What blood works should be checked if you are trying to get pregnant: 

 

For women:

  1. FSH/LH levels- test should be done on day 3 of your menstruation cycle. The number indicates how sufficient your estrogen levels are, which will give you an idea of the quality of your eggs. The ratio should be 1:1 ideally. If your LH is higher than your FSH levels, you could potentially not have ovulated this cycle.  Combined with other test results (such as high testosterone, ultrasounds, etc.), you could possibly have Polycystic Ovarian Syndrome (PCOS). 

  2. Progesterone level- test should be done on the 21st day of your cycle (in a normal 28 day cycle) or 7 days after your ovulation. The progesterone result has 2 purposes in fertility. One helps you confirm ovulation. It also helps to check your uterine lining thickness. Low progesterone in pregnancy has been linked with increased early miscarriages. 

  3. Thyroid Hormone- 

TSH- thyroid stimulating hormone

TPO- a test to detect antibiotics against TPO (thyroid peroxidase) in the blood

Free T4- tests for how much thyroid hormone you have reserved

Free T3- tests how much thyroid hormone is active

The thyroid gland produces hormones that regulate the body’s metabolic rate.  There are two thyroid- related conditions and diseases that are important to look out for when pursuing fertility treatment. Hypothyroidism is a condition where your thyroid gland doesn’t produce enough thyroid hormones (your blood test will show low TSH levels).  Hashimoto’s disease is an autoimmune disease where your immune system attacks and ultimately damages your thyroid gland, resulting in insufficient thyroid hormone production. Low levels of thyroid hormones can interfere with the release of an egg from your ovary during ovulation. This will impair fertility and could also cause miscarriages, as the fetus’ brain and nervous system development depend on the mother’s thyroid hormone supply. 

  1. Testosterone test- if you suspect you may have PCOS, you should get a testosterone level blood test. High levels of testosterone in women frequently result in anovulation (menstrual cycle where ovulation does not occur).

  2. HDL/LDL, AST/ALT- high cholesterol indicates there is blood stasis in your system, possibly in your liver and your heart. Everyone’s body produces cholesterol. The liver’s function is to produce but also to breakdown cholesterol. Liver problems can cause cholesterol to accumulate and high cholesterol has been linked to poor fertility. 

  3. Glucose- pre- diabetes and diabetes can affect fertility in both men and women. In women, elevated blood sugar levels and insulin resistance can complicate ovulation and make menstrual cycles unpredictable. Women with PCOS are more likely to have insulin resistance and to develop diabetes later in life. 

  4. Vitamin D- in women trying to conceive, good vitamin D levels have been linked to better fertility and healthier pregnancies. A low vitamin D level is associated with low birth weight, reduced fertility, and other adverse pregnancy outcomes. 

  5. Autoimmune test- if you have frequent miscarriages, you should get an autoimmune disorder test. Conditions like Lupus, Crohn’s Disease, Rheumatoid Arthritis, Scleroderma, Addison’s Disease and Celiac Disease can all cause chronic miscarriages. 

  6. Prolactin- high levels of prolactin in the blood can stop the ovaries from making estrogen. In men, prolactin can stop the testes from producing testosterone. 


 

For men:

A semen analysis is the most common procedure when it comes to male fertility testing and the result determines male infertility. If the sperm count is found to be low, a fertility specialist will most likely test for blood testosterone, FSH, LH, and prolactin levels. 

  1. Testosterone- testosterone (T) is a key male hormone. Low testosterone directly affects fertility by causing decreased sperm production and indirectly affects fertility by reducing his sex drive and causing erectile dysfunction. 

 

Physical exams that can be done to prepare for conception:

 

For women: 

  1. Hysterosalpingography (HSG)- an x-ray test that outlines the internal shape of the uterus and shows whether or not the fallopian tubes are blocked. During this procedure, a thin tube is threaded through the vagina and cervix. Block fallopian tubes or abnormal uterine cavities can cause infertility. 

  2. Transvaginal Ultrasound- uses sound waves to create images of the vagina, cervix, uterus, and ovaries. It is also used to diagnose pelvic pain, menstrual and gynecological problems, and abnormal bleeding. It is helpful in visualizing fibroids, cysts, tumors, and endometriosis, which can cause obstruction for embryo implantation. 

For men: 

Physical exams for make fertility/infertility are typically referred and performed by Urologists. The doctor may examine the penis, scrotum, testicles, and prostate for medical problems such as Varicocele (an enlargement of veins in the scrotum), irregular testicle size, and/or enlarged dysfunctional prostates.

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