Of late, we have been seeing lots of female clients who haven’t been able to get full hormonal testing for their fertility.
These are the basic tests that one should try and get done – some of them are very cycle specific which is a pain as it can mean a few cycles go by before you can get tested and some are not cycle specific.
Day 2 of your period (FSH and LH)
These are the base line hormones to check the fertility. Ideally you want FSH to be under 7 and LH to be around the 3-4 mark. If LH is greater than FSH, there is a slight chance you might have PCOS.
Day 21 (Progesterone)
Please remember that this test needs to be done 7 days AFTER ovulation and not specifically on day 21 if you are not a typical text book 28 day cycle. Charting you temperatures and using Ovulation sticks in conjunction with this will help you identify when ovulation has occurred. If you have PCOS and an irregular cycle, this will be prove difficult to test. This test will help check that you have ovulated but doesn’t necessarily mean that you have enough progesterone as levels can drop drastically post ovulation.
NHS will only test for TSH and T4. If this is the case, TSH needs to be between 1 and 2 for a pregnancy to possibly be successful without risk of miscarrying. Often thyroxine is prescribed. If you have a thyroid issue, please ask your GP to test for Selenium and iodine as these levels if low can affect the thyroid and you may unnecessarily be on thyroxine. Often diet changes and reducing stress levels can help (we have helped a couple of ladies in clinic by changing things). However, please follow the advice of your GP/Medical practitioner. If the thyroid does come back as an issue, it would be ideal to book in with an endocrinologist to investigate further.
Other parts of the thyroid which the NHS doesn’t offer that need testing are FT3, T3, TPO, TPA – if you have normal TSH and T4 but high antibodies, this can affect conception too and often requires going gluten free to help reduce the inflammation in the body. I work with a private lab which can help test for these extra Thyroid issues – please message for more info.
Vitamin D, B12, Iron (ferritin and haemoglobin), Prolactin
These can all be done at anytime in the cycle. These are all important to be tested and levels to be of good levels and not just borderline low or high. Most of the women we come across are often low in Vitamin D.
These check egg reserves but this on its own doesn’t mean much. Ask for an Antra-follicle scan too to check how many follicles are on the ovaries. If AMH levels are very low and FSH is higher than 20, it is very likely that you may be heading into peri-menopause and therefore conception with your own eggs is at a very reduced rate.
This is to check that fallopian tubes are not blocked – this is usually done mid cycle. It can be an uncomfortable procedure but it will help to know what is going on internally.
Immunity tests/Natural Killer Cells
If the GP is willing to do these, it would be ideal to have it done to ensure your immunity is where it needs to be and not attacking your body.
Some women have this condition and if so MUST NOT take the folic acid that is recommended but need Folate instead.
Hope that helps