What tests are done for female infertility?
Time to read 9 min
Time to read 9 min
| INFERTILITY - WOMEN | ||||||
| Infertility is on the rise and this can be attributed to a lot of different factors. Some couples cannot have a child if the woman or man is infertile, in rare cases it could be both. Infertility is when a woman can't get pregnant after a year of marriage or keeps having miscarriages. An estimated 10 to 18 percent of couples have trouble getting pregnant or having a successful delivery.Female infertility causes can be difficult to diagnose. There are many available treatments, which will depend on the cause of infertility. Many infertile couples will go on to conceive a child without treatment. After trying to get pregnant for two years, about 95 percent of couples successfully conceive. | ||||||
| Causes of female infertility: • Obesity • PCOS • Hypothalamic dysfunction • Ovarian insufficiency • Too much prolactin • Damage to fallopian tubes • Endometriosis • Benign polyps or tumors | ||||||
| Prevention: • Overweight and underweight women are at risk of ovulation disorders. • Smoking , drinking alcohol & caffeine has negative effects on fertility. • Stress increases infertility. | ||||||
| Blood test | What it is | Why is it tested ? | What it means | Nutritional intervention | ||
| Testosterone | Hormone | High testosterone leads to hyperandrogegism. | High testosterone is associated with significant prolongation of the follicular phase of the cycle and increased incidence of amenorrhea or anovulation. | • Diindolylmethane, or DIM, present in cauliflower and broccoli is known to reduce androgens. • Herbal tea consumption helps reduce testosterone levels. • If high testosterone is coupled with high DHEA , ensure adequate B6 & Vitamin C levels. • Eat foods that increase oestrogen levels ( as high oestrogen reduces testosterone levels) eg Soy, Flax seeds (contra indicated if DHEA is high). • Stop smoking and drinking alcohol. • Spear mint & pepper mint tea have anti androgenic effects. |
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| LH | Hormone involved in regulating menses | Hormone that promotes ovulation. | Imbalanced levels of these hormones cause both PCOS and irregular periods. High levels of LH increases testosterone levels. |
• Manage insulin levels • Omega 3 decreases LH levels • Inositol decreases LH (citrus fruits, sprouts, capsicum, oats, green leafy vegetables) |
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| Progesterone | Hormones involved in regulating menses | Progesterone helps prepare the uterine lining for pregnancy. Low progesterone levels cause PCOS. |
Low levels of Progesterone usually indicate that ovulation did not occur and no egg was released. Low progesterone also causes anxiety, weight gain, cellulite, insomnia, fluid retention, thyroid issues amongst others. |
• Ensure adequate Vit B6 & Vitamin C levels as it boosts progesterone production. • Adequate zinc levels ensure ovulation ( lamb, liver, cashew nuts and pumpkin seeds). • Magnesium helps maintain progesterone levels ( green leafy vegetables, pumpkin seeds). • HDL rich foods help progesterone production. • High fibre ensures that oestrogen ( which antagonises progesterone ) is low. |
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| Estradiol / Oestrogen | Estradiol is a female sex hormone produced by the ovaries, adrenal gland and also the placenta during pregnancy. | Estradiol is the most important hormone during a female’s reproductive years, and is required for reproductive. Estrogen dominance is a feature of PCOS. |
Most women with PCOS are surprised to find that their estrogen levels fall within the normal range (about 25-75 pg/ ml). This may be due to the fact that the high levels of insulin and testosterone found in women with PCOS are sometimes converted to estrogen. | MUFA rich foods: Olive oil, canola oil, avocados, almonds etc Zinc rich foods: wheat germ, chickpeas, oats, kidney beans Magnesium rich foods: banana, raisins, curds Estrogen rich foods are soya products, flax seeds, sesame seeds, peaches, pista , walnuts, peanuts, olives etc. |
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| Prolactin | Hormone secreted by the pituitary gland | High prolactin levels causes infertility. High prolactin levels may be due to medications or thyroid issues. | Excess production of prolactin (hyperprolactinemia), reduces estrogen production and may cause infertility. Prolactin stimulates the breast to produce milk during pregnancy. In women, high levels of prolactin in the blood often cause infertility and changes in menstruation |
• Higher levels of Vitamin B6 can reduce prolactin levels. • Vitamin E naturally prevents rises in prolactin levels. |
