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TESTS · FERTILITY HORMONE TESTS
Fertility hormone tests are blood tests that show whether you ovulate, how the ovaries or testes are responding, and whether the thyroid or prolactin is getting in the way. Each one answers a specific question, and the day you take it matters.
The core fertility hormone tests are FSH, LH and oestradiol (how the brain and ovaries are talking), progesterone (whether you ovulated), prolactin and TSH (two common reasons ovulation stops), and testosterone (PCOS in women, sperm production in men).
AMH, the egg reserve test, is often drawn at the same time but answers a different question, so it has its own page. Not everyone needs every test. Your cycle, your history and your partner's semen report decide which ones are useful.
AMH and ovarian reserveEach is a simple blood test from the arm, and most can be drawn together in one visit.
No fasting is needed for these hormones [CONFIRM: unless glucose or insulin is added]. Tell us if you are on the pill or other hormones, because they change the results. For men, testosterone is drawn in the morning, when it is highest.
FSH, LH and oestradiol change through the cycle, so they are measured early, on day 2 to 4 of the period, when they can be compared with standard values.
Day 1 is the first day of full bleeding, not spotting. Progesterone is measured about 7 days before your next period (day 21 of a 28-day cycle), when it peaks after ovulation. If your cycles are longer, the day moves later. Prolactin, TSH and AMH can be tested on any day.
Hormone tests cannot tell you whether your tubes are open, whether the sperm are healthy, or whether you will get pregnant.
A single abnormal value is often repeated before acting, because stress, poor sleep, illness and timing move hormone levels. An isolated day 2 FSH also varies from month to month. Hormones are one part of the picture, read with a scan, a tube check and his semen analysis.
Prolactin is not part of the routine infertility work-up. It is tested when periods are irregular or absent, or there is nipple discharge. The same logic applies to every test on the list: order it when it can change the plan. (What the evidence says (ASRM, 2021))
Most hormone problems that affect fertility can be treated, often with tablets rather than IVF.
High prolactin is usually brought down with medicine, and ovulation often returns. An underactive thyroid is corrected with a daily tablet before trying. PCOS is managed with weight, then ovulation tablets. For men with low hormone levels from the brain, hormone injections can restart sperm production.
Lifestyle, led by a healthy weight. Then smoking, alcohol, about seven hours of sleep, stress, folic acid, and correcting thyroid, diabetes, blood pressure and vitamin D. (Dr Vani Sundarapandian, on the factors couples can influence most)
Bring your reports with the dates and your cycle day written on them. We read them with you.
Units: Hormones are printed in different units by different labs (for example oestradiol in pg/mL or pmol/L, prolactin in ng/mL or mIU/L). Compare a result only with the reference range on the same report.
Follicle-stimulating hormone: the brain's signal to grow follicles.
Luteinising hormone: triggers ovulation and supports hormone production.
LH divided by FSH, printed by some labs.
The main oestrogen, made by growing follicles.
Made after ovulation; shows that you ovulated that month.
The milk hormone. High levels can stop ovulation.
Thyroid-stimulating hormone: the main thyroid screening test.
The thyroid hormone itself.
Male-type hormone, tested when PCOS is suspected.
Show whether the testes make sperm and hormones normally, and whether the brain is signalling.
IfAll within range, ovulation confirmed
Hormones are not the problem. We move on to the tube check and his semen analysis, if not done.
What that meansIfNo ovulation, with signs of PCOS
Weight and lifestyle first where relevant, then ovulation tablets with scans.
What that meansIfHigh prolactin (confirmed on repeat)
Look for the cause (medicines, thyroid, a small pituitary growth), then medicine to bring it down. Ovulation often returns.
What that meansIfRaised TSH or abnormal thyroid
Treat and recheck before trying or starting treatment.
What that meansIfRaised FSH or low reserve
Read with AMH and a follicle scan. Time matters more, so the plan moves faster.
What that meansIfMen: high FSH with no sperm, or low testosterone
An examination and genetic tests. Sperm retrieval, or hormone treatment when the brain signal is low.
What that meansDo any of these sound like you?
Your question is about egg reserve? Start with the AMH page.
Your cycle length, symptoms, medicines, and every test you've already had.
Only the hormones your history calls for, on the right cycle day, plus his semen analysis.
Each result explained, and what it changes: treat a hormone first, or move to the next test.
Thyroid or prolactin treatment, ovulation tablets, or fertility treatment when needed.
Still unsure? Ask us on WhatsApp — a real person replies.
A day 2 hormone test is a blood test for FSH, LH and oestradiol taken on day 2 to 4 of your period, when these hormones are at their baseline. It shows how the brain and ovaries are working and gives a rough sign of egg reserve.
The LH to FSH ratio compares the two hormones on a day 2 test; a high ratio is common in PCOS. It is not used on its own to diagnose PCOS, because many women with PCOS have a normal ratio.
Yes, high prolactin can stop ovulation and cause irregular or absent periods. It is usually treatable with medicine, after a repeat test confirms it and the cause is checked.
Common causes of high prolactin in women are stress, some medicines, an underactive thyroid, breastfeeding and a small, usually harmless pituitary growth called a prolactinoma. A mildly high result is repeated before any treatment.
Test progesterone about 7 days before your next period: day 21 of a 28-day cycle, later if your cycles are longer. Testing on the wrong day is the commonest reason for a falsely low result.
A thyroid test (TSH) is advised if you have symptoms, irregular periods, a thyroid history or a family history, and many clinics check it before treatment. An underactive thyroid is easy to treat before trying.
A man needs FSH, LH and a morning testosterone when his semen count is low or zero, or he has low libido, erection problems or small testes. With a normal semen analysis, hormone tests are usually not needed.
Dr. Vani mam is incredibly knowledgeable and took the time to explain everything clearly.
The billing section staff, financial counsellor, lab staff, pharmacist all work in splendid coordination avoiding any stress for us.
Share your hormone results with the cycle day and date. A real person from Dr Vani's team replies on WhatsApp, usually within minutes during clinic hours (Mon to Sat, 9am to 5pm. Sunday closed.).