What hormones should be tested when planning a pregnancy?

Perhaps the main purpose of a woman on Earth is procreation. Bearing and giving birth to a child is a huge creative work that a woman must cope with. Therefore, childbearing should be approached responsibly and seriously. The ideal option is when the body is prepared for an important mission long before pregnancy, and the reproductive organs are kept in perfect order.

“Science has shown us that natural birth control is not only possible, but absolutely effective. Any woman can notice the signs that indicate different periods of her cycle by learning what to look for. This knowledge is the basis of true freedom of love.” Jerome Lejeune, professor of general genetics (France)

We, living at the end of the twentieth century, are sometimes so proud of the rapid development of technology, space exploration, and progress in various fields of knowledge! We know surprisingly little about ourselves. This can also be said about that side of human existence, which means so much for the intimate life of a man and a woman and is associated with issues of procreation, conception and pregnancy. The depth of their mutual feeling, agreement and harmony in the relationship are strengthened through an understanding of different but complementary characteristics: fertility, emotionality and psyche. Ignorance of the physiology of the body leads to the saddest consequences. It is no secret that many married couples live in constant fear of an unplanned pregnancy, and this causes a negative attitude towards sex life in general. Others are forced to suffer because they cannot wait for the child they want, despite excellent health and good living conditions. Or maybe the point is just that both of them cannot correctly choose the optimal time for conception?

Read the section: Reproductive system. Fertility periods and learn to understand your body.

How to plan a pregnancy

The disease is difficult to cure, but easy to prevent. Doctors have long realized that it is much easier for them to engage in prevention - it brings much more tangible results, and it is much easier. Treatment always lags behind prevention. Prevention of diseases that do not yet exist is very simple, and if you take it seriously, they can really be avoided. Treatment of existing complications is always late and lags behind the mechanism of their development. Treatment is always a step of desperation, always consent to side effects in order to cure the underlying condition, always an advanced stage. The strategy of modern medicine is prevention, the strategy of modern obstetrics is planned, prepared pregnancy.

It has long been proven that most complications that develop during pregnancy can be prevented by proper preparation, namely by replenishing vitamin deficiencies, examination, diagnosis of possible diseases, conditions, predispositions, and their correction. There are conditions whose harmful effects can be completely eliminated if identified in advance: for example, lack of immunity to rubella. One vaccination, 3 months of contraception - and such a problem no longer exists, otherwise - 9 months of stress, constant testing and in the event, God forbid, infection - a 50% chance of developing fetal defects and a clear recommendation to terminate the pregnancy.

There are conditions that cannot be completely eliminated, but diagnosing them before pregnancy allows the attending physician to predict possible expected complications, be prepared for them and prescribe their correction in time - literally from the first days of the delay, before contacting the doctor, the woman begins taking medications that allow her to maintain pregnancy in the early stages.

A visit to the gynecologist can bring unpleasant surprises - for example, in the form of a mild inflammatory process that can become more active during pregnancy. Treatment will take time. Therefore, you need to start preparing for pregnancy at least three months before the expected conception.

. Better yet, six months.

Hormones. Their role in pregnancy planning.

Hormones are special “workers” of our body. They are produced in any unusual or stressful situation, and at the same time manage to manage all the functions of our body. Hormonal production depends on many circumstances: health status, age. They are especially important for women. Their condition will determine whether a woman becomes a mother or not. If at least one hormone functions incorrectly, problems arise with conceiving a baby. Therefore, it is so important to check your hormonal levels by taking a blood test when planning a long-awaited pregnancy. This will avoid bitter disappointments such as miscarriage or missed pregnancy.

Our chances: how long will it take from the start of planning to conception?

It may seem unusual that sometimes it takes six months or even a year to conceive a child. This is due to the fact that ovulation may not occur every month. If a woman has recently stopped taking birth control pills or interrupted some other course of hormonal contraceptives, it will take several months before her menstrual cycle returns. Emotional factors, lifestyle changes and poor health can also affect ovulation. But even if a woman had sex right before ovulation, if her egg was successfully fertilized, the developing embryo may not implant. Thus, a married couple should not be too surprised if their attempts to conceive are unsuccessful within six months or so. For healthy married couples who make love without using contraception two to three times a week, the typical picture looks like this:

• 60 out of every 100 couples can conceive within six months;
• 80 out of every 100 married couples can conceive a child within one year;
• 90 out of every 100 married couples can conceive a child within two years.

When is it necessary to take it?

Planning a pregnancy is an important stage in the life of future parents, requiring a full medical examination to identify possible pathologies of the body. Some couples, in addition to traditional studies, need to undergo basic hormone tests.

