Ways To Monitor Fertility

Many couples who have trouble conceiving are advised to undergo required lab tests or examinations. Various tests help in determining the condition of a woman’s reproductive function. A few tests include antral follicle count and clomiphene citrate test but one common test is cycle day 3 testing. Cycle day 3 testing involves measuring hormone blood levels such as follicle-stimulating hormone (FSH) and estradiol.

Why is day 3 important?

Cycle day 3 testing is when FSH and estradiol levels are checked at the start of the menstrual cycle. The hormone levels are checked anywhere from day 2 to day 4 but usually done on day 3. Day 3 testing of the hormones will determine how well the pituitary gland is stimulating the ovaries. FSH level is not checked alone but with other hormones such as estradiol. An important aspect to note is that hormone levels vary throughout the cycle and from cycle to cycle.

A brief on FSH

Produced by the anterior pituitary gland, FSH has a responsibility to ensure oocytes in the ovaries are growing. In response to the growth and development of oocytes, estrogen is progressively released and as a result, FSH level drops. A high FSH level means poor fertility potential or a sign of reproductive aging. Studies show that there is no confirmed FSH level that indicates a woman’s reproductive potential. Due to the unpredictability of this test, suggesting additional ovarian reserve tests to patients is advisable.

More on estradiol

Estradiol is an estrogen steroid hormone and is also measured on day 3 of the menstrual cycle. An increased level of estradiol indicates poor fertility potential; however, estradiol has a negative feedback on FSH level. When estradiol level is high and FSH is normal, the FSH level is automatically suppressed, leading to poor ovarian reserve. Because FSH and estradiol work together, there should be low FSH and low estradiol levels. In in vitro fertilization (IVF) procedure, estradiol level is considered to have low predictability.

Alternatives to day 3 testing

Although testing the hormone levels at day 3 is common, there are other ways to test ovarian reserve. Other ways include testing other hormones such as anti-mullerian hormone (AMH) or taking medications such as gonadotropins and clomiphene citrate. Also, doing a transvaginal ultrasound to check the follicle count is another method. The cycle day 3 testing is not always considered reliable but there are other tests a patient can undergo. Depending on the patient’s current situation, the healthcare provider will instruct the best procedure.