# Hormone levels - advice please.



## ClareS66 (Mar 10, 2013)

Hello! Can anyone tell me what the various hormone levels are expected to be, or post a link to a good website?

I had some tests via my GP recently, and I have a FSH level of 6.4 iu/L which is reported as 'normal'. Does that mean normal for my age? I'm 47 - nearly 48.  

I'm also having a blood test for AMH on thursday, and it would be useful to know what that may mean when I get my results.


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## Dudders (Jun 18, 2012)

Hi Clare,

Your FSH is good, and not just for your age  

Based on your FSH level, you would expect your AMH to be good too.  Primarily these numbers are used to indicate your ovarian reserve, and you're looking for low FSH and high AMH.  In terms of IVF it would be used to determine your drug protocol.

Good luck for Thursday xx


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## Dudders (Jun 18, 2012)

Just to add that if you are ovulating normally, a good AMH level could mean you are a suitable candidate for IUI - which has the bonus of being much cheaper!  x


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## Emmacat (Aug 2, 2012)

Hi,
DId you get your Estrogen (E2) tested at the same time as FSH?  My FSH was great, I thought, at 5.5 for my age (41), but my estrogen was 268!!  Elevated estrogen can falsely suppress FSH.  I also have a functional cyst which is probably the reason why my estrogen is so high.


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## ClareS66 (Mar 10, 2013)

Hi Emmacat, no I didn't, thanks for the advice - I'll see if they will do that thursday as well. To be honest, I had assumed DE was my only option at my age, but if I can have a try with my own eggs then I may do that first.

Dudders: not sure that I am ovulating normally any more, I guess I have this all to find out!


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## Dudders (Jun 18, 2012)

Emma makes a good point about the E2 suppressing FSH - sorry I'd forgotten that.  If you can get that tested too it will give you a more complete picture x


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## ClareS66 (Mar 10, 2013)

Does E2 need testing at any particular time in my cycle?


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## Ipomée (Oct 30, 2012)

Hello Clare  ,

E2 should be tested on "Day 3" of your cycle. The Drs should test it along with "FSH, LH and Progesterone." 
The values change according to our cycles and Day 3 is in the follicular phase.  The FSH can decrease further in the cycle. The Day 3 test determines more how hard the ovaries have to work to get the follicules to grow via the FSH. It's important to look at the relationship of the different hormones together.  FSH with LH, E2 with FSH as mentioned by Emmacat.

Hope this helps some.  
Impomée


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## ClareS66 (Mar 10, 2013)

Well my estrogen level is 130 - so not too sure about that. AMH result will take about 5 days.


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## melloumaw (Feb 2, 2012)

dont know if this is any use for you, it doesn't specify an age
http://www.fertilityplus.com/faq/hormonelevels.html#female
mel x

/links


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## Dudders (Jun 18, 2012)

That's a great website for reference - just be careful because it uses American measurements though! Your E2 was likely measured in pmol/l not the ng on that website.

I've copied the following from a website for you:

Why measure around Day 2?
At this time, estradiol is at its lowest so FSH should be at its highest. If the estradiol level on Day 2 is > 200pmol/l, then follicle growth will have already started, and the measurement of the FSH is not reliable because the raised estradiol will have already started to suppress the FSH level. This commonly happens in older women. From a functional point of view, early follicle growth may mean the endometrium does not have enough time to develop before ovulation occurs, leading to asynchronicity between the egg and the endometrium , and hence a reduced chance of implantation.

Possible interpretation of results are:
1. FSH < 9 iu/L; E2 < 200pmol/l = Normal basal follicle function, and normal amount of FSH being produced to stimulate the ovarian follicles
2. FSH >9 iu/l; E2 < 200 pmol/l = Brain responds to low ovarian reserve by producing more FSH to try to recruit a follicle. Ie. the brain is upping the production of its own fertility drug in recognition that there is something not right with follicle development.
3. FSH < 9 iu/l; E2 > 250 pmol/l = Ovary is racing ahead in follicle development, and correct interpretation of the FSH result is not possible because the estradiol level is not basal.
4. FSH > 9 iu/l; E2> 250 pmol/l = Ovary is racing ahead of follicle development, and although interpretation of the FSH result is compromised by raised estradiol, it is likely that were the estradiol to be basal (ie< 200pmol/l), the FSH would be even higher.

Day 21 Progesterone Measurement 
The corpus luteum is the gland formed in the ovary from the ovulated follicle(s). It makes progesterone and and estradiol that is secreted in to the blood and causes the lining of the uterus to become secretory. Blood level of progesterone in the middle of the luteal phase > 30nmol/l suggest that the endometrial effect of the progesterone is likely to be sufficient to assist an embryo implanting in the uterus. This progesterone in the blood also feeds back to the pituitary to ensure that little FSH is produced. There is no value in measuring the hormones FSH, LH and E2 at the same time as a Day 21 progesterone because their interpretation is not of any value if the progesterone is raised, as it should be in the mid-luteal phase.

Why Day 21?
This day is chosen on the assumption that the women are having a 26-30 day cycle, and luteal phase is normal and lasts about 10-14 days after ovulation. Thus, assuming ovulation is between Days 12-16 , Day 21 is the middle of the luteal phase when the production of progesterone from the corpus luteum gland peaks in an ovulatory cycle (and if there was then pregnancy, the HCG would prevent the corpus luteum from then dying and it would produce even more progesterone). If ovulation has occurred later than Days 12 - 16, then the progesterone check would be better done a few days later so as to strike the middle of the luteal phase. Conversely, if ovulation has occurred earlier than Day 12, an earlier progesterone test at about Day 18 is required.

Progesterone levels should be interpreted with respect to the number of days before the onset of the next period. Luteal function ( and hence ovulation) cannot be assumed if the period starts < 5 days later or > 9 days after the blood test.

Possible interpretation of results assuming the test is properly timed are:
1. Progesterone > 30nmol/l - ovulation has occurred and the corpus luteum is producing sufficient progesterone to induce adequate secretory changes in the endometrium to assist implantation.
2. Progesterone 3-30 nmol/l - ovulation has occurred > 10 days ago or < 5 days ago, or if ovulation did occurr 5-10 days ago, the level is probably not adequate to sustain endometrial growth for satisfactory implantation. 
3. Progesterone >120 nmol/l - two or more follicles have been recruited
4. Progesterone < 3nmol/l - no ovulation in previous 14 days.

Sounds like it's all fine according to that - I would anticipate a good AMH level xx


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## ClareS66 (Mar 10, 2013)

Thanks, my result was 130 pmol/L which converts to about 35 pg/mL so I guess that's not too bad...


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## Mimi37 (Apr 1, 2013)

Hi

My E2 is 287, does that mean my other results are false.? AMH 24.3, FSH 7, AFC/AFT 17


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## Dudders (Jun 18, 2012)

What cycle day were you on when the E2 was done Mimi?


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## Mimi37 (Apr 1, 2013)

Day 2


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## Dudders (Jun 18, 2012)

Hmm, well it is possible that your e2 level is suppressing your FSH.  But your AMH level is a constant and it's likely that your FSH would be disregarded in favour of your AMH level.  The AFC also ties in with the AMH level, so that's a good sign.

Reading what I quoted above from another website, it would suggest your follicles have already started growing and it makes interpretation of the FSH level less reliable - so but your AMH is good which is excellent.  How long are your typical cycles?  If you have a shorter cycle it is possible that the follicles are getting ahead of the lining and not giving it a chance to thicken enough before ovulation.


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