PCOS

Polycystic ovarian syndrome isn’t just a single issue, but a constellation of symptoms that many women have. And if you have a messed-up menstrual cycle, significant weight gain, or infertility, there’s a chance you may have it. You can thank an imbalance in your male and female hormones (androgen and progesterone) for getting you on this crazy train.

Even if you don’t have PCOS, it’s likely you know plenty of people who do—one in 10 women of childbearing age have the syndrome. And while any woman can develop PCOS, you’re more likely to have it if your mother or sisters had it, or if you’re overweight or obese. For some women, the symptoms start as soon as they get their first period, while others develop the syndrome later on—after significant weight gain, for instance.

Your body on PCOS

PCOS is one of those issues that may require some detective work (and some testing) before you get a diagnosis. Some of the most common PCOS symptoms include:

• Irregular periods: Your period may not follow a set schedule, may not occur often, or it may extend long beyond the typical five to seven days (lucky you). Women may also experience painful periods or pain during ovulation, says Dr. Janelle Luk, medical director and founder of Generation Next Fertility in New York City. 
• Hormonal imbalances: The increased levels of androgen can cause male-like hair patterns—including male pattern baldness, facial hair, and excess body hair—along with severe acne. You may also have a lower than normal level of progesterone, a key female hormone associated with fertility.
• Blood sugar fluctuations: We all get hangry from time to time, but if you have PCOS, this goes one step further. “Sometimes, women may also experience sugar cravings and blood sugar fluctuations that physically manifest themselves in a lack of energy or feeling light-headed,” Dr. Luk says. These blood sugar issues can sometimes lead to weight gain that’s hard to lose. PCOS can also boost your chances of developing prediabetes or type 2 diabetes. 
• Polycystic ovaries: Normally, ovary follicles release eggs during ovulation. But if you have PCOS, the excessive androgen could be working against ovulation. Your ovaries may appear swollen, and may contain several follicles that are holding on to eggs and not releasing them. That said, this isn’t a dead giveaway that you have PCOS. Having cysts alone isn’t enough for a PCOS diagnosis, and your doctor should assess your menstrual cycle (or lack thereof), hormone levels, and weight fluctuation. 

And just because you don’t check the box for every symptom, doesn’t mean you don’t have PCOS or PCOS infertility. You don’t have to have all the symptoms to be diagnosed with PCOS, and sometimes PCOS actually flies a bit under the radar. Your best bet is to head to a doctor who can specifically check for PCOS. 

How PCOS could impact your fertility

If the PCOS symptoms—like that insane menstrual cycle—don’t suck enough, they can also do a number on your ability to become pregnant. According to Dr. Luk, PCOS often creates infertility issues due to its impact on periods and ovulation; if you aren’t ovulating, you aren’t releasing an egg.

PCOS can make getting pregnant challenging, but it’s hardly impossible. While it’s super common, it’s actually one of the most treatable causes of infertility in women. If you know you have PCOS, Dr. Douglas suggests talking to your doctor about proactive steps you can take to balance your hormones and create a plan if and when you decide to try to get pregnant. 

So can I freeze my eggs if I have PCOS?

Absolutely. Like others, women with PCOS may want to freeze their eggs to proactively increase their chances of having children down the road. It’s best to freeze when you are younger, in order to get the most high quality eggs possible. 

You’ll want to make sure you work with the best doctors, because women with PCOS are more susceptible to developing ovarian hyperstimulation syndrome (OHSS) during egg freezing. This is because they are likely to have more follicles, and the more follicles an ovary has the more likely it is to be overstimulated by HCG, one of the drugs used during egg freezing. One study of 2,699 women with PCOS undergoing IVF found that 75.2% had a normal response to controlled ovarian hyperstimulation (COH), while 24.8% developed OHSS.

Interested in freezing your eggs? We can help! Freeze by Co is a better approach to egg freezing, where you can freeze for free when you give half to a family who can't otherwise conceive.

