Bloodwork

My doctor wants me to go for bloodwork (I'm not ovulating... haven't for a year) but he only ordered a test on my LH, FSH and a fasting serum glocose test.

I think I would rather have the entire work up. My DH's aunt (retired nurse practioner) said I should have also been tested for A1C hemoglobin and have my thyriod checked. She was not happy that he only ordered those tests considering I'm 35 and have been TTC for over 6 months.

Can you ladies tell me what they tested you for?
Someone last week told me they took 13 viles from her

Should he just have refered me to an RE?

I'd rather have a more comprehensive test done as I'll have to take off from work.

Feel free to FM me if you'd rather not post it.

Thank you so much. I don't really have anyone else to ask... my mom is deceased and all of my close friends are "fertile Myrtles"

Re: Bloodwork

If you are comfortable with your dr I would stay, but if not then seek an RE.
On my first consultation with the RE I was sent for bloodwork and they took about 13-15 vials.

I was tested for FSH, estrogen, progesterone, thyroid, and a whole genetic work up (cystic fibrosis, themallis (sp?) it has to do with if you're of Mediterrean descent) plus some other ones that I can't remember right now and I don't have my paperwork here at work right now.

I would also ask your Dr for a scrip for DH for a SA, let that be one more thing you can rule out and only have your ovulation as the issue

Good luck!

ETA: I also had an HSG to make sure to check the tubes, but I'm not sure if that's standard testing for every woman, but something you may want to look into.

I'm close to you in age (I turn 35 next month) so I've been trying to be very aggressive in this TTC game.

Message edited 9/21/2005 9:43:16 AM.

Re: Bloodwork

Re's do tons of bloodwork. A lot of it is hormonal, and some is exactly what Donna said. Genetic. Although I wish they would test for immune issues as well, prior to pg. Sometimes a person needs to sustain a pregnancy with baby asprin or heparin etc. I think this should be done prior to conceiving rather than when miscarriages occur.

The major hormones to be tested for when TTC are below with some information about each. The day you get the bloodwork is very important for some of these hormones. When you see an RE, Day 3 of every cycle, they check, your FSH/Estradoil. They even check for cysts on day 3 (every cycle). Another test, that I believe is essential to have every cycle, is the 7 dpo progesterone test. The 7 dpo progesterone test, will A) indicate you ovulated and B) indicate if you were to get pregnant, would the pregnancy be sustained. If your progesterone is low, it's very easy to fix with suppositories.

Follicle Stimulating Hormone (FSH) Day 3 3-20 mIU/ml FSH is often used as a gauge of ovarian reserve. In general, under 6 is excellent, 6-9 is good, 9-10 fair, 10-13 diminished reserve, 13+ very hard to stimulate. In PCOS testing, the LH:FSH ratio may be used in the diagnosis. The ratio is usually close to 1:1, but if the LH is higher, it is one possible indication of PCOS.


Estradiol (E2) Day 3 25-75 pg/ml Levels on the lower end tend to be better for stimulating. Abnormally high levels on day 3 may indicate existence of a functional cyst or diminished ovarian reserve.


Luteinizing Hormone (LH) Day 3 < 7 mIU/ml A normal LH level is similar to FSH. An LH that is higher than FSH is one indication of PCOS.
Luteinizing Hormone (LH) Surge Day > 20 mIU/ml The LH surge leads to ovulation within 48 hours.

Prolactin Day 3 < 24 ng/ml Increased prolactin levels can interfere with ovulation. They may also indicate further testing (MRI) should be done to check for a pituitary tumor. Some women with PCOS also have hyperprolactinemia.

Progesterone (P4) 7 dpo > 15 ng/ml A progesterone test is done to confirm ovulation. When a follicle releases its egg, it becomes what is called a corpus luteum and produces progesterone. A level over 5 probably indicates some form of ovulation, but most doctors want to see a level over 10 on a natural cycle, and a level over 15 on a medicated cycle. There is no mid-luteal level that predicts pregnancy. Some say the test may be more accurate if done first thing in the morning after fasting.

Thyroid Stimulating Hormone (TSH) .4-4 uIU/ml Mid-range normal in most labs is about 1.7. A high level of TSH combined with a low or normal T4 level generally indicates hypothyroidism, which can have an effect on fertility.

Free Triiodothyronine (T3) 1.4-4.4 pg/ml Sometimes the diseased thyroid gland will start producing very high levels of T3 but still produce normal levels of T4. Therefore measurement of both hormones provides an even more accurate evaluation of thyroid function.

Free Thyroxine (T4) .8-2 ng/dl A low level may indicate a diseased thyroid gland or may indicate a non- functioning pituitary gland which is not stimulating the thyroid to produce T4. If the T4 is low and the TSH is normal, that is more likely to indicate a problem with the pituitary.

Total Testosterone Day 3 6-86 ng/dl Testosterone is secreted from the adrenal gland and the ovaries. Most would consider a level above 50 to be somewhat elevated

Fasting Insulin 8-16 hours fasting < 30 mIU/ml The normal range here doesn't give all the information. A fasting insulin of 10-13 generally indicates some insulin resistance, and levels above 13 indicate greater insulin resistance.

Fasting Glucose 8-16 hours fasting 70-110 mg/dl A healthy fasting glucose level is between 70-90, but up to 110 is within normal limits. A level of 111-125 indicates impaired glucose tolerance/insulin resistance. A fasting level of 126+ indicates type II diabetes.


Glycohemoglobin / Glycosylated Hemoglobin (HbA1c) anytime < 6 % An HbA1c measures glucose levels over the past 3 months. It should be under 6% to show good diabetic control (postprandial glucose levels rarely going above 120). Good control reduces the risk of miscarriage and birth defects.

Message edited 9/21/2005 9:57:52 AM.

Re: Bloodwork

Michelle - you are a fountain of information!! Thanks for all of this!!

Theresa,
I just had the 3rd day of AF tests done and I am waiting for the results. This stuff is so confusing

Re: Bloodwork

Thanks again ladies.

Redstar... you deserve an honorary doctorate. Yoou hae just armed me with a ton of information. Considering knowledge is power, I'm a lot more powerful than yesterday.

I will call the office when I get home from school and ask him to call me back. I want to know why he did not suggest such and request a referral to an RE.

Thanks again

You ladies are the best.


Why, oh why, does DH have to be in CA this week?