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| FSH | Follicle stimulating hormone | To evaluate fertility issues- function of ovaries | To increase FSH levels: • Maintain a healthy weight. • Reduce stress levels to boost FSH production. • Balance omega 3 and Omega 6 fatty acids. • Avoid processed carbs and trans fats. • Ensure adequate consumption of essential fatty acids. |
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| Lipid profile | It measures cholesterol and triglyceride levels. | Dyslipidemia is an important feature of infertility in both men and women. This increases lipid peroxidase in gametes.Lipid peroxidation is the oxidative degradation of lipids. Dyslipidemia is also present in thyroid dysregulation and PCOS - both of which contribute to infertility. |
1. Reducing cholesterol levels : • Limit total fat and saturated fat • Reduce visceral fat • Increase consumption of soluble fibres • Decrease alcohol consumption • Increase consumption of Omega 3 • Foods rich in plant sterols and stanols which block cholesterol absorption into the cells eg whole grain, beans, nuts etc 2. Reducing Triglycerides • Maintain ideal weight • Avoid trans fats • Increase consumption of mono and polyunsaturated fats • Cut down on smoking • Consume soluble fibre • Reduce consumption of refined food |
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| Leptin | Hormone which is predominatel y responsible for fat gain. | Increased levels of leptin is associated with obesity and infertility. | There is a strong co relation between serum leptin levels and BMI and unexplained fertility among women. | • High leptin level is linked to high body-fat mass. Maintain healthy weight. • Foods containing pectin such as apples improve leptin sensitivity. |
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| DHEA | Dehydroepia ndrosterone is a hormone produced by your body's adrenal gland | DHEA is involved in the production of oestrogen. Increased levels of DHEA leads to infertility. | • DHEA is a naturally existing hormone that the female body converts into androgens, mainly testosterone. • High DHEA levels increase fatigue, weight gain, infertility, baldness etc • Increased abdominal obesity |
• Reduce foods containing Omega 3 as it promotes DHEA production. • Salmon, tuna, shellfish, mackerel, sardines are fatty fish containing Omega 3 • Adaptogens like Ashwagandha 500mg -2000mg help reduce androgens. Other adaptogens are thulsi, liquorice, drumstick leaves. • Reduce your intake of refined carbs. |
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| Anti- Mullerian Hormone (AMH) | Hormone | AMH is a member of the transforming growth factor β family of growth and differentiation factors | In the ovary, AMH has an inhibitory effect on primordial follicle recruitment as well as on the responsiveness of growing follicles to FSH | • Ensure healthy Vitamin D levels. • Maintain healthy BMI • Exercise reduces AMH |
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| Vitamin B | Vitamin | Deficiency causes reduce fertility. | Deficiency causes ovulatory disorders. | • Check for gastritis, pernicious anaemia, GI diseases like Chron’s, celiac or lupus. This effects Vitamin B levels severely. • Having a healthy gut with good gut micro biome helps to breakdown Vitamin B from food. • Anti biotics and anti seizure drugs decrease Vitamin B levels |
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| Vitamin D | Vitamin | Vitamin D is an emerging factor influencing female fertility and IVF outcome | Healthy Vitamin D levels increases live births. | • In most cases Vitamin D supplementation is needed. • Ensure that a source of fat is taken with the Vitamin D supplement. • Vitamin D in large quantities can be toxic. Monitor blood levels frequently. |
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| Folate | Vitamin B9 | Increased progesterone levels and a lower risk of irregular ovulation. | Folate rich foods are green leafy vegetables, peas, eggs etc | |||
| Zinc | Mineral | • DNA and protein synthesis, and cell division are all related to zinc levels in the body. • Adequate zinc ensures healthy ovulation. Eggs also need large amounts of zinc to reach maturity. |
• Zinc deficiency is also associated with decreased sense of taste and smell. Check for other nutritional deficiencies. • Although the cause in some cases may be inadequate dietary intake of zinc, inhibitors of zinc absorption are most likely the most common causative factor. • Phytate, which is present in staple foods like cereals, corn and rice, has a strong negative effect on zinc absorption from composite meals. • The amount of protein in a meal has a positive effect on zinc absorption, but individual proteins may act differently; e.g., casein has a modest inhibitory effect of zinc absorption compared with other protein sources. • Zinc and iron interact competitively during intestinal absorption. |