What your doctor might recommend for managing PCOS

Medication is generally the first step to try to get everything moving. If you’re trying to conceive soon, progestin therapy might be used to level out your hormones. Metformin, a medication that is used to treat type 2 diabetes, can also help treat PCOS. Although metformin isn’t FDA approved for the treatment of PCOS, decreasing insulin resistance in women with PCOS has been shown to give spontaneous ovulation rates a boost, says Dr. Marra Francis, MD, FACOG, an OB/GYN in The Woodlands, Texas. 

Some women may need to move on to ovulation-inducing medications, like Clomid, but women with PCOS need to be carefully monitored if they do. If you have PCOS and take Clomid, you may be at increased risk of releasing more eggs than the one or two typically released with each Clomid cycle, which could result in twins. 

If these treatments still can’t help you conceive, your doctor may move onto other protocols. Get ready—here come the injections, like Follitism or Menopur. If the injections alone still don’t get you pregnant, IVF may be your best bet, according to Daniel Kort, associate medical director and practice director at Neway Fertility in New York City.

Summing it up

PCOS can lead to some really crappy symptoms. But fortunately, there are plenty of tools and treatments you can use to combat your PCOS and boost your chances of getting pregnant.

Anti-Mullerian hormone (AMH) is a hormone produced by ovarian follicles. It is commonly used as a marker of ovarian reserve and can be measured in the blood. A high AMH level is often associated with polycystic ovary syndrome (PCOS), but it can also have other causes. In this article, we will explore what a high AMH result means and answer some common questions about AMH testing.

First off, what is AMH?

AMH is a hormone that is produced by the granulosa cells in the ovarian follicles. It plays a role in the growth and maturation of ovarian follicles in females. AMH levels are relatively stable throughout the menstrual cycle and can be measured in the blood.

AMH is commonly used as a marker of ovarian reserve, which is a rough number of eggs that a female has remaining in her ovaries. Since females are born with a fixed number of eggs, this number naturally declines over time. 

What are normal AMH numbers?

What is considered a “normal” AMH level depends on your age, as well as the lab where you take the test. Since there is no international standard, it’s best to use the reference ranges included on the test results (your doctor can share those with you if you did a test through a clinic). 

In general, however, an AMH between 1.0 and 3.5 ng/mL suggests a “normal” range that is likely to have a good response to egg freezing.

If you are looking to donate your eggs, however, minimum AMH requirements may be slightly higher. For example, with Cofertility’s Split program, we require a minimum AMH of 2.0, though clinics may have their own unique requirements. This is to increase the chances of retrieving enough eggs to actually split, to ensure positive outcomes for both parties involved.

What AMH level is considered high?

In healthy females of reproductive age, higher levels of AMH mean that the ovaries have a larger supply of eggs. This means one would be expected to have better than average outcomes for egg freezing. 

Remember, there is no universal standard for AMH, so it can vary depending on the lab where the test is run. Your test results will include if your range is “normal”, “low”, or “high” and the cut-off can differ. For example, Atlanta Fertility considers over 4.5 ng/mL high. Advanced Fertility considers anything over 4.0 ng/ml high. While RMA would consider an AMH over  3.0 ng/ml as “very high”.

With high levels of AMH, you may be at higher risk for ovarian hyperstimulation syndrome (OHSS). This means your doctor may choose a specific protocol and/or do extra monitoring to decrease the risk of complications during egg freezing.

What AMH level is considered too high?

Again, this question depends on the lab. Your test results will come with a reference range, and will indicate if your number is high for your age. If your doctor considers your levels abnormally high and has concerns, they will discuss the results with you. 

Common reasons for high AMH

The most common reason for high AMH is that you are very fertile and likely to retrieve more eggs in an egg freezing cycle.  

But a high AMH level may also indicate PCOS, which is a hormonal disorder that affects 8–13% of females of reproductive age. Those with PCOS typically have high levels of androgens (male hormones) and may have irregular periods, acne, and excess hair growth. Patients with an average AMH level ≥ 4.45 ng/ml have a 9.35 times higher likelihood of developing PCOS, but not all patients with a high AMH have PCOS.

In rare cases, abnormally high AMH could be a sign of an ovarian tumor. Certain types of ovarian tumors, such as granulosa cell tumors, can produce high levels of AMH. 

Does high AMH always mean PCOS?

While an increase in AMH levels has been reported to be associated with PCOS, high AMH alone is not enough to diagnose PCOS. 

