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The Role of Hormones in Fertility Treatments: Everything You Need to Know

Understanding the role hormones play in fertility treatments is essential to family planning and maintaining your reproductive health. However, grasping why they matter, how they interact, and what their test readings mean, can prove challenging. Check out our easy guide on how fertility hormones affect your body, their interactions, and what test readings mean.

What Are Fertility Hormones? 

Fertility hormones are the key players that regulate different reproductive systems in the body. They act as signals for key parts of the reproductive cycle, from initiating menstruation to ovulation. Others can be found working with testosterone to support sperm health and motility.

While men and women share many of the same hormones, they affect each person differently. Here are the key fertility hormones that are frequently tested:

• Follicle-stimulating hormone (FSH) - The pituitary gland makes, and releases, FSH that affects both the testicles and ovaries. In the testes, FSH works with testosterone to stimulate and sustain sperm production. In the ovaries, FSH stimulates ovary follicles to grow eggs in preparation for ovulation.
  
  As a follicle grows, it releases estrogen into the bloodstream. FSH works with Luteinizing hormones (LH), where the hormone causes the mature follicle to rupture and release the follicle's egg around day 14 of the menstrual cycle. After ovulation, the follicle becomes a corpus luteum and releases progesterone.
  
  
• Luteinizing hormone (LH) - LH is a pituitary gland hormone that triggers ovulation and regulates the menstrual cycle. While FSH stimulates ovary follicle growth, LH is the signal hormone that causes the follicle to release the egg.
  
  LH levels typically surge 24 - 36 hours before ovulation. LH also stimulates cells in the testes to produce more testosterone, which affects libido and sperm production.
  
  
• Anti-Müllerian hormone (AMH) - Granulosa cells in ovarian follicles produce AMH during the antral follicle stage. High AMH levels indicate a good ovarian reserve, while low levels may indicate difficulties with fertility. AMH is also useful in egg freezing and IVF, where it can provide an estimate of how many eggs might be obtained in a single egg retrieval cycle. 
  
  
• Estradiol (E2) - A hormone produced by Granulosa cells in the ovaries, adrenal glands, and the placenta during pregnancy. It's a growth hormone for reproductive organs like the fallopian tube, cervical glands, and endometrium.
  
  Estradiol works with Progesterone to prepare the uterus for embryo implantation. Leydig cells in the testes also produce E2 where it regulates sperm maturation, maintains libido, and supports strong bone health.
   
• Progesterone (P4) – The follicle, after ovulation, called a corpus luteum, produces Progesterone. Along with Estradiol, Progesterone helps the body prepare for pregnancy as it stimulates the endometrium to be receptive for embryo implantation. 

How Do Labs and Clinics Test Hormone Levels?

While there are ways to test your fertility at home, it’s best to have a clinic or lab test your hormones for you. These tests are conducted by healthcare professionals and processed in certified laboratories held to rigorous healthcare standards to ensure results are accurate.

Here's how labs and clinics test each type of hormone:

• FSH - FSH levels are measured with a blood test, usually taken on day 2 or 3 of the menstrual cycle. A FSH test assesses ovarian reserves and sperm levels in testes. Normal FSH levels fall between 4 - 9 mIU/mL on days 2 or 3 of a patient's cycle.
  
  Levels that exceed 10 mIU/mL during that time may indicate a reduced ovarian reserve or functionality. High FSH levels are often associated with perimenopause, while low levels may indicate a disorder like pituitary gland disorders.
  
  
• LH – A LH test involves drawing blood or providing a urine sample. In women, a LH test looks for a “Surge,” in levels, which means that ovulation will occur within the next 24 – 36 hours; this is the best time to try for conception. LH tests can also measure testosterone levels in men.
  
  Ovulation Predictor Kits (OPKs) are available over the counter in pharmacies and use urine strip tests or digital tests to measure LH levels. OPK’s are best taken in the middle of a patient's cycle, around 10 - 12 days for cycles that are roughly every 28 days.
  
  
• AMH - An AMH test is useful to assess ovarian reserve. A normal AMH range generally falls between 1.0 - 5.0 ng/mL. However, AMH levels vary widely among individuals and are influenced by age, medical history, genetics, and gynecologic disorders such as PCOS.
  
  
• E2 – Estradiol is measured with a blood test and is usually taken at the same time as the FSH test. High E2 levels indicate a high level of Estrogen, which can impact the accuracy of FSH levels and other fertility treatment outcomes.
  
  The normal range for Estradiol falls between 20 – 80 pg/mL. Levels often fluctuate throughout the cycle, peaking right before ovulation, and may remain elevated during pregnancy as conception occurs.
  
  

Always Review Your Results With a Fertility Specialist

Each fertility hormone plays a complicated, intertwined role in fertility health and reproduction. While it's useful to read and interpret your results, only a certified REI fertility specialist can accurately diagnose how your hormone levels impact your fertility. 

At Pacific Fertility Center, we test for a variety of hormone levels including AMH, E2, FSH, and more. New patients at PFC get a follicular ultrasound along with an AMH blood draw during their initial appointment, in which the MD will review the results of the ultrasound with you as the blood results are sent to labs for testing, and later reviewed by your doctor.

Want to learn more about how your hormones are impacting your fertility from a certified reproductive specialist? Schedule a consultation today!

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