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Wednesday, July 26, 2017

REPRODUCTIVE HORMONES: NORMAL LEVELS EXPLAINED

Monitoring FSH and Other Hormones

If you've ever had your hormone levels tested, you probably know it's hard to know what's high, low, normal or borderline.
See: www.getpregnantover40.com for more on balancing hormones naturally and my video on lowering FSH

I should mention that by the time I conceived my daughter, I had given up on fertility treatments and actually did not even want to know what my hormone levels were.  I figured that if the information was negative, it might derail me.  However, I know many women and their doctors do monitor and want to monitor their hormones.

http://www.getpregnantover40.com/fertility-necklace.htm
Click here for our fertility necklaces
 Here is a good resouce which explains hormonal levels:

See Also: HcG Levels and Miscarriage (www.getpregnantover40.com)

Follicle Stimulating Hormone (FSH) Day 3 3-20 mIU/ml FSH is often used as a gauge of ovarian reserve. In general, under 6 is excellent, 6-9 is good, 9-10 fair, 10-13 diminished reserve, 13+ very hard to stimulate. In PCOS testing, the LH:FSH ratio may be used in the diagnosis. The ratio is usually close to 1:1, but if the LH is higher, it is one possible indication of PCOS.
Estradiol (E2) Day 3 25-75 pg/ml Levels on the lower end tend to be better for stimulating. Abnormally high levels on day 3 may indicate existence of a functional cyst or diminished ovarian reserve. 

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 Estradiol (E2) Day 4-5 of meds 100+ pg/ml or 2x Day 3 There are no charts showing E2 levels during stimulation since there is a wide variation depending on how many follicles are being produced and their size. Most doctors will consider any increase in E2 a positive sign, but others use a formula of either 100 pg/ml after 4 days of stims, or a doubling in E2 from the level taken on cycle day 3.
Estradiol (E2) Surge/hCG day 200 + pg/ml The levels should be 200-600 per mature (18 mm) follicle. These levels are sometimes lower in overweight women.
Luteinizing Hormone (LH) Day 3 < 7 mIU/ml A normal LH level is similar to FSH. An LH that is higher than FSH is one indication of PCOS.
Luteinizing Hormone (LH) Surge Day > 20 mIU/ml The LH surge leads to ovulation within 48 hours. 

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Prolactin Day 3 < 24 ng/ml Increased prolactin levels can interfere with ovulation. They may also indicate further testing (MRI) should be done to check for a pituitary tumor. Some women with PCOS also have hyperprolactinemia.
Progesterone (P4) Day 3 < 1.5 ng/ml Often called the follicular phase level. An elevated level may indicate a lower pregnancy rate.
Progesterone (P4) 7 dpo > 15 ng/ml A progesterone test is done to confirm ovulation. When a follicle releases its egg, it becomes what is called a corpus luteum and produces progesterone. A level over 5 probably indicates some form of ovulation, but most doctors want to see a level over 10 on a natural cycle, and a level over 15 on a medicated cycle. There is no mid-luteal level that predicts pregnancy. Some say the test may be more accurate if done first thing in the morning after fasting. 

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Thyroid Stimulating Hormone (TSH) Day 3 .4-4 uIU/ml Mid-range normal in most labs is about 1.7. A high level of TSH combined with a low or normal T4 level generally indicates hypothyroidism, which can have an effect on fertility.
Free Triiodothyronine (T3) Day 3 1.4-4.4 pg/ml Sometimes the diseased thyroid gland will start producing very high levels of T3 but still produce normal levels of T4. Therefore measurement of both hormones provides an even more accurate evaluation of thyroid function. 

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Free Thyroxine (T4) Day 3 .8-2 ng/dl A low level may indicate a diseased thyroid gland or may indicate a non- functioning pituitary gland which is not stimulating the thyroid to produce T4. If the T4 is low and the TSH is normal, that is more likely to indicate a problem with the pituitary. 
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Total Testosterone Day 3 6-86 ng/dl Testosterone is secreted from the adrenal gland and the ovaries. Most would consider a level above 50 to be somewhat elevated.
Free Testosterone Day 3 .7-3.6 pg/ml
Dehydroepiandrosterone Sulfate (DHEAS) Day 3 35-430 ug/dl An elevated DHEAS level may be improved through use of dexamethasone, prednisone, or insulin-sensiting medications. 

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Androstenedione Day 3 .7-3.1 ng/ml
Sex Hormone Binding Globulin (SHBG) Day 3 18-114 nmol/l Increased androgen production often leads to lower SHBG
17 Hydroxyprogesterone Day 3 20-100 ng/dl Mid-cycle peak would be 100-250 ng/dl, luteal phase 100-500 ng/dl
Fasting Insulin 8-16 hours fasting < 30 mIU/ml The normal range here doesn't give all the information. A fasting insulin of 10-13 generally indicates some insulin resistance, and levels above 13 indicate greater insulin resistance. 


 excerpted from:
 www.fertilityplus.org

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