Not all patients with PCOS have high AMH levels, and not all patients with high AMH levels have PCOS. Diagnosis of PCOS requires a combination of symptoms, hormone levels, and imaging studies, such as ultrasound.

Does high AMH mean good egg quality?

Not necessarily. While a high AMH level is often associated with a larger number of ovarian follicles and eggs, it does not necessarily mean that the eggs are of good quality. Egg quality is determined by factors such as your age, genetics, and environmental factors, and cannot be measured directly by AMH levels.

Am I ovulating if my AMH is high?

AMH levels do not indicate if you’re ovulating or not. Ovulation is the release of a mature egg from the ovary and can be confirmed by monitoring the menstrual cycle and/or performing ultrasound studies.

Will I get a lot of eggs if I have a high AMH?

The success of egg freezing outcomes largely depends on the number and quality of eggs retrieved. Studies have shown that AMH levels can be used as a predictor of egg quantity, and can thus help to predict the potential success of egg freezing. Those with higher AMH levels tend to have better outcomes with egg freezing, as they are likely to have more eggs retrieved and a higher chance of success in future fertility treatments. 

But by no means does a high AMH level guarantee a lot of eggs during an egg retrieval procedure for fertility treatments. The number of eggs retrieved during an egg freezing cycle depends on several factors, including your age, ovarian response to stimulation medications, any other underlying medication conditions, and the skill of the doctor performing the procedure.

What is a good AMH level for egg freezing?

Research has found that AMH is a good predictor of the response to ovarian stimulation and the number of eggs retrieved. Because of this, fertility doctors typically use your AMH levels (along with other biomarkers) to determine the drugs and dosages you will need to maximize your response to ovarian stimulation. 

Now, what about a correlation between AMH and actual babies born (live birth rate)? Well, while AMH does seem to have some association with live birth rates after IVF, its ability to actually predict a live birth is not that great. This is especially true for younger people. A 2021 study found that AMH is a good predictor of live birth in older (>39 years old), but not younger, people. They found that younger participants (≤38 years old) could get pregnant even with low AMH levels as long as they had frequent egg retrievals. 

Freeze your eggs with Cofertility

One option to make egg freezing better is working with Cofertility. Through our Split program, qualified freezers can freeze their eggs for free when donating half of the eggs retrieved to a family who can’t otherwise conceive. 

Through our Keep program — where you keep 100% of eggs retrieved for your own future use — we offer exclusive discounts on expenses, such as frozen egg storage. Keep members also still gain free access to our Freeze by Co Community, a safe space for those engaging in the egg freezing process (or gearing up for it) to connect and lean on each other. It also enables access to exclusive guidance, free expertise, and community events. 

By making egg freezing easier and more accessible, our programs further strengthen the American Society of Reproductive Medicine (ASRM)’s Committee Opinion that egg freezing can help promote social justice and strengthen gender equality.

Summing it up

A high AMH level is generally a good sign for your ability to successfully freeze your eggs. But for some, it can also be one indicator of PCOS. While a high AMH level is often associated with a larger number of ovarian follicles and eggs, it does not necessarily mean that the eggs are of good quality (egg quality is more dependent on age). 

AMH levels are commonly used as a marker of ovarian reserve and can be helpful, in conjunction with other measures, in predicting the number of eggs that can be retrieved during an egg freezing cycle. However, it is important to keep in mind that egg quality is determined by several factors and cannot be measured directly by AMH levels. If you have concerns about your fertility or AMH levels, it is important to speak with a fertility doctor for personalized advice and treatment options.

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Read more:

• Which Matters More for Fertility: AMH or Age?
• What AMH Level Do I Need to Freeze My Eggs?
• Do’s and Don’ts During Egg Freezing: Alcohol, Baths, Exercise, and More

Egg freezing, also known as oocyte cryopreservation, is a process in which a woman's eggs are retrieved, frozen, and stored for future use. It has become an increasingly popular option for those who want to preserve their fertility for later in life, whether due to medical reasons or personal choice. We get a lot of questions from people wondering if egg freezing is an option for them, given their unique circumstances. In this article, we will share the most common questions we get and hopefully settle some debates once and for all. 

