E2

Estradiol (E2) is the most effective estrogen of the estrogen hormone family and is the female fertility hormone. It influences the maturation of the follicles and acts mainly as a growth hormone for the reproductive structures in females. The amount of estrogen produced depends on the phase of the menstrual cycle. When the ovaries are functioning well, estradiol levels are relatively low around day three of the menstrual cycle and are therefore referred to as baseline estradiol levels.

Estradiol is not typically utilized as an indicator of ovarian reserve; its primary role is to complement the interpretation of FSH levels. When both estradiol and FSH levels are within the normal range, it suggests a normal ovarian reserve, indicating good egg quality and quantity, as well as age-related fertility potential. It is crucial to assess both FSH and estradiol since elevated estradiol levels can artificially suppress FSH levels. Elevated estradiol combined with normal or elevated serum FSH may signal a reduction in ovarian reserve, potentially diminishing a woman’s chances of conception.

Abnormally high estradiol levels in non-pregnant women could be indicative of an underlying health issue, such as endometriosis or infrequent ovulation.

Conversely, extremely low or undetectable estradiol levels may lead to various symptoms, including vaginal dryness, headaches, reduced libido, and decreased bone density.

LH

LH (Luteinizing Hormone) is a hormone produced by pituitary gland and helps the reproductive system in both men and women. It plays a role in puberty, menstruation, and fertility. In women, LH levels change with age and throughout the menstrual cycle. There is a sudden increase between the 12th and 14th day of the menstrual cycle that triggers ovulation. A normal value usually means that there is enough estradiol and progesterone available and that the ovaries are not yet restricted in their function. An increased FSH level in combination with a normal LH level can, however, also occur during the menopause and shows that the ovaries still have residual function.

Slightly elevated levels of LH, alongside elevated FSH levels, suggest impaired ovarian reserve (poor egg quantity and quality) that accompanies chronological aging and might predict a lower chance for a successful pregnancy. Abnormally high levels of LH during nonovulatory times or persistently high levels can indicate that you have entered menopause. During menopause, the LH value rises to five times, but it can be subject to strong fluctuations. After menopause, the LH level remains slightly elevated.

FSH

FSH, a hormone present in both men and women, plays a crucial role in the reproductive system. In women, it is responsible for promoting the growth and maturation of ovarian follicles, which, in turn, produce estrogens and progesterone to regulate the menstrual cycle. It’s worth noting that estradiol levels naturally inhibit FSH on the third day of the menstrual cycle. When FSH levels remain relatively low but within the normal range, in conjunction with normal day 3 estradiol levels, this indicates a healthy ovarian reserve, reflecting good egg quality and quantity as well as normal age-related fertility potential.

On the other hand, slightly elevated FSH levels, when accompanied by elevated LH levels, suggest a compromised ovarian reserve, characterized by diminished egg quantity and quality associated with the aging process. Such findings may indicate a reduced likelihood of successful pregnancy. In women experiencing the natural decline in ovarian function, elevated FSH levels can often coincide with increased estradiol levels. Additionally, in premenopausal women, elevated FSH alongside elevated estradiol levels may raise suspicion of functional cysts, which typically do not impact fertility and often resolve on their own.

It’s worth noting that minor increases in FSH levels can also be attributed to factors like stress or being underweight.

TSH

Thyroid Stimulating Hormone (TSH) is a hormone produced by the pituitary gland in the brain that controls thyroid hormone production. Thyroid hormones are crucial for regulating metabolism, energy production and play a big part in fertility and pregnancy. Normal TSH levels generally indicate a normally functioning thyroid gland that does not interfere with a woman’s ability to get pregnant.

Reduced levels can be attributed to either hyperthyroidism or hypothyroidism. Thyroid function abnormalities have a detrimental impact on reproductive health and are linked to an elevated risk of unexplained infertility and recurrent miscarriage. When TSH levels are low, it is imperative to follow up with measurements of thyroid hormones, specifically thyroxine (T4) and triiodothyronine (T3). Slightly decreased levels may stem from subclinical hyperthyroidism or subclinical hypothyroidism, which represent early, mild stages of thyroid disorders that can potentially hinder a woman’s fertility.

Conversely, slightly elevated levels can result from subclinical hypothyroidism or subclinical hyperthyroidism, also representing early, mild forms of thyroid disorders that may impact a woman’s ability to conceive.

Extremely high TSH levels are typically accompanied by disruptions in thyroid hormone levels, leading to impaired ovarian follicle maturation, reduced fertilization rates, and lower embryo quality. This, in turn, contributes to unexplained infertility and recurrent miscarriage. Both high and low TSH levels should prompt follow-up measurements of thyroid hormones, namely thyroxine (T4) and triiodothyronine (T3).

Prolactin

The hormone prolactin is formed in the front part of the pituitary gland and reaches its place of action via the blood system. This is primarily the female mammary gland: prolactin promotes its growth and, after childbirth, the production and secretion of breast milk. In addition, during pregnancy and breastfeeding, prolactin inhibits the menstrual cycle by preventing the release of various other hormones.

Prolactin levels are rarely decreased. The reason can be a dysfunction of the pituitary gland or the use of medications that lower prolactin. In most cases, a low prolactin level isn’t a problem. If a functional weakness of the pituitary gland can be ruled out as the cause, usually the doctor will just continue to check the prolactin level regularly. The doctor will also check whether any medication you may have been taking is responsible for the low levels.
Possible causes for an increased prolactin level (Hyperprolactinemia) can be:

• A deficiency of dopamine (dopamine works as an inhibitor of prolactin)
• Medication (such as hormonal contraceptives, antidepressants, blood pressure medication)
• A deficiency of thyroid hormones (hypothyroidism)
• A prolactin-forming tumor
• Severe kidney failure (renal insufficiency), leading to prolactin not being excreted sufficiently
• Increased levels of male sex hormones in women

However, high prolactin levels can also be caused by other things like pregnancy and breastfeeding, but also by physical or emotional stress.

General

Please read the following instructions in detail, before starting with the sample collection.