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Fertility Tests

Blood Tests for Infertility

If you are unable to become pregnant after one year of unprotected intercourse, or six months if you are a woman over 35, you and your partner should have a full physical and medical evaluation. Several blood tests are available to determine if you, your partner, or both of you have a problem that is causing infertility.

FSH

Follicle-stimulating hormone (FSH) helps control a woman’s menstrual cycle and the production of eggs. In men, it regulates the production and transportation of sperm.

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Estradiol Levels

Estradiol is a type of estrogen, the major sex hormone in women. It is secreted by the ovarian follicles. As the follicles grow and develop each month, they produce estradiol. This sets the rest of the reproductive cycle in motion.

Why Would You Have Estradiol Checked?

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Anti-Mullerian Hormone (AMH) Fertility Test

The AMH test (Anti-Mullerian Hormone) is a blood test to help the fertility doctor assess the woman's ovarian reserve. The test measures the levels of AMH in a woman's blood and is helpful in determining whether a woman has premature ovarian aging (diminished ovarian reserve) or premature ovarian failure.

What Is AMH?

The Anti-Mullerian Hormone is a substance secreted by the granulosa cells in the developing egg sacs (ovarian follicles). When a woman grows older, her number of ovarian follicles begins to decrease; therefore, the amount of AMH in the blood decreases.

A woman who has very remaining follicles will have low AMH levels and is close to menopause. A woman who has many small ovarian follicles — a condition known as polycystic ovarian syndrome (PCOS) — typically has high levels of AMH.

How AMH Is a Predictor of Ovarian Reserve?

Because AMH levels correlate with the number of ovarian follicles, the test is a good predictor of ovarian reserve. Researchers have found that women with higher concentrations of AMH have a better response to ovarian stimulation and are likely to produce more eggs for IVF (in vitro fertilization) than women with low or undetectable AMH. Also, unlike follicle stimulating hormone (FSH), the levels of AMH in the blood do not fluctuate as much; therefore the test can be done at any point during the menstrual cycle.

A low AMH indicates there is a problem with the quantity and quality of a woman's eggs. Women with low AMH tend to be "poor responders" to fertility treatment — even with high doses of fertility drugs.

It's important to ask your fertility doctor if he or she is using age thresholds when considering the AMH test because a woman's "normal" AMH range is also dependent upon age — the average AMH level in younger women is higher than the average level in older women. Therefore, a young woman with a very low AMH could have a similar level to an older woman who is considered to have an "average" AMH level for her age.

AMH only one of the tests that assesses ovarian reserve. Others include blood tests for FSH and estradiol levels, the clomiphene citrate challenge test (CCCT), and a vaginal ultrasound examination of the antral follicles.

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Surgical Tests: Hysteroscopy and Laparoscopy

If blood tests and other diagnostic tests do not determine the cause of your infertility, your health care professional may suggest one or two surgical tests to try to diagnose or treat the problem. One test lets the doctor see inside the uterus and the other shows the outside of the uterus, the ovaries, and fallopian tubes.

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Diagnostic Tests for Infertility

In order to get pregnant and successfully give birth, your uterus and fallopian tubes must be healthy and working properly. If blood tests do not determine the cause of infertility, your fertility doctor or Ob/Gyn will order additional tests.

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New Warning Label on Drospirenone-Containing Birth Control Pills

by Leigh Ann Woodruff, April 11, 2012

Birth control pills containing drospirenone will carry a new warning label about the risk of blood clots. The new labels state that combination oral contraceptives containing drospirenone may be associated with a higher risk of venous thromboembolism (VTE) than oral contraceptives containing levonorgestrel or some other progestins.

The birth control pills affected include brand names Yaz, Yasmin, Beyaz and Safyral.

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New Tool Helps Assess Ovarian Reserve, IVF Success

a blog by CHR, April 6, 2012

A new tool developed by the Center for Human Reproduction (CHR) offers new insights into understanding ovarian reserve and may help doctors better determine a woman’s pregnancy chances with in vitro fertilization (IVF).

The tool, referred to as FSHo, is the ratio of follicle stimulating hormone levels per retrieved oocyte (egg) in an IVF cycle. Historically, when a doctor is trying to determine how well a woman’s ovaries are functioning, he or she will measure two different hormones: anti-Müllerian hormone (AMH) and follicle stimulating hormone (FSH). However, these hormones represent two different stages of the development of an egg inside the ovary, and are not necessarily very accurate predictors of whether or not an IVF cycle will result in a pregnancy for a woman with low ovarian reserve.

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