Can I freeze my eggs if I have PCOS?

Absolutely. Like others, women with PCOS may want to freeze their eggs to proactively increase their chances of having children down the road. It’s best to freeze when you are younger, in order to get a greater number of eggs and the highest quality eggs possible. 

You’ll want to make sure you work with the best doctors, because women with PCOS are more susceptible to developing ovarian hyperstimulation syndrome (OHSS) during egg freezing. This is because they are likely to have more follicles, and the more follicles an ovary has the more likely it is to be overstimulated by HCG, one of the drugs used during egg freezing. 

Read more

Can I freeze my eggs if I have endometriosis?

Yes. Some doctors will actually recommend egg freezing for women with endometriosis while they're young and the condition is still in the early stages. Because some surgeries for endometriosis can worsen fertility by inadvertently removing healthy ovarian tissue or compromising vascular supply to the ovary, egg freezing should be done before any such surgeries.

Read more

Can I freeze my eggs if I’m a virgin?

Being a virgin does not prevent you from being able to freeze your eggs for future use. The egg freezing process is the same for all patients, and it does not involve any kind of sexual contact. If you are considering egg freezing, reach out to see if we can help. 

Read more

Can I freeze my eggs if I’m on birth control?

It depends on which type! Hormonal birth control methods work by regulating hormones in the body to prevent ovulation, while non-hormonal methods physically prevent sperm from reaching the egg or alter the environment in the uterus to prevent implantation. While it is possible to freeze your eggs while on various types of birth control, it depends on which one. 

• Definitely okay: condoms, diaphragms
• Generally okay: IUD, birth control implant
• Need to stop: the pill, the patch, NuvaRing
• Potential wait of three-six months: Depo-Provera

Of course, do not start or stop your current birth control regimen without talking to your fertility doctor first.  

Read more

Can I freeze my eggs if I have HPV?

An HPV diagnosis alone should not affect your ability to get pregnant or to freeze your eggs. Most fertility specialists will require an up to date pap smear and HPV test as part of their evaluation and you’ll usually be allowed to continue with the freezing process as long as the HPV is low-risk, since those cases are expected to clear on their own.

If you do have a high-risk HPV, you’ll need to discuss those results with both your OB/GYN and your fertility doctor to figure out what next step is right for you. Depending on the specific HPV strain, if there are any lesions and how advanced they are, your doctor will recommend continuing with egg freezing or delaying until after treatment. 

Read more

Can I freeze my eggs if I’ve had gender affirming surgery?

It depends on what was involved in the surgery. If the ovaries were removed (an oophorectomy or total hysterectomy), you will not be able to freeze your eggs. This is because egg freezing requires the ovaries to produce mature eggs, which are then retrieved and frozen for future use. If the ovaries have been removed, then the eggs were removed too and egg freezing is not an option.

Read more

Can I freeze my eggs if I have started hormone therapy?

If you have already started hormone therapy, such as testosterone (T) therapy, it may still be possible to freeze your eggs. However, your doctor will likely recommend discontinuing testosterone until your period returns (usually under six months) to begin the egg freezing process.  

Read more

Can I freeze my eggs if I’m afraid of needles?

Yes, it does involve both injections and blood draws. This is because the process of egg freezing involves stimulating the ovaries with hormones (aka fertility medication) to produce multiple eggs, which are then retrieved with a needle. There are also blood draws to determine your hormone levels, and an IV for sedation during the retrieval itself.  If you are afraid of needles, it's important to acknowledge your fear and work through it. Ignoring or avoiding the issue will only make it worse. 

Read more

Can I freeze my eggs if I vape?

While the effects of vaping on fertility are still largely unknown, many fertility clinics advise their patients to quit vaping in an effort to improve egg freezing outcomes related to quality and quantity based on the above research on smoking. Lower quality eggs with a higher DNA damage rate could impact the success of a future pregnancy using these frozen eggs, as these eggs may be less likely to fertilize into embryos (or result in a successful implantation). In addition, fewer eggs retrieved from those who vaped may result in fewer options for future use, which can increase the likelihood of needing additional egg freezing cycles.

Read more

Can I freeze my eggs if I drink?

