Your Guide to Female Fertility & Fertility Blood Testing
If you’re thinking about planning a family, have been trying to conceive for a few months, or are simply curious about your hormone health, you might be wondering what you can do to check on your hormone and fertility health. One of the first steps you can take is to consider simple fertility blood tests. These tests can provide the reassurance you need and help identify areas where you might need further assistance.
Fertility blood tests provide valuable insights into your fertility health. They can help determine if your hormones are functioning properly, if you need further investigations, and whether your ovarian reserve is appropriate for your age. Blood tests can empower you with knowledge about your hormonal health and fertility, and if necessary, help you advocate for further investigations or treatment from your doctor.
Understanding Your Hormonal and Fertility Health
It’s never too early to become informed about your hormonal and fertility health, especially if you have concerns. Hormonal imbalances are common and can be due to conditions such as Polycystic Ovarian Syndrome (PCOS). Blood tests can identify hormone imbalances and help you get the necessary diagnosis and treatment.
While many couples achieve pregnancy easily, 1 in 7 couples will struggle to conceive. Many factors influence your fertility potential, including age, lifestyle factors (such as smoking, alcohol consumption, and environmental exposure), the health of the sperm, and social infertility, which refers to the difficulty single people or same-sex couples may face in conceiving. Sadly, for 10% to 28% of couples, the cause of infertility is unknown, and they may be diagnosed with unexplained infertility.
Struggling to conceive can be isolating and confusing. By taking steps to become informed about your hormonal health, you are taking control and doing all you can to understand why getting pregnant may be taking longer.
Testing Fertility Hormones
Several hormones can provide you with an excellent insight into your health and your fertility, including:
Follicle Stimulating Hormone (FSH)
This vital hormone helps control a woman’s menstrual cycle and the growth of follicles that contain eggs in the ovaries. This test is used to help evaluate your egg supply and ovarian function. The fewer eggs you have the more FSH your brain produces to encourage the remaining eggs to mature. Monitoring your FSH can help you understand more about your reproductive health. It can help to diagnose certain conditions such as premature ovarian insufficiency (POI), peri-menopause or menopause.
Luteinising Hormone (LH)
The pituitary gland produces LH, an important component in initiating ovulation as it surges mid-cycle. Some women with conditions such as PCOS or pituitary disorders may have altered levels of LH.
Oestradiol
Oestradiol is the main female sex hormone and is responsible for a healthy reproductive system. Oestradiol increases and is more dominant in the first part of the cycle, peaking at ovulation. Oestradiol impacts your general health and imbalance can cause symptoms such as dry skin and vaginal dryness. Oestradiol declines with age and low levels of oestrogen are responsible for symptoms experienced in menopause such as hot flushes, night sweats and brain fog.
Thyroid Stimulating Hormone (TSH)
TSH is produced by the pituitary and stimulates the thyroid gland to make two other important hormones Thyroxine (T4) and Triiodothyronine (T3). Abnormal thyroid function can manifest as an overactive or underactive thyroid. This can impact your overall health causing problems with weight, tiredness, digestion and mood. In some circumstances, abnormal prolactin function may affect your ability to conceive and can increase your risk of miscarriage.
Testosterone
In women, testosterone is produced naturally in small amounts by the ovaries. It is responsible for certain ‘male characteristics’ such as excess bodily hair, hair thinning on the scalp and acne. Monitoring testosterone can help to identify the causes of these symptoms and in some circumstances, women who are diagnosed with Polycystic Ovarian Syndrome (PCOS) may have raised levels of testosterone.
Sex Hormone Binding Globulin (SHBG)
SHBG is a protein which transports the sex hormone testosterone (among others) in the blood. Hormones which bind to SHBG are inactive and unavailable in your cells. Measuring the level of SHBG can help provide important information about your hormonal health and help in diagnosing hormonal conditions such as PCOS.
DHEA-S
DHEA-S is the sulphated form of DHEA, a hormone which is produced by the adrenal glands and is responsible for male characteristics such as excess bodily and facial hair, thinning of hair on the scalp and acne in women. This test is helpful when investigating certain hormonal conditions such as PCOS, delayed puberty or adrenal disorders.
Anti-Mullerian Hormone (AMH)
AMH is a hormone produced by the ovaries. Levels can indicate how high or low your ovarian reserve is based on the degree to which your egg reserve decreases with age. When considering your fertility potential, this test result mustn’t be considered as a guarantee of a baby. It is recommended that the results of an AMH test are interpreted with other blood test levels such as FSH and Oestradiol, and that the result of an AMH is also considered alongside other tests such as a scan to assess your ovarian reserve. AMH is also used to determine how many eggs you are likely to achieve at egg collection when going through IVF treatments.
How are These Tests Interpreted?
Blood tests offer a quick and easy way of understanding your hormonal health and provide you with a unique insight into your reproductive health, however, it is important to remember that they form part of the picture and it is recommended that you share these results with your doctor to discuss what they mean for you and your health.
Your doctor can help you understand your test results and, if necessary, arrange further investigations. You can also use the results of your test to monitor your hormonal and fertility health going forward, and how healthy changes to your lifestyle positively influence your test results.
