What is Female Fertility Panel? 

Most couples become pregnant within a year when they have unprotected sex at least twice a week. If they do not, it can be a reproductive issue like infertility. Infertility can occur because of problems in either man or woman. Sometimes, no cause is found, while in others, more than one reason exists. 

Infertility in women may be due to different reasons: 

  • Hormonal problems
  • Age
  • Lifestyle
  • Environmental problems
  • Physical problems

A common cause of infertility in women is difficulty producing eggs. The woman’s ovaries stop functioning before menopause, the eggs may not be released regularly, or the released eggs may not be healthy. Female reproductive issues are the cause of infertility in a couple about 33% of the cases, in 33% cases, it is the man and the rest of the times the exact cause is unknown.

Female fertility is initially evaluated with the help of medical history and family history. Additional blood tests may help in diagnosing and treating infertility. The female fertility panel checks for the following: 

  • Luteinising hormone (LH): It is a hormone produced by the pituitary gland, a small gland present in the brain. During the ovulation phase of the menstrual cycle, the brain sends out LH, which triggers ovaries to release an egg.
  • Follicle-stimulating hormone (FSH): FSH is a hormone made in the pituitary gland. It has an important role in sexual development and helps in the growth of the egg in women during the menstrual cycle. In men, it helps in the production of sperms.
  • Prolactin: The pituitary gland produces another hormone, prolactin. It is normally available in small quantities in both men and women. Prolactin is responsible for regulating the menstrual cycle in women and the production of sperm in men.
  • Thyroid-stimulating hormone (TSH): The pituitary gland secretes this hormone. TSH regulates the thyroid hormones, which, in turn, affect almost all cells in the body. Thyroid hormones also regulate the ovulatory cycle in women. Abnormal levels of TSH may cause infertility in some women.
  • Testosterone: Testosterone is produced in both men and women. In women, it is synthesised in the adrenal glands and ovaries. It works with oestrogen for the proper functioning of ovaries. If the level of testosterone is too high in women, they may develop features like reduced breasts and deep voice. Abnormal levels of testosterone can also decrease libido in women.
  • Progesterone: Progesterone is a hormone produced mainly by ovaries in women. It helps in getting the uterus ready for pregnancy and prepares the breasts for milk production. Progesterone levels keep fluctuating during the different phases of the menstrual cycle. The levels may indicate if the woman has ovulated or not.
  • Estradiol: Produced by the ovaries, estradiol is one of the most potent estrogens, a group of hormones that are responsible for the functioning of the reproductive organs and the development of secondary sex characteristics in women. Along with progesterone, and the other estrogens, estradiol helps in regulating the menstrual cycle. It is also needed for maintaining a normal pregnancy. Hence, an oestradiol test may be ordered to diagnose infertility.

All of the abovementioned tests help check if a woman is fertile.

  1. Why is a Female Fertility Panel performed?
  2. How do you prepare for a Female Fertility Panel?
  3. How is a Female Fertility Panel performed?
  4. What do the Female Fertility Panel results mean?

Your doctor may order this panel of tests if you have symptoms of infertility. An obvious symptom of infertility is the difficulty in getting pregnant. Depending on the cause of infertility, you may show different symptoms such as irregular periods or infrequent ovulation. 

Stress, rapid weight loss, obesity, low body weight or eating disorders are some of the causes of infertility in women. 

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Infertility may also be caused because of hormonal abnormalities. The symptoms that suggest a hormonal problem are:

  • Tiredness
  • Acne
  • Excessive hair loss or growth
  • Unexpected weight gain or loss

Additionally, ovarian cysts may cause female infertility as they interfere with ovulation. These cysts cause pain in the pelvis

Infertility may also result from scarring in fallopian tubes. This scarring may be due to multiple reasons such as an earlier surgery, a pelvic inflammatory disease (a bacterial infection in the pelvis), or due to any abnormality in the lining of the uterus or the shape. The abnormality can show the following symptoms:

Presence of scar tissue within the uterus can lead to reduced or infrequent menstrual flow. It may be formed as a complication of the following conditions: 

You do not need to do anything special to prepare for this test. Notify your doctor if you are taking any medicines including herbs, vitamins and supplements. While going for the test, wear a short-sleeved t-shirt or shirt for easy withdrawal of blood.

For the LH test, you may have to discontinue some medicines, such as birth control pills and testosterone, temporarily before the test. A blood sample is collected on a certain day of the menstrual cycle for the LH test. Also, before the LH test, inform your doctor if you have had any exposure to a radioisotope such as in nuclear medicine test.

For prolactin test and testosterone test, a blood sample is collected in the morning in the fasting state as testosterone and prolactin levels tend to be highest in the morning. Antifungal medicines like ketoconazole and hormone therapy can affect the results of a testosterone test; therefore, if used, it should be informed to the doctor.

For FSH test, progesterone and oestradiol, some medicines like birth control pills may affect the test results. Convey to your doctor if you are consuming any of those medicines. For the progesterone test, taking steroids may affect the test results. If you are taking hormone therapy, your oestradiol results may be affected.

The following drugs affect the results of a TSH test:

  • Phenytoin 
  • Dopamine
  • Phenothiazines
  • Glucocorticoids
  • Dexamethasone
  • Enoxaparin
  • Beta-blockers
  • Furosemide
  • Heparin
  • NSAIDs
  • Salicylates

A sample of the blood will be taken from a vein in your arm. The procedure for the test is as follows:

  • A technician will tie a tourniquet (a tight band) tied around your upper arm. 
  • The technician will clean a site on your lower arm with an antiseptic. 
  • With the help of a syringe, he/she will withdraw the blood sample. You may feel pricking sensation when the needle is inserted. 

Some risks associated with blood tests are:

Normal results:

The results may vary depending on the following:

  • Gender
  • Age
  • Medical history
  • The method used for the test

So, discuss your results with your healthcare provider to understand what they indicate. The normal results of the fertility panel in women are as follows: 

  • LH

    • In the follicular phase of the menstrual cycle: 1.68-15 IU/L (international units per litre)
    • At the mid-cycle peak: 21.9-56.6 IU/L
    • In the luteal phase: 0.61-16.3 IU/L
  • Prolactin
    • Less than 20 mcg/L (microgram per litre)
  • Oestradiol 

    • 30-400 pg/mL (picogram per millilitre) for premenopausal women
  • Progesterone

    • In the follicular stage of menstrual cycle: 0.1-0.7 ng/mL (nanogram per millilitre)
    • In the luteal stage of menstrual cycle: 2-25 ng/mL
  • Testosterone 
    • 15-70 ng/dL (nanogram per decilitre) for women 
  • FSH

    • In the follicular phase: 1.4-9.9 IU/mL (international units per millilitre)
    • At the ovulatory peak: 6.2-17.2 IU/mL
    • In the luteal phase: 1.1-9.2 IU/mL
  • TSH
    • 0.40-4.50 mIU/mL (milli-international units per litre of blood) 

Abnormal results:

Abnormal results on this panel may indicate the cause of infertility, e.g., FSH may be low in a woman who has no periods as FSH stimulates the growth of the follicle containing the egg.

The doctor may order other tests such as x-ray hysterosalpingogram to check the patency of the fallopian tubes, transvaginal ultrasound and saline sonohysterogram if needed as that will give the doctor a better idea as to what the problem is, which will help in further treatment.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.


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