Hormone Monitoring
Blood tests for hormone monitoring can be used to determine a patient’s normal hormonal levels at the beginning of a cycle and to assist in determining medication type, dosage and start date. Ovulation induction involves the use of fertility drugs that mimic the body’s natural hormones in an attempt to stimulate the ovaries to produce multiple eggs during an IVF cycle. Blood tests for hormone monitoring can be used to determine a patient’s normal hormonal levels at the beginning of a cycle and to assist in determining medication type, dosage and start date.
Hormone Monitoring Fertility Tests
Beta-HCG (Human chorionic gonadotropin hormone)
In females, measurement of HCG is used as a determination and monitoring of pregnancy status. HCG is secreted by the cells of the placenta that attach the baby to the uterus. Almost from the time of implantation HCG production begins. Ectopic pregnancies and pregnancies terminating in spontaneous abortions tend to have lower than normal circulating HCG levels, while somewhat higher levels are often seen in multiple pregnancies.
Estradiol
A hormone produced in the ovaries by cells that surround a developing egg (follicle). In terms of ovarian reserve, this test is used to confirm the results of a day 3 FSH. A high estradiol level may artificially lower (or mask) what otherwise would be a higher (potentially abnormal) FSH. The other two uses of this test are: 1.) for the diagnosis of amenorrhea (the absence of a menstrual period) and 2.) to monitor progress during ovulation induction.
Follicle Stimulating Hormone (FSH-female)
A hormone produced by the pituitary gland which is located in the brain. It plays a key role in the development of follicles (immature eggs) into mature eggs. FSH also plays an important role in telling the ovaries when it is time to release a mature egg (ovulation). A normal FSH level indicates a woman has a good supply of eggs (ovarian reserve) and is a good candidate for ovarian stimulation in IVF. As a woman gets older and the number of eggs she has remaining becomes low it takes more FSH to produce an egg. Therefore a high FSH score indicates a low or declining egg supply (ovarian reserve). FSH values can fluctuate from one cycle to the next, so when looking at multiple FSH values the highest value is the one that is considered to be the most accurate. For example if a woman had an initial FSH of 9 and had another FSH a month later with an FSH of 5 it does not mean her ovarian reserve had improved. Her true score is still considered to be an FSH of 9.
LH (Luteinizing Hormone, lutropin – female)
Serum LH determinations have been very useful in the diagnosis and treatment of infertility in women. A midcycle rise is a good indication that ovulation will occur approximately 24 hours later. Subfertile couples, and women being treated with gonadotropin for infertility, can be informed that ovulation is imminent. In the woman LH is necessary for the production of estrogen. When estrogen reaches a critical peak, the pituitary releases a surge of LH (the LH spike), which releases the egg from the follicle.
Progesterone
Progesterone is a steroid hormone secreted by the ovary during the second half of the menstrual cycle (luteal phase). It plays an important role in the preparation for and maintenance of pregnancy. Daily progesterone levels are considered the most accurate means for documenting a defective luteal phase. Measurements of serum progesterone have also been used to check the effectiveness of ovulation induction, to monitor progesterone replacement therapy and to detect and evaluate patients at risk of abortion during the early weeks of pregnancy.
