Chances are, you haven’t thought much about hormones since puberty. When you start fertility treatment, though, you’ll discover that hormones play an important role in your overall reproductive health. 

When you go to an initial consultation at a fertility clinic, they’ll likely take several vials of blood to measure levels of different hormones. We’ve compiled a list of hormones that you might hear about throughout your fertility journey, plus ways to improve your levels, if possible.

AMH 

What is AMH? 

Anti-mullerian hormone (AMH) is found inside cells in the follicles of a woman’s ovaries. Testing the level of AMH can help estimate a woman’s egg count. People with a higher AMH level have more eggs, while lower levels indicate diminished ovarian reserve.

How do you test AMH? 

It’s a simple blood test, usually done at your fertility clinic consultation.

Can AMH levels be improved? 

AMH is considered a snapshot of about a 6 month window of your ovarian reserve. The levels are not a direct correlation to quantity. The result may vary from lab to lab, but will decrease over time as we lose eggs each menstrual cycle.

If you’re currently taking hormonal birth control, your reported AMH level may not be accurate until those hormones are out of your system, either by stopping birth control pills or removing a hormonal IUD, and retesting.¹ Typically, if you’re on hormonal birth control, this test will show a lower AMH level than you actually have. Ask your doctor for details about how your birth control might affect your AMH test results.

Follicle-stimulating hormone (FSH)

What is FSH? 

FSH is a hormone secreted from the pituitary gland in the brain that is responsible for the stimulation (growth) of the follicles in each menstrual cycle. FSH peaks very early on in the menstrual cycle, and the level can be an indicator of “how hard” your body is working to recruit a follicle to grow and eventually ovulate. Many doctors will check baseline FSH bloodwork, which is done on day 2 or 3 of your period. It can shed some light on how well a woman may respond to treatment. 

How do you test FSH? 

It’s a simple blood test that can be done in your doctor’s office or ordered by your doctor at an outside lab for convenience.

Can FSH levels be improved? 

FSH levels can’t be improved, but they can be altered with medication. You may see fluctuation month to month if you choose to repeat testing, but it’s not often a good use of time and resources. FSH alone is not a useful data point: FSH and estradiol have an inverse relationship (if one is elevated, the other is often suppressed), so it’s necessary to look at both levels together.

Estradiol (estrogen) 

What is estradiol? 

Estradiol is a hormone released from the ovary. Different levels of estradiol can mean many different things at various points in a menstrual cycle, but the main role of estrogen is to thicken the endometrial lining and prepare the uterus for implantation of an embryo. Estrogen rises as follicles grow in the follicular phase of the cycle and peaks just before ovulation occurs. Fertility specialists use estradiol to supplement or replace estrogen in different treatment protocols.  

How do you test estradiol? 

It’s a simple blood test that can be done in your doctor’s office or ordered by your doctor at an outside lab for convenience.

Can estradiol levels be improved? 

In the early part of fertility treatment, your doctor will prescribe estrogen-based medication to regulate the ovaries and suppress follicle development. Your doctor might also recommend making small lifestyle changes to help improve low estrogen levels, like exercising moderately, getting a good night’s sleep, and reducing stress.²

Luteinizing Hormone (LH) 

What is LH? 

LH is the hormone responsible for ovulation, which is when the egg completes its maturation process and is released from the follicle.⁶ People with irregular or no periods might have high levels; people who are very underweight and don’t have periods might have very low levels. Luteinizing hormone (LH) levels fluctuate depending on where you are in a menstrual cycle, and the level isn’t necessarily good or bad across the board.³ Your doctor can help explain what your personal LH level might indicate.

How do you test LH? 

It’s a simple blood test that can be done in your doctor’s office or ordered by your doctor at an outside lab for convenience.

Can LH levels be improved? 

Like other hormones, it is possible to alter abnormal LH levels with medications. If you’re underweight, establishing a healthy BMI can help correct LH levels.

Progesterone 

What is progesterone? 

Progesterone is a hormone that is essential for preparing the uterus for pregnancy, and continues to be crucial as the fetus develops. After ovulation, the residual follicle (called the corpus luteum) creates progesterone to proliferate the endometrium. Progesterone levels are maintained until pregnancy is established. If not pregnant, the progesterone will withdrawal, inducing the onset of the next menses. In many fertility treatments, progesterone supplements are used in the form of vaginal suppository or injection.   

Estrogen and progesterone are both important hormones in reproductive health. 

How do you test progesterone levels? 

It’s a simple blood test that can be done in your doctor’s office or ordered by your doctor at an outside lab for convenience.

Can progesterone levels be improved? 

Progesterone levels can be improved with various medications. Your clinical team can advise you what treatment is best for you.

Prolactin (PRL)

What is prolactin? 

It’s a hormone responsible for breast development and milk production in women. If you have high levels of prolactin, it might mean that you have a pituitary tumor that can prevent you from getting pregnant. 

Some foods and breast stimulation can affect your prolactin levels. If your initial lab results come back elevated, you may be asked to repeat the test while fasting and abstaining from sexual activity. If levels continue to remain elevated, it may be suggested you have an MRI of your brain to see if there is a pituitary tumor. This can be a cause of infertility. 

How do you test prolactin? 

It’s a simple blood test that can be done in your doctor’s office or ordered by your doctor at an outside lab for convenience.

Can prolactin levels be improved? 

Your doctor might recommend taking a progesterone medication to help improve your level of prolactin. Eating apricots and dates can also increase prolactin.⁴

Androgens 

What are androgens? 

Androgens are hormones responsible for growth and reproductive processes in men and women. A higher than expected level of androgens can be a sign that you might have ovulation problems or polycystic ovarian syndrome (PCOS), both of which can contribute to fertility challenges.⁵

How do you test androgen levels? 

It’s a simple blood test that can be done in your doctor’s office or ordered by your doctor at an outside lab for convenience.

Can androgen levels be reduced? 

Your doctor might recommend taking a progesterone medication to help improve your level of androgens. Consult your doctor on the best way to reduce your androgen levels. 

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