­t­ra­diol (E2): es­t­ra­diol is pro­duced in the ova­ries and is re­lated to FSH. The two hor­mones con­di­tion ova­rian func­tion. [5]
• LH: This hor­mone is re­spon­sible for ovu­la­tion and mens­trual cycle. If the le­vels are out­side the normal range, egg ma­tu­ra­tion may fail. [6]
• Tes­to­ste­rone: In po­ly­cy­stic ovary syn­drome — PCOS short for — tes­to­ste­rone le­vels can get out of whack and af­fect the cycle. [7]
• Pro­lactin: If the level is not in the normal range, cycle dis­tur­bances can occur. Du­ring lac­ta­tion, pro­lactin con­tri­butes to the pro­duc­tion of milk and can sup­press ovu­la­tion. [8]

Can I do a hor­mone test at home?

Me­an­while, a fer­ti­lity test for women can also be purchased at the phar­macy or drugs­tore. The test can be per­formed at home and pro­vides quick re­sults. Ho­wever, it cannot be used to de­ter­mine the fer­tile cy­cles: un­der­stand your own cycle, nor the quan­tity of eggs. The self-tests only pro­vide in­for­ma­tion on whe­ther ovu­la­tion oc­curs and when the woman has her fer­tile days ovu­la­tion cal­cu­lator.

Home fer­ti­lity test with la­bo­ra­tory ex­ami­na­tion  
Me­an­while, there are also hor­mone tests on the market that can be done at home and then sent to the la­bo­ra­tory for eva­lua­tion. This will give you a de­tailed fer­ti­lity pro­file, in­for­ma­tion about your egg re­serve and an as­sess­ment of your fer­ti­lity ac­cor­ding to your age.

Fer­ti­lity or hor­mone testing is usually the first step when cou­ples fail to con­ceive, de­spite un­pro­tected in­ter­course. They can also be used when women want to have their ova­rian re­serve che­cked in order to de­cide on so­cial free­zing if ne­ces­sary. The fer­ti­lity test pro­vides re­la­tively re­liable re­sults on how many fer­ti­lizable eggs are pre­sent in the body and ap­pro­xi­m­ately how much time re­mains until me­no­pause. In ad­di­tion, hor­monal dis­or­ders such as PCO syn­drome can be dia­gnosed. The de­ter­mi­na­tion of thy­roid le­vels can help to find the causes of an unful­filled child wish.

If you visit a doctor in the course of an unful­filled child wish, he or she can per­form a hor­mone test or order one in the course of fer­ti­lity tre­at­ment. In this case, the fer­ti­lity test is free of charge and co­vered by your he­alth insu­rance. The cost of ovu­la­tion tests to de­ter­mine fer­tile days is about 30 euros per month. A de­tailed hor­mone test in­clu­ding la­bo­ra­tory eva­lua­tion costs about 120 to 150 euros.

An unful­filled child wish can have many causes, which can just as ea­sily lie with the man. Men can have li­mited fer­ti­lity if the sperm count is low or their moti­lity is rest­ricted. In prin­ciple, men are ca­pable of fa­the­ring children into old age. Nevert­heless, sperm count may de­crease with in­cre­asing age. It is also pos­sible that the sperm oxi­dize or the ability to fer­ti­lize de­creases for this re­ason.

Com­monly, a sper­mio­gram is per­formed for the man at the uro­lo­gist’s of­fice. A fresh semen sample is given to a la­bo­ra­tory in order to be ex­amined for quan­tity, qua­lity, per­for­mance, agi­lity and shape of the sperm. There is also a li­mited ver­sion of the fer­ti­lity test for men that can be per­formed at home. [9]

At Fer­tilly, we have made it our mis­sion to ac­com­pany cou­ples (ho­mo­se­xual and he­te­ro­se­xual) and sin­gles on the way to ful­fil­ling their child wish. In doing so, it is im­portant to us to create trans­pa­rency in the area of fer­ti­lity ser­vices, to pro­vide in­for­ma­tion and know­ledge on the to­pics of pregnancy and fer­ti­lity and to help you to find the most sui­table Fer­ti­lity Center. Th­rough co­ope­ra­tion with first-class Fer­ti­lity Cen­tres and cli­nics in Eu­rope, en­qui­ries about Fer­tilly are given pre­fe­ren­tial tre­at­ment. This means that our pa­ti­ents avoid the usually long wai­ting times and get ap­point­ments more quickly.

If you would like more in­for­ma­tion about Fer­ti­lity Cen­ters, suc­cess rates and prices, please contact us using this ques­ti­on­n­aire. We will ad­vise you free of charge and wi­t­hout any ob­li­ga­tion.