Indications for their use are:

• irregular menstrual cycle, scanty periods;
• lack of conception within a year with regular sexual activity without the use of contraceptives;
• formation of benign tumors (for example, fibroids);
• miscarriages or miscarriages in the past;
• weight gain;
• decreased sexual desire;
• tendency of the skin to rashes, intensive growth of hair on the body (face, chest area), deterioration of the condition of hair and nails;
• emotional instability, mood swings;
• the age of the spouses is over 35 years.

Appropriate procedures are prescribed for older couples, taking into account the fact that the activity of the ovaries in women and sperm in men decreases, which is a natural physiological phenomenon after 35 years.

For a referral for tests, a woman should contact a gynecologist or endocrinologist. When planning a pregnancy, the best time to get tested is five to six months before the expected date of conception. The spouses will have enough time to successfully eliminate the problem and achieve stabilization of hormonal levels.

How to prepare for pregnancy

• Quit smoking 2-3 months before conception - together with your husband. • Refuse to consume alcohol in any form 2-3 months before conception - together with your husband. • Reduce the amount of coffee and strong tea you consume (any caffeine-containing drinks). • In a cycle in which conception is possible, do not visit the bathhouse, sauna, do not take a hot bath, do not allow overheating and hypothermia. • During the conception cycle, it is not advisable to fly on airplanes or vacation in distant countries where the climate is strikingly different from what is usual. • Do not practice any diets aimed at losing weight. • Do not engage in active sports, fitness, do not exercise your muscles and especially your abdominal muscles. • Do not take any medications without consulting a doctor and carefully reading the instructions for the drug. • Try not to get sick, and if you get sick, treat yourself with folk remedies. If antibiotics were used during treatment, a woman needs to postpone conception for a month, and a man – for 2-3. • Take multivitamins, and especially folic acid (prevention of fetal malformations). You can continue taking vitamins during pregnancy. To prepare for pregnancy, folic acid before pregnancy should be taken with your spouse for 2-3 months before the expected conception, and then in the first 3 months of pregnancy. • If you are taking oral contraceptives, remember that in the first three months after stopping them, you have an increased likelihood of multiple pregnancies (the so-called rebound effect - withdrawal effect). Think about it - do you need it? • Your work should not be associated with occupational hazards - radiation, chemicals, mercury, vibration, etc. Modern computers do not harm pregnancy. If there are hazards in your work, decide on the issues of moving to another area or changing jobs. • Your diet should be varied, balanced and easily digestible. • If you need to take any medications on a regular basis, discuss with your doctor which medications you will take during a future pregnancy, taking into account the possible effect on the fetus. • Visit the dentist and get your teeth in order. • Well, in the end, it’s worth saying that in the vast majority of cases, pregnancy occurs on its own and proceeds exactly as it does. All our tricks can only slightly reduce risks, but never eliminate them completely. So - GOOD LUCK!

What tests will you need to take?

To check your hormonal levels, you need to figure out which hormone tests you should take when planning. The list of examinations is selected by the doctor taking into account the patient’s medical history, her state of health, the presence of excess weight or signs of hyperandrogenism.

FSH

Follicle-stimulating hormone is responsible for the growth of follicles, the process of egg maturation and its release into the fallopian tube. It affects the synthesis of estrogen and creates favorable conditions for ovulation.

FSH is produced in the pituitary gland and enters the ovaries through the bloodstream. The hormone is released into the blood irregularly, so you need to take tests to check its level on days 2-4 of the cycle. To determine the period of egg maturation, you can donate blood for FSH on days 5-8 of the menstrual cycle.

Important information: What is FSH in men and a table of norms by age

An increase in its level is possible if the patient:

• endometriosis;
• pituitary tumor;
• ovarian function is impaired.

A decrease in FSH is observed with polycystic changes in the ovaries, overweight or underweight.

LH

In the first phase of the cycle, simultaneously with follicle-stimulating hormone, gynecologists recommend checking the level of luteinizing hormone. They are interconnected: under the influence of FSH and LH, ovulation occurs and the corpus luteum begins to form. LH reaches its maximum level during the release of the egg from the follicle.

If the ratio of the levels of follicle-stimulating and luteinizing hormones is disturbed, the functioning of the pituitary gland must be checked.

In such a situation, a woman’s egg may not mature and be released. These hormone tests when planning pregnancy can help identify the cause of infertility.

Elevated LH levels can be observed with ovarian depletion and ovulatory disorders. LH decreases in overweight patients with pituitary tumors. It may be lower than normal in women under prolonged stress.

Prolactin

The pituitary gland is responsible for the production of prolactin. This hormone is needed to prepare the mammary glands for milk production. Additionally, it is responsible for reducing pain during childbirth and stimulating the onset of breathing in newborns.

An increase in prolactin is one of the causes of infertility, because... its growth provokes a decrease in FSH concentration and suppresses the process of egg release from the follicle. The level of prolactin depends not only on the phase of the cycle, but also on the time of day. The minimum levels will be in the morning and the maximum at night.