Yes, but alcohol consumption is not recommended during the egg freezing process itself. Studies have shown that alcohol consumption can negatively impact fertility and may also increase the risk of certain complications associated with egg freezing. The good news is there are loads of EANABs (equally-appealing, non-alcoholic beverages) these days. Try a soda water with lime and no one will bother you!

Can I freeze my eggs if I’m a smoker?

Smoking is not recommended during the egg freezing process (or ever!). Studies have shown that smoking can negatively impact fertility and may also increase the risk of certain complications associated with egg freezing. Smoking can decrease the number and quality of eggs retrieved, and increases the risk of ovarian hyperstimulation syndrome (OHSS), a potentially serious complication of the egg freezing process.

Can I freeze my eggs if I'm over a certain age?

American Society for Reproductive Medicine (ASRM) does not recommend egg freezing for people older than 38, but this isn’t a strict cutoff. Everyone’s ovarian reserves declines at a different rate. Having your fertility hormones checked can sometimes help you and your doctor get a general idea of what your ovarian reserve is. This can better help you decide if egg freezing is right for you.

Can I freeze my eggs if I'm not ready to have children yet?

Absolutely! Egg freezing is often chosen by those who are not yet ready to start a family, but want to keep options open for the future. It’s important to understand that the younger you are when you freeze your eggs, the higher the chances of success. 

Read more

Can I freeze my eggs if I have already had children?

Absolutely. In fact, some people choose to freeze their eggs after having children, including those who went through divorce, as a way to preserve their fertility for future pregnancies.

Can I freeze my eggs if I have had my tubes tied?

If you have had a tubal ligation (commonly known as "getting your tubes tied"), you can still be a candidate for egg freezing as the process does not require the fallopian tubes to be open. 

Read more 

Can I freeze my eggs if I’m on antidepressants?

For sure. The most commonly used antidepressant (SSRIs) and anti-anxiety medications (benzodiazepines) don’t have any clear, long-term impacts on egg quantity or quality, ovulation, or chances of conception (though SSRIs do have short-term effects on sperm). 

Read more

Can I freeze my eggs if I have diabetes?

While egg freezing can be a game-changer, it's not without risks. Women with diabetes may have an increased risk of ovarian hyperstimulation syndrome (OHSS). However, with proper medical supervision and careful management of blood sugar levels, most women with diabetes successfully undergo egg freezing.

Read more

Let us help you freeze those eggs!

Cofertility is a human-first, tech-enabled fertility ecosystem that provides people agency over if, how, and when they have babies — today or someday. We have two programs for egg freezers:

1. Our Split program, which offers women a chance to both freeze their own eggs and donate half the eggs to a family who cannot conceive otherwise. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure —  medications, supplements, travel if necessary, insurance, and 10 years of storage — is completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.
2. Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.

The benefits for of working with Cofertility include:

• Power of choice: Freeze your eggs more affordably or, if you qualify, freeze for free when you give half to a family who can’t otherwise conceive.
• Community: Our inclusive online spaces allow you to connect with others going through the process in our private online community.
• Compassion: We’ll always treat you with care, and our Split program gives you the opportunity to make someone’s family building dreams a reality.
• Data-driven: We provide you with trustworthy guidance and evidence-based research so you can make informed decisions about your fertility.
• Free egg freezing: Freeze and store your eggs for 10 years, entirely for free if you qualify for our Split program.

Ready to learn about more affordable (even free!) egg freezing with Cofertility? Fill out this quick quiz to learn about our accessible egg freezing options and see if you qualify for our programs — it only takes one minute.

Are you ready to embark on a journey through the fascinating world of female fertility hormones? We've got all the details on those tiny chemical messengers that hold the key to your reproductive prowess. Whether you're curious about boosting your chances of egg freezing success or simply want to understand the inner workings of your amazing body, this article will dive into a hormonal adventure that will leave you feeling empowered and in control. Let’s go!

Anti-Mullerian Hormone (AMH)

What it is

The most talked about hormone of them all: AMH. AMH is produced by the developing follicles in the ovaries and serves as an biomarker of ovarian reserve. It helps estimate the quantity of eggs remaining in the ovaries and is commonly used in assessing how well your body will respond to IVF or egg freezing. 

