Hormone evaluation is particularly useful in evaluating ovarian function.
These tests are performed by obtaining a blood sample. Most of the tests
are performed in our laboratory, so the results will be available within
a couple of days. Since the levels may vary greatly at certain times
in the menstrual cycle, the tests may need to be performed on a particular
day of the menstrual cycle. The following are some of the tests that
Dr. Steinkampf may order for you based on your history:
Androgen levels: Androgens, often referred to as
“male hormones,” are normally produced in women by the ovaries
and adrenal glands. However, some women produce high levels of androgens
that result in ovulatory dysfunction. Some of the androgen levels that
may be ordered for you include testosterone, 17-hydroxyprogesterone
(17-OHP), and dihydroepiandrosterone sulfate (DHEA-S) levels. In general,
these tests may be performed at any time in the menstrual cycle.
Day 3 labs: Follicle stimulating hormone (FSH), Luteinizing
Hormone (LH), and Estradiol (E2) levels are generally low in the very
early part of the menstrual cycle of women with normal ovarian reserve.
However, in women with diminished ovarian reserve (peri-menopause or
menopause), these levels may be elevated. Most patients are instructed
to have these tests performed to evaluate their ovarian reserve. Day
3 labs may actually be performed on day 2, 3 or 4 of the menstrual cycle.
Estradiol levels (E2): As a follicle grows and develops,
it produces increasing amounts of estradiol. Patients with normal ovulation
or those who respond well to clomiphene citrate, estradiol monitoring
has not be shown to be beneficial. However, for patients who require
high doses of clomiphene citrate or gonadotropins for infertility treatment
do benefit from estradiol monitoring. In general, this test is performed
in conjunction with transvaginal ultrasound prior to ovulation.
Progesterone levels (P4): Progesterone is produced
by the remnants of the follicle after ovulation, called the corpus luteum.
Ovulation can be confirmed if the progesterone level reaches a specific
threshold a week after ovulation. This test is recommended for patients
who require no medications or clomiphene citrate to stimulate ovulation,
and is performed eight days after the LH surge.