Lab Tests

​

          Your provider will let you know which laboratory tests are necessary to ensure you receive the treatment that is best for you.  The following is a list of some of the most commonly ordered tests.  Not everyone needs all of these tests.  If you’ve had these tests performed recently, they may not need to be repeated.  If you have a history of pregnancy losses, other testing may be recommended.

• Antimüllerian Hormone (AMH):  AMH is a hormone produced by special (granulosa) cells in microscopic and very immature follicles (egg sacs) before they are even big enough to be seen on ultrasound.  The results provide valuable information about ovarian reserve (what is gradually lost between youth and menopause).  This test may be performed at any time in the menstrual cycle.

• Estradiol (E2):  Estradiol is the key hormone that is produced by developing follicles (egg sacs).  The amount of estradiol increases as follicles enlarge and become more mature.  This test is often performed in conjunction with ultrasound for monitoring your response to fertility medications.

• Follicle Stimulating Hormone (FSH):  FSH is produced by the pituitary gland near the brain.  This hormone directly stimulates the ovary to grow and mature follicles and the egg contained inside each follicle.  The best time to perform this test is in the first few days of the menstrual cycle.  This test is one of the ways to evaluate your ovarian reserve.

• Genetic Carrier Screening:  Certain genetic disorders can negatively impact fertility.  In addition, even though a patient may have no family history of genetic disorders, she can still be a carrier of various disorders.  Most people are carriers for a few genetic disorders.  However, if both the patient and her husband/partner are carriers for the same disorder, any pregnancy may result in a fetus/child affected by the actual genetic disorder.  We recommend genetic carrier screening on every female patient who is attempting pregnancy using her own eggs.  If she is found to be a carrier for genetic disorders, her husband/partner should then be tested.  If you opt not to have this testing performed, you will be asked to sign an opt-out consent form.

• hCG (pregnancy test):  A blood pregnancy test will be ordered if you are late for a period or a couple of weeks after certain fertility treatments.  Please keep in mind that certain medications can affect the accuracy of home pregnancy tests.

• Hemoglobin A1c (HgbA1c): This blood test measures the percentage of the oxygen-carrying protein in your blood that has sugar attached to it. Simply stated, this level gives us an idea about your average blood sugar levels over the past 2 - 3 months. The higher your A1c level is, the poorer your blood sugar control and the higher your risk of diabetes and its complications.  Women with polycystic ovary syndrome (PCOS) are at a higher risk for having an elevated HgbA1c levels, and it is important that this be treated to promote a healthy pregnancy.

• Progesterone (P4):  After ovulation, the remaining follicle sac forms a functioning gland called a corpus luteum.  The corpus luteum makes the hormone progesterone.  Measuring the progesterone level in your blood helps us to know if you had a normal ovulation.  We can adjust your treatment plan in your next treatment cycle if your progesterone level is low.

• Prolactin:  Prolactin is a hormone made by the pituitary gland at the base of the brain. This hormone causes the breasts to grow and make milk during pregnancy and after birth. While it is normal for the level to be high in pregnant women and new mothers, a high level at other times may interfere with normal ovulation and with continuing a pregnancy.

• Thyroid Stimulating Hormone (TSH):  The thyroid is one of the master glands in the body.  A TSH level shows how well the thyroid is functioning.  Abnormal thyroid function (either too much or too little) can lead to ovulation disorders and pregnancy complications, as well as other health issues.

• Thyroid Peroxidase Antibodies (TPO antibodies):  Thyroid peroxidase is an enzyme that plays an important role in normal thyroid function. Some patients develop antibodies to this enzyme.  High levels of TPO antibodies suggest an autoimmune disorder of the thyroid, such as Hashimoto’s or Graves’ disease.  While not all patients who have high antibody levels have thyroid disorders, these findings are suggestive that the patient is at high risk for future thyroid disease.  A high TPO antibody level may indicate an increased risk of miscarriage, and this risk can be treated.