Normal AMH levels

You can take an AMH test any time in your cycle. In general, AMH levels can be interpreted by:

• Above 1.0 ng/ml (nanograms per deciliter): Normal
• Below 1.0 ng/ml: Showing weakness in the ovarian reserve
• Below 0.5 ng/ml: Showing severe weakness in the ovarian reserve

Keep in mind that lab numbers can vary. Your blood test results will show the lab’s normal range on the report.

What AMH can tell you

As we age, our AMH levels naturally decrease until we hit menopause and our AMH reaches 0. While the decline in fertility happens to ALL of us, the specific age when we can no longer conceive varies from individual to individual. And in some cases, it may be earlier than expected. AMH can give us insight into where we are on that journey.

While AMH is pretty awesome, there are two things it can’t tell us: (1) it can’t tell us the quality of the eggs remaining and (2) it can’t tell us our chances of getting pregnant unassisted.

Estrogen

What it is

Estrogen hormone is the ultimate multitasker, responsible for so many amazing things. It's the power behind that glowing, radiant skin and full, thick hair. And it also takes charge of thickening the uterine lining each month, which either sets the stage for a growing embryo, or culminates in your period.

Estrogen is actually a collective term used to describe a group of hormones that play a vital role in the female reproductive system. It includes three types of hormones: 

• Estrone (E1) which is the only type of estrogen that our bodies keeps making even after menopause
• Estradiol (E2) causes the maturation and release of the egg as well as the thickening of the uterus lining each month
• Estriol (E3) is really only present during pregnancy, and helps the uterus grow and stay healthy

Estrogen levels fluctuate throughout the menstrual cycle, with estradiol being the dominant form during the follicular phase (leading up to ovulation) and progesterone taking the lead during the luteal phase (after ovulation). Understanding the dynamics and functions of estrogen and estradiol can help shed light on the intricate mechanisms underlying female reproductive health.

Altogether, estrogen plays a key role in regulating the menstrual cycle, supporting the growth and development of the uterus and breasts, and maintaining bone health.

Normal E2 levels

Estrogen levels fluctuate throughout your life, often aligning with other hormones that regulate crucial bodily functions, such as the menstrual cycle. These dynamic changes in estrogen levels are considered a normal part of the body's hormonal rhythm. 

Estradiol (E2) is the hormone most often tested for fertility. E2 levels vary widely through the menstrual cycle, and are expected to fluctuate from test to test. A normal range is considered:

• Premenopausal: 30 to 400 pg/mL (110 to 1468.4 pmol/L)
• Postmenopausal: 0 to 30 pg/mL (0 to 110 pmol/L)

There can be variations in the normal value ranges for laboratory tests, as different laboratories may use different measurement methods (e.g. saliva, blood prick, or venipuncture) or test different samples. Your doctor will be able to provide you with accurate interpretation and insights based on your individual circumstances.

What E2 can tell you

If you consistently test on the lower range, it may indicate the onset of menopause, premature ovarian failure, or low estrogen from rapid weight loss or anorexia. If your results are higher, it may suggest a tumor of the ovary.

Follicle-Stimulating Hormone (FSH)

What it is

‍FSH is the ultimate fertility cheerleader. Like the squad captain, FSH leads the charge in the growth and development of those ovarian follicles, which contain the eggs. It's the one shouting, "Let's grow those eggs, ladies!" 

Our FSH levels change throughout the menstrual cycle, with the highest levels happening just before ovulation (when an egg is released by the ovary).

Normal FSH levels

For fertility testing, you need to have the FSH blood test on day 3 of your menstrual cycle (day 1 is the day your period begins). In general, normal FSH levels are:

• Premenopausal: 4.7 to 21.5 mIU/mL
• Postmenopausal: 25.8 to 134.8 mIU/mL

Keep in mind that lab numbers can vary. Your blood test results will show the lab’s normal range on the report.  

What FSH can tell you

‍Higher-than-normal levels of FSH can be a sign of infertility due to premature ovarian failure or menopause. It could also be due to certain types of tumors in the pituitary gland, or due to Turner syndrome.