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| Vitamin E | Vitamin | It may improve ovulation decline. | Vitamin E is another powerful antioxidant and has been shown to increase fertility | • Nuts, seeds, vegetable oils and green leafy vegetables are a good sources of Vitamin E. • High doses of vitamin E may increase the body's vitamin K requirement. • Increased intake of omega-6 fatty acids may increase vitamin E requirements. |
| CRP/hsCRP | CRP or C r e a c t i v e protein is an acute phase protein. | CRP is made by the liver and released into the blood within a few hours after tissue injury or infection. It is used to identify the presence of inflammation and to monitor response to treatment for an inflammatory disorder | High CRP levels indicate non specific inflammation. Implantation failure requires cellular changes in the endometrium and modified expression of different cytokines, growth factors, transcription factors and prostaglandins. Thus , an inflammatory process is involved. |
• Increase consumption of anti inflammatory foods. Foods rich in Vitamin C and E. • Reduce refined carbs and processed foods. Aerated drinks should also not be consumed. • Ensure adequate hydration. |
| ESR | The test a c t u a l l y measures the rate of fall (sedimentatio n ) o f erythrocytes (red blood cells) in a sample of blood that has been placed into a tall, thin, vertical tube |
To measure the degree of inflammation. | It is a non specific marker of inflammation. | • Mediterranean diet helps to reduce inflammation. • Vitamin E and Vitamin C rich foods decrease inflammation. • Anti oxidant rich foods such as amla, oranges etc help reduce inflammation. |
| Vitamin C | Vitamins | Vitamin C regulates the catabolism of cholesterol. | • Vitamin C helps improve hormone levels. • For women who have luteal phase defect, an issue characterized by insufficient progesterone, increased C appears to promote fertility. |
• Vitamin C is heat sensitive and is best taken in the raw form. • Smokers need higher doses of vitamin C. |
| Cortisol | Hormone which regulates metabolism, immune response, control sugar level etc | Cortisol is a glucocorticoid steroid hormone that plays a range of important roles in the body including regulating reproductive function. Infertility stress negatively influences cortisol levels which has a negative effect on embryo quality. |
High cortisol levels can lead to symptoms such as weight gain, hypertension, high blood sugar, osteoporosis and fragile skin while low levels may cause weight loss, weakening of muscles, fatigue, low blood pressure, vomiting and diarrhea and loss of consciousness. | To reduce Cortisol levels: • Anti inflammatory diet: whole grains, no processed, nuts , fish, turmeric, ginger, cinnamon • DHEA promoting foods: wild yams, soya, flax seeds, salmon, olive oil • Vitamin B complex • Adaptogens To increase cortisol levels: • Dark chocolate, pro & pre bionics, green tea, banana , pears helps increase cortisol levels. • Avoid caffeine, alcohol, processed food, & refined sugar. |
| Thyroid panel | Hormones that are essential to regulate growth and metabolism | • In hypothyroidism, the thyroid gland doesn't produce enough of certain important hormones. • Low levels of thyroid hormone can interfere with the release of an egg from the ovary (ovulation), which impairs fertility. |
Thyroid dysfunction and associated metabolic imbalance & weight gain. | • Avoid goitrogen rich food like raw broccoli, cabbage, soy etc • Thiocynates are sulphur containing compounds- which make it harder for thyroid glad to absorb iodine. Foods that form thiocyanates are Corn, flax seeds. sweet potatoes, broccoli, lima beans, radish , turnip • Flavanoids ( like apigenin)present in millets reduce the activity thyroid peroxidase, the enzyme that inserts iodine into thyroid hormone. Apigenin is also present in onions, redwine, beer. • Consume at least 150mcg of iodine everyday. |
| HbA1c | Glycated hemoglobin | To test for diabetes or /& monitor intervention for diabetes. | Higher HbA1c and uncontrolled diabetes leads to increased risk of infertility and PCOS. | • Small frequent meals • Low to medium GI foods • High fire and high protein foods. • Continuous blood sugar monitoring system. |
| Mercury | High mercury levels can disrupt metabolic processes. Mercury exposure can lead to oxidative stress and decrease detoxification. | • Adequate zinc is needed for mercury elimination. • Higher blood mercury concentratio n is associated with male and female infertility. |
• Higher seafood consumption is associated with elevated blood mercury concentrations. |
* Medical Disclaimer - The following information is for educational purposes only. No information provided on this website, including text, graphic, and images, are intended as substitutes for professional medical advice. Please consult with your doctor about specific medical advice pertaining to your condition(s).