The level of this hormone may increase in patients who:

• pituitary tumor;
• there is no ovulation;
• body weight deficiency;
• diseases of the liver and urinary system;
• problems with the functioning of the thyroid gland.

Reduced prolactin concentrations are rare. This situation is possible with a disease of the pituitary system.

You can suspect that a patient has elevated prolactin based on indirect signs:

• vaginal dryness;
• discharge from the breast;
• blurred vision;
• delays in menstruation.

To get reliable results, you need a positive attitude when taking tests. Under stress, prolactin increases.

Progesterone

One of the mandatory tests for women who cannot get pregnant is the determination of progesterone levels. Its deficiency can lead to the fact that a fertilized egg cannot implant in the uterus. Progesterone promotes the growth of the endometrium and the formation of a favorable environment for embryo implantation. Even if pregnancy has occurred, progesterone deficiency increases the risk of miscarriage or arrested fetal development.

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Phase 2 is best suited for the delivery of progesterone. It is advisable to schedule the analysis for 21-23 days from the start of menstruation. In the middle of phase 2, its level rises to maximum values. If you have an irregular cycle, it is better to take the test several times after ovulation has passed.

Donating blood at the planning stage is recommended for patients whose periods are irregular or painful. Women with acyclic uterine bleeding should also check their progesterone levels.

Estradiol

Under the influence of luteinizing and follicle-stimulating hormones, estradiol is produced in the ovaries. It is responsible for the development of the uterus, fallopian tubes, preparation of the uterine cavity for fetal implantation and the intensity of blood loss during menstruation. Its maximum level is observed 1-3 days before ovulation.

Gynecologists recommend taking this test for women who cannot become pregnant for more than 6 months in a row.

It is better to do this on days 2-5 or 21-23 of the cycle.

Estradiol decreases with anovulation, increased prolactin, and excessive physical exertion. An increase is possible with tumors or cystic formations of the appendages.

DEA sulfate

In women, this hormone is produced in small quantities. It is recommended to take it if there is a suspicion of ovarian pathology. DEA sulfate is taken on any day of the cycle.

An increase in the level of this male hormone in the female body is possible with tumors of the adrenal glands or other diseases of these organs. A decrease is observed with long-term use of steroid hormones.

Testosterone

The male hormone testosterone is produced in small quantities in the ovaries and adrenal glands. An increase in its quantity provokes ovulation disorders. To determine the level of this hormone, you can take an analysis on any day of the cycle after the end of menstrual flow.

An increase is indicated by a deepening of the voice and male-pattern hair growth (the appearance of hair on the chest and face). Its growth is possible with tumors of the appendages or increased work of the adrenal glands.

AMG

The production of anti-Mullerian hormone begins immediately after the birth of a girl and ends after menopause. Its level is not affected by a woman’s diet or lifestyle. Patients over 30 years of age who are unable to conceive a child are recommended to have AMH checked. It displays the follicle reserve and the probability of ovulation. The level of anti-Mullerian hormone can predict the time of menopause.

Important information: How to prepare for donating blood for sex hormones to women and what not to do before taking a gynecological test

With ovarian depletion, androgenism, and polycystic changes, the AMH level changes. Disorders of sexual development and obesity can lead to deviations from the norm.

Thyroid hormones

A woman’s ability to conceive and bear a child depends on the functioning of the thyroid gland. If its functioning is impaired, problems may arise with conceiving a child. If problems are suspected, the gynecologist may recommend that a patient planning a pregnancy be tested for thyroid hormones.

The levels of thyroid-stimulating hormone (TSH), thyroxine (T3), 17-ketosteroids, cortisol, triiodothyronine (T4) are checked. It is advisable to take hormone tests no later than 10 am. Before this, you cannot eat, drink tea, coffee, or carbonated drinks. You should also stop taking iodine-containing drugs and hormonal drugs a week before the examination.

Thyroid-stimulating hormone is responsible for the production of prolactin. TSH levels decrease in patients with renal failure, mental illness, tumors and hypothyroidism. If the pituitary gland is injured and the thyroid gland malfunctions, the concentration of TSH may increase.

Triiodothyronine affects metabolic processes and is responsible for enriching tissues with oxygen. Simultaneously with TSH, thyroxine is produced. Synthesized T3 affects protein metabolism and oxygen saturation of tissues.

Should everyone be tested before pregnancy?

In each case, the gynecologist individually assesses the need for hormonal studies. The optimal time to visit is 6 months before the planned pregnancy. It is extremely important for women to undergo testing if they have the following risk factors:

• absence of pregnancy after a year of regular unprotected sexual activity;
• age over 30 years;
• excess body weight;
• the presence of chronic diseases, hormonal disorders (regardless of the diagnosis);
• irregular cycles, periods of delays and heavy bleeding, severe premenstrual syndrome;
• burdened obstetric history - miscarriages in the past, frozen pregnancy, stillbirth, severe toxicosis (early or late).

