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			Concern Treatment Pregnancy Experiences Treatment The Doctor's Visit Couples Evaluation Female Specialist Tests Cervical Mucus Endometrial Biopsy Hormone Assay Hysterosalpingogram Hysteroscopy Karyotyping Ovarian Procedures Laparoscopy Medical History Postcoital Prolactin Surgery Tubal Procedures Ultrasound Male Specialist Tests Personalised Treatment Female Treatments Male Treatments Implications of Treatment Enhance Your Well-being Questions to Ask Your Doctor Treatment FAQ Contact Your Doctor		Hormone Assay A thorough endocrine investigation is conducted on people who have signs or symptoms of hormonal abnormalities detected during the medical history and physical examination. Many of these assays are crucial in diagnosing infertility disorders caused by disturbances in the hypothalamic-pituitary-ovarian axis. Many specialists offer a hormonal panel of tests for infertility patients, which might include FSH, TSH, DHEAS, prolactin and others. However, the number of hormonal assays may be limited by the ability or willingness of the person to pay for them. The most common hormonal assays are presented in the following table. Hormonal assay examination Target organ and hormone Procedure Rationale Pituitary gonadotropins FSH and LH levels. Blood serum measurement. Taken days 2-6 of menstrual cycle. May help to rule out ovarian failure. Abnormal levels of FSH and LH may indicate infertility due to hyperprolactinaemia LH-FSH ratio may be useful in PCOS diagnosing and selecting proper therapy. Prolactin Prolactin levels. Blood serum measurement taken. Usually taken days 2-6 of menstrual cycle. High levels of prolactin (hyperprolactinaemia) can indicate the presence of pituitary tumour and can cause /menstrual ovulation disorder. Hyperprolactinaemia blocks the action of LH and FSH. Ovary Oestradiol (E2) levels. Blood serum measurement taken. Usually taken days 2-6 of menstrual cycle. Used to assess ovarian function. Oestradiol levels can be used to monitor follicular development. Ovary Testosterone (T) levels. Blood serum measurement. Provides evidence of the occurrence of ovulation. Ovary Progesterone (P) levels. Blood serum measurement, taken at day 21 of the menstrual cycle (7 days post ovulation). Provides evidence of the occurrence of ovulation. Used to determine adequacy of luteal phase. Adrenal gland Androgen levels. DHEAS. Cortisol. Androstenedione. 17-hydroxyprogesterone. SHBG. Blood serum measurement of various androgens. Usually taken days 2-6 of cycle. Dexamethasone suppression. Used as an assessment of androgen production. Abnormally elevated androgen levels may be a factor for infertility in females. Abnormally deficient testosterone levels may lead to infertility in males. Can determine the site of excess androgen production. Thyroid Thyroid function tests (TSH, T3, T4). Blood tests to determine total serum thyroxine (T4), TSH and TRH. To detect hypothyroidism (a deficiency of thyroid activity) that may lead to infrequent ovulation. As can be seen from this table, it is very important to conduct certain tests within the infertility evaluation at a particular time during the woman’s menstrual cycle for the results to be valid. Some typical presentations and hormonal profiles of women presenting to infertility clinics with complaints of delay in becoming pregnant are summarised in the table below. It is important to note that, with the exception of patients with premature ovarian failure, most of these women can today be helped to achieve pregnancy.
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