Lower levels could mean pregnancy, being very underweight or having had recent rapid weight loss, not ovulating, or that parts of the brain are not producing normal amounts of hormones. If you have abnormal results, your doctor will discuss your situation and next steps. 

Luteinizing Hormone (LH)

What it is

This hormone takes center stage and demands attention as it triggers the grand finale of the menstrual cycle: the release of a mature egg. LH sends that egg on its way, ready for its moment in the spotlight and a chance at fertilization.

While LH has a major job for our reproductive system, it’s actually secreted by a tiny structure in your brain called the pituitary gland.

Normal LH levels

LH fluctuates throughout your cycle, and the ranges are:

Premenopause: 5 to 25 IU/L

Postmenopause: 14.2 to 52.3 IU/L

Remember, lab numbers can vary. Your blood test results will show the lab’s normal range on the report.  

What LH can tell you

Abnormal LH levels can indicate ovulatory disorders, such as polycystic ovary syndrome (PCOS) or hypothalamic amenorrhea. 

LH testing (via urine test strips) can also help to predict ovulation. By detecting the LH surge each cycle, these test strips give us a glimpse into our fertile windows, or when we’re most likely to get pregnant. 

Progesterone

What it is

Progesterone swoops in after ovulation (which, remember, was ushered in by LH) to prepare the uterine lining, transforming it into a cozy, welcoming haven for a potential embryo. Progesterone is crucial for early pregnancy, helping maintain the thickened endometrium. But if an egg isn’t fertilized during that cycle, progesterone levels decrease, your uterine lining thins, and your period begins. 

Normal progesterone levels

• Pre-ovulation: less than 1 nanogram per milliliter (ng/mL) or 3.18 nanomoles per liter (nmol/L)
• Mid-cycle: 5 to 20 ng/mL or 15.90 to 63.60 nmol/L
• Postmenopausal: less than 1 ng/mL or 3.18 nmol/L
• Pregnancy 1st trimester: 11.2 to 90.0 ng/mL or 35.62 to 286.20 nmol/L
• Pregnancy 2nd trimester: 25.6 to 89.4 ng/mL or 81.41 to 284.29 nmol/L
• Pregnancy 3rd trimester: 48 to 150 to 300 or more ng/mL or 152.64 to 477 to 954 or more nmol/L

What progesterone can tell you

While LH tests can help us predict when we’re about to ovulate, progesterone tests can help confirm if we actually did ovulate. 

If you have low progesterone and aren’t pregnant, you may have symptoms like irregular periods, infertility, mood changes, trouble sleeping, or hot flashes.

If you have low progesterone and are pregnant, it could mean a higher risk of miscarriage or an ectopic pregnancy.

Prolactin

What it is

Prolactin is the hormone that orchestrates the magic of breastfeeding. It causes the breasts to grow and make milk during pregnancy and after birth. While its primary role lies in the breastfeeding realm, elevated levels of prolactin when not pregnant or postpartum can sometimes interfere with ovulation and menstrual regularity.

Normal prolactin levels

Made in the the pituitary gland, normal levels of prolactin are:

• Nonpregnant: less than 25 ng/mL (25 µg/L)
• Pregnant: 80 to 400 ng/mL (80 to 400 µg/L)

Keep in mind that lab numbers can vary. Your blood test results will show the lab’s normal range on the report. Talk to your doctor about your specific results.

What prolactin can tell you

Abnormally high levels of prolactin when you are not pregnant could mean a condition called hyperprolactinemia, which is actually quite common. Believe it or not, about a third of women in their childbearing years with irregular periods (but perfectly normal ovaries) have hyperprolactinemia. Hyperprolactinemia could mean trouble getting pregnant. Not to mention, your boobs might start producing milk when you're not even expecting it (hello, galactorrhea!).

High prolactin levels can also throw a wrench in the normal hormone production, messing with the likes of estrogen and progesterone. And when that happens, it can disrupt ovulation or lead to irregular or missed periods. 

Thyroid-Stimulating Hormone (TSH)

What it is

This hormone ensures that our thyroid gland, that tiny powerhouse in our neck, is working harmoniously. Thyroid health is crucial for maintaining menstrual regularity and fertility, so when TSH steps onto the scene, you know it's time to keep that thyroid in check!