Our Female Fertility Blood Test
Take Control of Your Fertility Health
Understanding your hormonal health can significantly benefit your fertility awareness, giving you control over your reproductive health and potentially reducing the time it takes to conceive. We discussed important hormones involved in reproduction and the fertility tests to consider. Remember, fertility blood testing is just one step.
Healthy lifestyle choices, taking folic acid and vitamin D, and regular sexual intercourse are also crucial. If you have concerns about your fertility, consult your doctor promptly, as early action can make a significant difference. Good luck on your fertility journey and in creating your family.
Frequently Asked Questions
How do I know if I’m fertile?
When you start thinking about trying to conceive, or if you have been trying for a few months, you may want to understand more about your fertility. Simple tests like blood tests for women and sperm tests for men provide good insights into fertility. Tracking your menstrual cycles to identify your fertile window and maintaining a healthy lifestyle can also help.
How does age affect fertility?
Age significantly influences fertility. For women, fertility starts to decline around age 35. Conception is still possible after 35 but may take longer, might require medical assistance, and carries a higher risk of miscarriage. Men's fertility begins to decline from around 40-45.
What age is a woman most fertile?
Women are most fertile in their teenage years and their 20’s. However, in today’s society, women tend to leave getting pregnant until later and the majority of women will go on to conceive and have healthy pregnancies.
How can a woman become more fertile?
A healthy lifestyle can optimise fertility. Eating a balanced diet, regular exercise, maintaining a normal BMI, not smoking, and reducing alcohol and caffeine intake can help. Heterosexual couples should have regular sexual intercourse every 2-3 days throughout the menstrual cycle.
What decreases fertility?
Many factors reduce fertility, for example, your age, having a poor lifestyle, or having a diagnosis of conditions such as PCOS, endometriosis or male factor fertility issues. However, this doesn’t mean that you won’t be able to conceive, it may mean that achieving pregnancy will take a little longer and you may need help from your doctor.
What are the signs of poor egg quality?
Unfortunately, it’s not possible to know whether you have poor egg quality when trying to conceive naturally. You can investigate your ovarian reserve through blood tests like AMH, FSH and Oestradiol and follicle scans, however, your reserve is different to the actual quality of eggs. For women going through fertility treatments, it is possible to identify that egg quality, or indeed the quality of sperm may be a concern as they progress through their treatments.
Can you increase fertility?
Having a healthy lifestyle can help to increase fertility for both men and women. Luckily this is something that you are in control of and can actively do. Fertility treatments can help women and couples conceive if they are struggling to do so naturally.
What are fertility treatments and how do they work?
IVF is one type of fertility treatment available to help people struggling to conceive. During IVF, eggs are removed from a woman’s ovaries and fertilised with sperm in the laboratory. The resulting embryo is transferred, a few days later, to the uterus or frozen for transfer at a later date. IVF can be carried out using your eggs and your partner's sperm or donor egg, sperm and embryos. Other treatments include medication, investigations and treatments for male factor fertility problems.
Does taking folic acid increase fertility?
Folic acid does not increase fertility but it does increase your maternal folate levels to reduce the risks of neural tube defects in the developing baby. It is recommended that you take 400 mcg of folic acid daily as soon as you want to start trying to conceive and for the first 12 weeks of pregnancy. Women who have an increased risk of having a baby with a neural tube defect, or those who have an elevated BMI, may be advised by their doctor to take a prescribed dose of 5 mg of folic acid daily.
How can I check how fertile I am?
Blood tests can help you understand your fertility health and if there are any issues or conditions that may impact your fertility. Sperm tests for men also help to understand the health of the sperm and how fertile a man may be.
What are some causes of infertility?
There are many causes of infertility and in some circumstances, it’s not possible to know why a person may be struggling to conceive. Advancing age is the most common cause of infertility. People may also struggle because they have conditions that impact fertility such as PCOS, endometriosis or male factor fertility issues.
Having a poor lifestyle can also impact your ability to conceive and therefore making healthy changes to your lifestyle, for example not smoking, reducing alcohol and caffeine, eating a nutritious diet and maintaining a normal BMI can all help to improve your fertility potential.
How do hormones affect fertility?
Our hormones play a crucial part in our reproductive health. In a woman, the fine balance of the hormones oestrogen, LH and FSH are responsible for the maturing of an egg and for inducing ovulation. The hormone progesterone plays a pivotal role in supporting the implantation of the embryo in the womb. In men, testosterone is vital for healthy sperm production. An irregular balance of one or more hormones can be associated with difficulties in conceiving. However, these are often treatable with lifestyle changes or medication.
What is the oldest age a woman can get pregnant naturally?
A woman’s peak reproductive years are between her teenage years and late 20s, however, it is still possible to conceive in your 30s and early 40s. However, after the age of 35 getting pregnant may take a little longer. If you are over the age of 35 and have been struggling to conceive for 6 months or more, it is recommended that you see your doctor for further investigations and referral to a fertility specialist to get the help and support you need. After the age of 45 getting pregnant naturally is less likely. Women who do conceive after this age have most likely used frozen or donor eggs.