Infertility Levels
— Are your Test Levels Beyond Normal?
Trying to test if you are fertile or not? Getting tested means that you’ll have to sift through the numbers and try to get something to make sense. With the numerous tests you’ll have to take, it can get a little intimidating. So here are some basics about these numbers to help you make sense of it all. Knowing more about the meanings behind the numbers can help you better understand when you are at normal levels or at “infertility levels” and give you a better idea on how to discuss your problems with your doctor.
Let’s start by first establishing that numbers and tests are not absolute. They will differ from lab to lab, and trying to get a universal delineation between normal and infertile levels is unrealistic. Furthermore, there is no single level that will clearly indicate your fertility or infertility. It is always going to be a combination of numbers and interpretations. That’s why you have to go through all those tests! Remember to never self-diagnose from your interpretation of the data. Always discuss the results with a doctor. These are merely guides to help you better understand the data and help with the discussions. Also, try not to get bogged down by the units. They may be hard to visualize but you can take the numbers as baselines, not as pure measurements.
For females, you will be interested in your hormone levels. These would include progesterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol.
1. For progesterone, the hormone that prepares the uterine lining for implantation, on average the normal level is at 1.5 ng/ml (nanograms per milliliter) or less. Going too low and too high may indicate a problem.
2. For FSH, the hormone responsible for the growth of follicles which house the eggs, a normal level is around 15 mIU/ml (milli-International Units per milliliter) or lower. Usually lower is better as higher FSH levels would indicate low ovarian reserves (or low egg count).
3. For LH, the hormone responsible for the release of the egg from the follicle and the transformation of cervical mucus to allow the passage of sperm during ovulation, a normal level should be close to the FSH level. If there is a big discrepancy between the two numbers, that can be an indication of a problem like PCOS (polycystic ovarian syndrome).
4. Estradiol is normally around 25-75 pg/ml. A level on the lower range may require you to take medication to stimulate the production of the hormone. A higher level may be a sign of low ovarian reserves or the presence of cysts.
5. Your thyroid hormones may be tested as well because hypothyroidism (an under productive thyroid gland) can be detrimental to fertility. TSH (thyroid stimulating hormone) and FT4 (free thyroxin) levels are tested. TSH should be normal around 1.7 and FT4 should be between 0.8 – 2. Low FT4 and high TSH would be an indicator of hypothyroidism.
For males, hormones play a big part as well. Testosterone, Prolactin, as well as FSH levels are key numbers that you’d want to see.
1. Testosterone is usually normal at around 300 to about 1,100 ng/dl (nanograms per deciliter).
2. Prolactin should be at 20 ng/ml. FSH should be around 4 to 10 mIU/ml.
3. Your semen will also be analyzed. Sperm count should be at 40 – 300million. 10 million is considered low and 20 million can be okay as long as the other factors are normal. Motility, the ability of the sperm to swim, is measured in two numbers. The first one is a percentage of active sperm. Above 50% is good. The next is a rating between 0 and 4 (0 is the lowest) that describes the quality of movement. Getting a 2 is enough but higher is better. Morphology, which is the size and shape of the sperm, should be around 30% which means 30% are fit for reproduction. Having a number of 4% is indicative of serious infertility problems.
These are just part of the numbers and levels that you will come across and evaluate to get a picture of your fertility. But remember to always consult your doctor! The numbers and levels can be very misleading if you take them out of context.
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