What Can—and Can't—Fertility Hormone Tests Actually Tell You?
Quick Answer
Fertility hormone tests are a key part of a fertility assessment. These tests measure the levels of hormones like anti-mullerian hormone (AMH), follicle-stimulating hormone (FSH), and estradiol (E2) to identify potential challenges for getting pregnant. While fertility hormone tests provide a lot of insight into your fertility potential, they can’t tell you with certainty whether or not you will be able to get pregnant.
Here’s what people beginning their fertility journey need to know about hormone testing, who it’s right for, and who can provide it.
What Are Fertility Hormone Tests?
Fertility hormone tests typically measure your body’s levels of anti-mullerian hormone (AMH), follicle stimulating hormone (FSH), and/or the estrogen estradiol (E2) as the first step in a fertility assessment. All three hormones are key biological markers of ovarian reserve, aka “fertility potential”:
- Anti-mullerian hormone (AMH) is produced by the ovarian follicles, or the small fluid-filled sacs that house and develop eggs. AMH is a key indicator of egg quantity, but not egg quality. AMH is commonly the first fertility hormone tested. It is a highly sensitive marker of fertility potential, and it can be tested throughout the menstrual cycle.
- Follicle-stimulating hormone (FSH) is produced by the pituitary gland, a critical part of the brain in charge of regulating many of the body’s systems. FSH makes the follicles in your ovaries grow. FSH is typically tested on day 3 of the menstrual cycle, when fertility hormones are at their baseline.
- Estradiol (E2) is a hormone that ovarian follicles release to tell the pituitary gland to decrease FSH production. If follicles develop too quickly, they won’t be able to mature into healthy eggs. Estradiol is typically tested on day 3 of the menstrual cycle.
The American Society of Reproductive Medicine advises that AMH should be tested first, followed by FSH and E2, for the most complete picture of fertility potential. Fertility doctors will often do an antral follicle count after measuring AMH, which counts the number of immature follicles/potential eggs themselves rather than relying only on what AMH levels suggest.
What Can You Learn From Fertility Hormone Tests?
Fertility hormone testing is a way to gather insight into your fertility through measuring your body’s levels of certain hormones. These tests can’t tell you whether or not you will be able to get pregnant, carry a healthy pregnancy, and have a healthy birth, but they can help you understand if there are any hormonal indicators of potential issues with fertility down the line. Getting pregnant is the only way to know with 100% certainty that you can get pregnant.
Fertility hormone test results that are higher or lower than average can be a sign of conditions that may make it harder to get pregnant, like menopause, polycystic ovary syndrome (PCOS), primary ovarian insufficiency, or issues with the pituitary gland or hypothalamus—another important area of the brain involved in hormone regulation. Because of the relationship between higher- or lower-than-average levels and certain health conditions, fertility hormone testing can help explain irregular periods or difficulty getting pregnant.
What to Expect When Testing Your Fertility Hormones
If you need fertility hormone testing, here’s what you can expect:
- You will typically schedule a blood draw for day 3 of your menstrual cycle.
- A phlebotomist or other healthcare professional will collect a blood sample using a small needle inserted into a vein.
- The healthcare professional will take the sample to the lab, where your hormone levels will be measured.
- You will receive your blood test results and have an opportunity to discuss them with a healthcare professional. If results suggest possible fertility issues, you can work together to come up with a plan to meet your fertility goals.
More FAQs About Fertility Hormone Tests
Who is fertility hormone testing right for?
Fertility hormone testing is a critical first step in fertility assessments, as well as a helpful tool for anyone who wants a better understanding of their fertility potential. However, many insurance plans will only cover this testing if you meet the diagnostic criteria for “infertility.” This means that if you want to proactively test your fertility hormones, you are likely to pay out of pocket.
Where can you go for fertility hormone testing?
Fertility specialists will recommend fertility hormone testing as part of a standard fertility assessment. The testing may be conducted at their clinic or a nearby lab (e.g., Quest Diagnostics, LabCorp).
If you are comfortable paying out of pocket for fertility hormone testing, you can get it at your nearest lab. However, with this approach, you won’t get the benefit of an expert fertility specialist explaining your results and what they mean.
There are also some direct-to-patient options for fertility hormone testing. While they may provide more clinical support than a blood draw at a lab would, the companies selling these tests may not be able to refer you to appropriate specialists if necessary.
Does health insurance cover fertility hormone testing?
Some but not all health insurance plans cover fertility hormone testing. Many states don’t require insurance providers to cover fertility-related services, so it’s often up to employers and insurance providers to decide.
Many insurance plans only cover fertility-related services if you meet the diagnostic criteria for “infertility.” This criteria varies by state and insurance plan. In many plans, getting covered for fertility-related services requires trying to conceive unsuccessfully for 12 months if you’re under 35 years old and six months if you’re over 35 years old. Because of this, many people planning to conceive on their own or who are in LGBTQ+ partnerships are excluded from coverage by definition.
What This Means for Pacific Northwest Fertility Patients
Fertility hormone testing will be one the first steps before receiving treatment at Pacific Northwest Fertility. Once your doctor has conducted a complete fertility assessment—including health history, blood tests, physical exams, and other necessary follow-up diagnostic procedures—you will work together to develop a plan to meet your fertility goals.
At Pacific Northwest Fertility, possible treatment plans may include:
However your journey takes shape, we will be with you from taking the first test to building your family the right way for you.
Next Steps for Pacific Northwest Fertility Patients
Whether you’re beginning your journey or exploring your options, Pacific Northwest Fertility is here to help you meet your fertility goals on the right timeline for you.
Reach out today to find out how we can support you along your path to parenthood.
Clinically reviewed by Emily Gray, RN
This article is for informational purposes only and is not intended to represent medical advice. Please consult with a fertility care expert for personalized recommendations.