To plan a pregnancy, you need to undergo a study of the main sex hormones: estradiol, progesterone, testosterone. Their formation is controlled by the pituitary gland with the help of follicle-stimulating hormone, luteinizing hormone and prolactin. Increased levels of male steroids may be related to the adrenal glands. This can be determined by testing for dehydroepiandrosterone in the blood or 17-ketosteroids in the urine.

What might a deviation from the norm indicate?

If the test results reveal malfunctions in the hormonal system, then special therapy is prescribed. Your doctor may recommend medications, prescribe a diet, or advise you to make lifestyle changes. In some cases, only surgery can eliminate the cause of hormonal imbalance.

When prescribing hormonal treatment, the patient's condition is monitored over time. If necessary, the treatment regimen is adjusted.

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The list of hormone tests is quite extensive and includes tests such as:

• Estradiol. The test is taken in the morning on an empty stomach. The evening before the test, you are prohibited from eating fatty foods, drinking alcohol, and smoking.
• Progesterone. Blood is also taken in the morning from a vein during the period of ovulation, approximately on the 14th day and after 22 days from the end of menstruation.
• Follicle stimulating hormone (FSH). Blood for testing is taken on an empty stomach on days 2-5 or 20-21 of the monthly cycle.
• Luteinizing hormone (LH). It is usually taken together with FSH, since the analysis is carried out in a complex.
• Testosterone. High levels of this hormone can cause miscarriage.
• Prolactin. The analysis is performed in the morning on an empty stomach. On the eve of the test, it is forbidden to have sex, be nervous and stimulate the breasts, as this increases the level of hormone levels. Available for rent on days 5-8 of the cycle.
• Thyroid hormones such as TSH and T4. It is important to take it for absolutely all women who have cycle disruptions, miscarriage or the inability to become pregnant.
• DHEA-S. For analysis, blood serum is taken on an empty stomach. The day before the test, it is forbidden to drink alcohol, eat fatty foods, smoke and exercise.
• Anti-Mullerian hormone (AMH) level. The analysis is performed in women who are planning a pregnancy after the age of 30.

Deviation from the norm of estradiol may indicate an endometrioid cyst of the appendages, a tumor, or the existence of an unovulated follicle. This is possible due to smoking, a lot of stress on the body, etc. Poor progesterone levels may indicate inflammatory processes in the appendages.

There are many reasons for hormone deviations from the norm, and only your attending physician can best explain their occurrence to you, based on the indicators of your tests. Therefore, doctors strongly recommend that six months before the planned conception, you check your health and get tested in order to give birth to a healthy baby and reduce various risks.

Preparation

To ensure the reliability of the results of hormone tests before planning a pregnancy, you need to prepare for them 2-3 days in advance:

1. Eliminate stressful situations.
2. Limit physical activity.
3. Do not take medications, especially hormonal ones. If this is not possible, notify your doctor about this.
4. Stop taking vitamins and medications containing iodine.
5. Stop going to physical therapy.
6. Do not eat 12 hours before the blood test.
7. Eliminate fatty, salty, spicy foods from your diet.
8. No smoking.
9. Do not drink alcoholic beverages.
10. A woman needs to know the day of her menstrual cycle.
11. On the morning of the test, drink a glass of water on an empty stomach.

When planning pregnancy, you need to donate blood for hormones and urine, taking into account some specific rules:

• women donate blood for LH and FSH on days 3-8 (or 19-21) of the cycle; in men, venous blood can be collected at any time in the morning;
• before taking a prolactin test, you need to lie down for half an hour, relax and calm down, the procedure is performed in phase 1 or 2 of the cycle;
• a blood test for testosterone requires strict adherence to the general rules of preparation for the test; women take it on the 6-7th day of the cycle;
• Blood sampling for progesterone content is done on the 20-23rd day of the cycle in the morning; if it is disrupted, a repeat test must be carried out;
• the amount of 17-ketosteroids (metabolites of male sex hormones) is determined based on a daily urine test.

List of main hormones

If a woman cannot get pregnant, the reason is not only her. A man's reproductive health determines the successful fertilization of an egg. Depending on the identified problem, the doctor prescribes different examinations. Basic list of hormone tests:



The secretion produced by the endocrine system is responsible for cell growth, metabolic processes, and the formation of genital organs. Hormonal levels are of great importance before and during pregnancy. Even minor disruptions in the system can negatively affect conception, the course of pregnancy and the development of the baby.

Violation of hormone levels can lead to spontaneous miscarriage and fetal death. Therefore, when planning a future child, it is important to check your hormonal levels and pass all the necessary tests. This will help you properly prepare for conception and protect yourself from disastrous consequences.