Normal TSH levels

Another hormone produced by the pituitary gland, TSH can give us insight into thyroid disorders, such as hypothyroidism or hyperthyroidism.

• Nonpregnant: 0.27 – 4.2 uIU/mL.
• First trimester (9 to 12 weeks): 0.18 – 2.99 (uIU/mL).
• Second trimester: 0.11 – 3.98 uIU/mL.
• Third trimester: 0.48 – 4.71 uIU/mL.

What TSH can tell you

Low levels of TSH typically indicate hyperthyroidism, or overactive thyroid, when your thyroid gland is making excess thyroid hormone. On the other hand, high levels of TSH may suggest an inadequate production of thyroid hormone, leading to a condition called hypothyroidism or underactive thyroid. 

Testosterone

While testosterone is often associated with male reproductive health, females also produce small amounts of testosterone from the ovaries. It helps preserve muscle mass and supports an overall sense of wellbeing. It also helps the development of those follicles and even plays a role in boosting our libido.

Testosterone does fluctuate throughout your cycle, so if you notice that your libido surges at certain times of your cycle (usually around ovulation), you can thank testosterone.

Normal testosterone levels

15 to 70 ng/dL or 0.5 to 2.4 nmol/L

What testosterone can tell you

Abnormal testosterone levels can negatively affect fertility. 

Too little testosterone could mean you are nearing menopause or have premature ovarian failure. It could also be lower due to certain medications, malnutrition, chemotherapy/radiation, 

Too much testosterone could be a sign of PCOS.

At-home fertility hormone testing

If you’re curious to test your hormones, you'll be glad to know that there are convenient at-home options available. These tests allow you to assess your hormone levels from the comfort of your own home, providing valuable insights into your reproductive health. 

Let's take a closer look at some of the top at-home fertility hormone testing options for you to consider:

• Natalist Women’s Fertility Test: Priced at $149, this comprehensive test covers a range of essential hormones. It measures five key hormones: estradiol, LH, FSH, TSH, and total testosterone. By examining these hormone levels, you can gain a better understanding of your reproductive health. And here's a bonus for our readers: use the code COFERTILITY20 to get 20% off!
• LetsGetChecked Ovarian Reserve Test: For $139, this test specifically focuses on measuring anti-Müllerian hormone (AMH), a critical marker for ovarian reserve. By understanding your ovarian reserve, you can make informed decisions about family planning and fertility preservation. And guess what? You can save 25% on this test by using code COFERTILITY25.

These at-home fertility hormone testing options give you the opportunity to better understand your reproductive health. But keep in mind that if you are planning to freeze your eggs, your doctor may want you to test again. 

Summing it up

These fertility hormones - AMH, Estrogen, FSH, LH, Progesterone, Prolactin, and Testosterone– work in harmony to regulate the menstrual cycle, facilitate ovulation, prepare the uterus for pregnancy, and support early gestation. 

Imbalances or abnormalities in these hormone levels can affect fertility and reproductive health. Unfortunately for many of us, we don’t find out there’s a problem until we start trying. 

Evaluating the levels of these hormones through diagnostic tests can provide insights into your fertility health and empower you with knowledge to make informed decisions about your reproductive journey.

By understanding your hormone levels, you can identify potential issues that may hinder reproductive health, now or in the future. 

Sources:

• Estradiol (Blood). Health Encyclopedia. University of Rochester Medical Center. URL
• Follicle-stimulating hormone (FSH) blood test. Mount Sinai. URL
• Shufelt CL, Torbati T, Dutra E. Hypothalamic Amenorrhea and the Long-Term Health Consequences. Semin Reprod Med. 2017;35(3):256-262. doi:10.1055/s-0037-1603581. URL
• Hyperprolactinemia (High Prolactin Levels). ReproductiveFacts.org. URL
• Testosterone. Mount Sinai. URL
• Soman M, Huang LC, Cai WH, et al. Serum androgen profiles in women with premature ovarian insufficiency: a systematic review and meta-analysis. Menopause. 2019;26(1):78-93. doi:10.1097/GME.0000000000001161. URL