"Sisters, have you ever had such an experience? After getting up early, asking for leave, registering, and waiting in a long queue, it was not easy for you to take a blood sample, but the doctor told you that 'time is wrong, come back next time', and your mentality collapsed instantly!"
In the daily consultations at Tulip International Reproductive Center, we found that many female friends waste their precious time and energy because they do not understand the "hidden rules" before the six tests for sex hormones. Today, we will use the most straightforward way to thoroughly explain the core test for evaluating fertility, helping you get it done in one go and no longer stepping on pitfalls.
1、 Understanding Your Endocrine Transcript: What are the Six Elements of Sex Hormones?
The six sex hormones are the "gold standard" for evaluating the endocrine and ovarian function status of women. We can consider these six indicators as the six key roles on the "chain of command" within your reproductive system:
Two commanders issued by the "headquarters" (pituitary gland) of the brain:
Follicle stimulating hormone (FSH): responsible for commanding the basal follicles in the ovary to start growing and developing.
Luteinizing hormone (LH): After the follicle matures, its value will instantly soar, giving the final command to "ovulate".
The two 'frontline executives' of the ovaries:
Estrogen (E2): mainly secreted by developing follicles, responsible for thickening the endometrium and preparing for embryo implantation.
Progesterone (P): mainly secreted by the corpus luteum after ovulation, responsible for making the endometrium more "soft and fertile" to facilitate embryo implantation and growth.
Two important 'environmental control officers':
Prolactin (PRL): It is mainly related to lactation, but if its level abnormally increases during non lactation, it can "interfere" with the normal issuance of ovulation instructions.
Testosterone (T): Women also have a small amount of androgens in their bodies, mainly secreted by the ovaries and adrenal glands. If testosterone levels are too high, it is often one of the important signals of polycystic ovary syndrome (PCOS).
2、 Don't run away in vain anymore! Three hidden rules before checking
Rule 1: Time! Time! Time! ——Choose the right day for the results to be effective
This is the most important rule, there is no one. The levels of sex hormones are dynamically changing during the menstrual cycle, and drawing blood at the wrong time results in meaningless outcomes.
Check the "baseline value" (to evaluate ovarian reserve function): Blood must be drawn on the 2nd to 4th day of menstruation. The value at this time point reflects the "initial state" of the ovary at the beginning of a new cycle and is the most important reference for evaluating its function.
Real case: 32 year old customer Xiaoyang, who has been preparing for pregnancy for a year but has not become pregnant. She went to the hospital on the 7th day of her menstrual cycle to have her blood drawn, and the results showed a high FSH level, which made her extremely anxious. After arriving at the Tulip International Reproductive Center, our experts asked her to have a follow-up examination on the third day of her next menstrual cycle, and the result showed that her FSH value was completely normal. The 'high' result that time was only due to physiological fluctuations caused by incorrect blood draw time.
Checking ovulation: If a doctor wants to understand your ovulation situation, they usually arrange blood tests when the dominant follicle is close to maturity (such as follicle diameter>16mm) detected by ultrasound, mainly looking at the levels of LH and E2 to predict ovulation time.
What should I do if I don't have my period for a long time? Don't wait. Go to the hospital for treatment at any time, and the doctor will use ultrasound to check your endometrial thickness and follicle condition to determine whether blood can be drawn or if medication is needed to induce menstruation before checking.
Rule 2: Status! ——The body must be in a basic state of 'calmness'
Fasting: It is recommended to fast for 8-12 hours before drawing blood. Avoid eating after 10 pm the night before and drink a small amount of water.
Sit still: Before drawing blood, please be sure to sit quietly in the waiting area and rest for 20-30 minutes. Rushing, climbing stairs, and other activities can cause the body to be in a state of stress, which may temporarily increase prolactin (PRL) levels and create the illusion of "hyperprolactinemia".
Avoid stress: Ensure sufficient sleep the night before the examination, avoid vigorous exercise and emotional fluctuations.
Rule 3: Communication! ——Proactively inform the doctor of your medication status
If you are taking any hormone drugs (such as short acting contraceptives, progesterone, fipronil, etc.), be sure to inform your doctor proactively before prescribing. These drugs directly affect endocrine levels, and doctors need to understand this information in order to accurately interpret the results.
3、 'Golden Partner': Why do doctors always recommend checking six sex hormones and AMH together?
Nowadays, experienced reproductive doctors would recommend doing these two tests together. Their relationship can be understood as follows:
The six sex hormones: like a dynamic 'monthly work report', reflecting the functional status and operation of your ovaries during this specific cycle.
AMH (anti Mullerian hormone): It is like a static "inventory report", directly secreted by small follicles in the ovary, which can more stably and accurately reflect the remaining "egg inventory" in your ovary.
The great advantage of AMH is that it is not affected by the menstrual cycle, blood can be drawn on any day, and there is no need to go on an empty stomach.
By combining the two, doctors can not only understand how much AMH is left in your "family", but also determine whether the "production line" is operating normally this month (six items of sex hormones), making the assessment more comprehensive and accurate.
4、 How to get a preliminary understanding of your laboratory report?
FSH>10 IU/L: If FSH is measured above this value on the 2nd to 4th day of menstruation, it usually indicates a decrease in ovarian reserve function (DOR).
LH/FSH>2-3: It is common in patients with PCOS.
AMH<1.1 ng/mL is also an important indicator of decreased ovarian reserve function.
AMH>6.8 ng/mL: often indicates the possibility of polycystic ovary syndrome (PCOS).
The most important reminder: The above is only basic science popularization, do not self diagnose! The interpretation of hormone levels requires a comprehensive judgment based on various information such as your age, menstrual history, and ultrasound results. Please make sure to submit the report to a professional reproductive specialist for interpretation.
For fertility consultation in Kyrgyzstan, please contact your dedicated consultant
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Dr.Chan
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