Hormones when planning a pregnancy

The balance of hormones in the female body changes periodically, so it is very important to check the blood for hormones when planning a pregnancy. After all, the possibility of conception itself, as well as the normal course of the gestation process, may depend on the required level of hormones.

In particular, women who have previously experienced menstrual dysfunction, unsuccessful pregnancies, or who have been unable to conceive a child for a long time should pay attention to changes in hormonal levels.

What hormones should be checked when planning a pregnancy?

What hormones should be checked when planning a pregnancy? How does a particular hormone affect the ability to get pregnant?

To begin with, we will provide a list of hormones when planning a pregnancy, the level of which is recommended to be checked by gynecologists-reproductologists.

• Estradiol.
• Progesterone.
• FSH.
• LG.
• Testosterone.
• Prolactin.
• Thyroid hormones.
• DHEA-S.

Women over 30 years of age who are planning a pregnancy may also be prescribed an AMH test.

List of hormones when planning pregnancy

Let's consider what these hormones are, what they are responsible for, and why we need to know their quantity.

Estradiol - the amount of this hormone in the female body is not constant and depends on the monthly phase. Estradiol is synthesized in adipose tissue, as well as in the ovaries and follicles under the influence of other hormones - LH and FSH. Under the influence of estradiol, the uterine cavity prepares for implantation, natural growth of the endometrial layer occurs. Most often, blood for estradiol is taken on the 2-5th or 21-22nd day of the cycle. The analysis is taken in the morning on an empty stomach, the day before you cannot eat fatty foods, drink alcohol, smoke or do heavy physical labor.

Progesterone - this hormone is synthesized by the ovaries and in smaller quantities by the adrenal glands. In pregnant women, progesterone is synthesized by the placenta. It helps the implantation of the egg, activates the enlargement of the uterus during pregnancy, protects it from excessive contractile activity, which helps to preserve the fetus in the uterus. The hormone test is taken during ovulation (approximately on the 14th day), as well as after the 22nd day, depending on the length of the monthly cycle. Venous blood for analysis is given in the morning before eating.

Follicle-stimulating hormone (FSH) – activates the development of follicles and the production of estrogens in the body. A normal level of this hormone promotes ovulation. Blood for testing is given on days 2-5 or 20-21 of the monthly cycle, on an empty stomach.

Luteinizing hormone (LH) – together with follicle-stimulating hormone, participates in the growth of follicles, ovulation, and formation of the corpus luteum of the ovaries. The peak amount of the hormone is observed during ovulation; during pregnancy, the level of LH decreases. An LH test is usually prescribed along with FSH, since one hormone without the other is of little use. It is much more important to determine the quality of the ratio of the two hormones. We will talk about the norms of hormonal indicators below.

Testosterone is rightfully considered a male sex hormone, although it is also produced in women, in the ovaries and adrenal glands. High levels of the hormone can disrupt the ovulation process and provoke a miscarriage in the early stages. The greatest amount of the hormone in the body is produced during the luteal phase and in the ovulatory period.

Prolactin is a hormone synthesized in the pituitary gland. It ensures the development of the mammary glands in women, activates the production of breast milk. The amount of this hormone is closely related to the amount of estrogens and thyroid hormones. The analysis is taken in the morning before eating. The day before the analysis, it is not recommended to have sex and stimulate the mammary glands, and also not to be nervous, since because of this, the hormone levels can be high. Most often, prolactin is taken on the 5-8th day of the cycle.

Thyroid hormones – these should be taken by all patients who consult a doctor with irregularities in their menstrual cycle, miscarriage or unsuccessful attempts to conceive. First of all, we need thyroid stimulating hormone (TSH) levels, and, at the doctor’s discretion, free T4 and T3. The TSH hormone is involved in stimulating the production of prolactin, a hormone necessary for pregnancy. Thyroid disorders can negatively affect ovulation and the functioning of the corpus luteum.

DHEA-S is an adrenal hormone, an androgen, its name stands for dehydroepiandrosterone sulfate. Thanks to this hormone, a pregnant woman's placenta begins producing estrogens. Analysis of this hormone is often used to diagnose ovarian pathology. Blood serum is taken on an empty stomach, 24 hours before the test, alcoholic beverages and fatty foods are excluded, smoking and physical exercise are prohibited an hour and a half before the test.

The level of anti-Müllerian hormone (AMH) is checked mainly in women who are planning a pregnancy after 30 years. As is known, women's ovaries cannot produce follicles indefinitely, and sooner or later their reserve runs out, and a woman can no longer get pregnant on her own. So the amount of AMH determines the ovarian reserve of the ovaries, that is, it indicates how likely it is that follicles will mature and ovulate, and also indicates the possibility of early menopause.

Hormonal norms when planning pregnancy

Estradiol (E2):

• in the follicular phase – 12.5-166.0 pg/ml;
• in the ovulatory phase – 85.8-498.0 pg/ml;
• in the luteal phase – 43.8-211.0 pg/ml;
• menopause period – up to 54.7 pg/ml.

