Hormone Levels

Hormone to Test
 

Time
to Test

Normal
Values

What Value Means
 

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.

Estradiol (E2)

Day 4-5 of meds

100+ pg/ml or 2x Day 3

There are no charts showing E2 levels during stimulation since there is a wide variation depending on how many follicles are being produced and their size. Most doctors 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 in E2 from the level taken on cycle day 3.

Estradiol (E2)

Surge/hCG day

200 + pg/ml

The levels should be 200-600 per mature (18 mm) follicle. These levels are sometimes lower in overweight women.

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)

Day 3

< 1.5 ng/ml

Often called the follicular phase level. An elevated level may indicate a lower pregnancy rate.

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)

Day 3

.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)

Day 3

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)

Day 3

.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.

Free Testosterone

Day 3

.7-3.6 pg/ml

Dehydroepiandrosterone Sulfate (DHEAS)

Day 3

35-430 ug/dl

An elevated DHEAS level may be improved through use of dexamethasone, prednisone, or insulin-sensiting medications.

Androstenedione

Day 3

.7-3.1 ng/ml

Sex Hormone Binding Globulin (SHBG)

Day 3

18-114 nmol/l

Increased androgen production often leads to lower SHBG

17 Hydroxyprogesterone

Day 3

20-100 ng/dl

Mid-cycle peak would be 100-250 ng/dl, luteal phase 100-500 ng/dl

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.