Day 3 exams
Follicle Stimulating Hormone (FSH)
Day3 (3- 20 mlU/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.
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Estradiol (E2)
Day 3 (25 - 75 pg/ml)
Day 4 -5 with meds (100+ pg/ml or 2x day 3)
Surge/hcG day (200+ 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.
There is no chart showing E2 levels during stimulation depending on how many follicles are being produced and their size. Most MD's will consider any increase in E2 a positive sign, but others use a formula of either 100 pg/ml after 4 days of stims, or a doubling of E2 from the level taken on CD3 without meds.
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Luteinizing Hormone (LH)
Day 3 (<7 mlU/ml)
Surge Day (>20 mlU/ml)
A normal LH level is similar to FSH. An LH that is higher than FSH is one indication of PCOS.
The LH surge leads to ovulation within 48 hours.
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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.
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Progesterone (P4)
Day 3 (<1.5 ng/ml)
7 dpo (>15 ng/ml)
Often called the follicular phase level. An elevated level may indicate a lower pregnancy rate (Day 3)
For the 7 dpo level, the 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.
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Thyroid Stimulating Hormone (TSH)
Day 3 (.4 - 4 ulU/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.
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Free Triiodothyronine (T3)
Day3 (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.
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Free Thyroxine (T4)
Day3 (.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.
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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.
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Free Testosterone
Day 3 (.7 - 3.6 pg/ml)
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Dehyroepiandrosterone Sulfate (DHEAS)
Day 3 (35 - 430 ug/dl)
An elevated DHEAS level may be improved through use of dexamethasone, prednisone, or insulin-sensitizing medications.
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Androsteredione
Day 3 (.7 - 3.1 ng/ml)
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Sex Hormone Binding Globulin (SHBG)
Day 3 (18 - 114 nmol/l)
Increased androgen production often leads to lower SHBG.
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17 Hydrxyprogesterone
Day 3 (20 - 100 ng/dl)
Mid cycle peak would be 100 - 250 ng/dl, luteal phase 100 - 500 ng/dl.
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Fasting Insulin
8 - 16 hours fasting (<30 mlU/ml)
The normal range here doesn't give all the information. A fasting insulinof 10 -13 generallly indicates some insulin resistance, and levels above 13 indicate greater insulin resistance.
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This information was taken from Fertility Plus.
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