Progesterone:

• in the follicular phase – 0.2-1.5 ng/ml;
• in the ovulatory phase – 0.8-3.0 ng/ml;
• in the luteal phase – 1.7-27.0 ng/ml;
• menopause period – 0.1-0.8 ng/ml.

Follicle-stimulating hormone:

• in the follicular phase – 3.5-12.5 mIU/ml;
• in the ovulatory phase – 4.7-21.5 mIU/ml;
• in the luteal phase – 1.7-7.7 mIU/ml;
• during menopause – 25.8-134.8 mIU/ml.

Luteinizing hormone:

• in the follicular phase – 2.4-12.6 mIU/ml;
• in the ovulatory phase – 14.0-95.6 mIU/ml;
• in the luteal phase – 1.0-11.4 mIU/ml;
• during menopause – 7.7-58.5 mIU/ml.

To determine the FSH/LH ratio, the FSH value must be divided by the LH value. The resulting value must correspond to:

• 12 months after puberty – from 1 to 1.5;
• 2 years after puberty and before the onset of menopause - from 1.5 to 2.

Testosterone:

• in the follicular phase – 0.45-3.17 pg/ml;
• in the luteal phase – 0.46-2.48 pg/ml;
• during menopause – 0.29-1.73 pg/ml.

Prolactin:

• women before pregnancy – from 4 to 23 ng/ml;
• women during pregnancy – from 34 to 386 ng/ml.

Thyroid-stimulating hormone (thyrotropin, thyroid hormone TSH) – 0.27-4.2 μIU/ml.

Free thyroxine (thyroid hormone FT4) – 0.93-1.7 ng/dl.

DHEA-S, normal values:

• for women aged 18 to 30 years – 77.7-473.6 mcg/dl;
• for women aged 31 to 50 years – 55.5-425.5 mcg/dl;
• for women aged 51 to 60 years – 18.5-329.3 mcg/dl.

Anti-Müllerian hormone (AMH, MIS):

• in women of reproductive age – 1.0-2.5 ng/ml.

Reference values may vary between laboratories, so interpretation of results and diagnosis should only be made by your treating physician.

Hormones before planning pregnancy: deviations from the norm

Exceeding the norm of estradiol may indicate:

• continued existence of an unovulated follicle;
• presence of endometrioid cyst of the appendages;
• the presence of a tumor of the appendages capable of secreting hormones.

Decreased estradiol levels:

• when smoking;
• during heavy physical exertion that is unusual for the body;
• with increased production of prolactin;
• with insufficient luteal phase;
• in case of risk of spontaneous abortion of hormonal etiology.

Excess progesterone levels may indicate:

• pregnancy;
• danger of uterine bleeding;
• disturbances in the formation of the placenta;
• diseases of the adrenal glands and kidneys;
• the presence of a cystic formation of the corpus luteum.

Decreased progesterone levels:

• anovulatory cycle;
• disorders of the functionality of the corpus luteum;
• chronic inflammatory process in the appendages.

An imbalance in the FSH/LH ratio may indicate pituitary insufficiency, hypothyroidism, amenorrhea syndrome, or renal failure.

Increased testosterone levels may be a sign of:

• strengthening the function of the adrenal glands;
• tumors of the appendages;
• hereditary predisposition.

Low testosterone levels may indicate the following situations:

• presence of endometriosis;
• increased estrogen levels;
• development of uterine fibroids or breast tumors;
• osteoporosis.

Increased prolactin levels can be observed in the following pathologies:

• pituitary tumor;
• decreased thyroid function (hypothyroidism);
• polycystic adnexal disease;
• anorexia;
• liver and kidney diseases.

Low prolactin levels are only worth noting when their levels are lowered against the background of other hormones (for example, thyroid hormones). This may indicate diseases of the pituitary system.

Thyroid stimulating hormone may be elevated:

• in case of renal failure;
• for tumors;
• for some mental illnesses.

A decrease in the level of thyrotropin may indicate:

• thyroid dysfunction;
• pituitary gland injury.

An increased amount of thyroxine indicates hyperthyroidism, and a decreased amount indicates hypothyroidism.

An increased amount of DHEA-S indicates the phenomenon of increased production of androgens due to dysfunction of the adrenal glands: this may cause the inability to carry a pregnancy to term.

A decreased level of anti-Müllerian hormone indicates:

• about the onset of menopause;
• about decreased ovarian reserve;
• about ovarian exhaustion;
• about obesity.

Increased levels of AMH may be observed:

• in case of anovulatory infertility;
• with polycystic ovaries;
• for tumors of the appendages;
• in case of LH receptor disorders.

Women who are planning a healthy pregnancy can have their blood tested 3-6 months before the expected attempt to conceive.

Only a qualified gynecologist or reproductive specialist can prescribe and evaluate hormone tests. You can take hormone tests when planning a pregnancy in almost all modern clinics and laboratories.