What is it? AMH is a hormone secreted by immature ovarian follicles (eggs), and indicates ovarian reserve. AMH declines as we age, so women over 35 will naturally have lower levels. Although AMH is considered a good indicator of ovarian reserve, and can somewhat predict oocyte retrieval, it does not reflect egg quality or pregnancy outcome. High levels of AMH are associated with Polycystic ovarian syndrome and an increased risk of Ovarian hyperstimulation syndrome (OHSS).
Normal Range?
| Ovarian Fertility Potential | pmol/L | ng/mL |
| Optimal Fertility | 28.6 – 48.5 | 4.0 – 6.8 |
| Satisfactory Fertility | 15.7 – 28.6 | 2.2 – 4.0 |
| Low Fertility | 2.2 – 15.7 | 0.3 – 2.2 |
| Very Low / undetectable | 0.0 – 2.2 | 0.0 – 0.3 |
| High Level | > 48.5 | > 6.8 |
*from http://www.drmalpani.com/amh.htm
Thyroid Stimulating Hormone (TSH)
What is it? A hormone secreted by the pituitary gland to stimulate the thyroid gland. Thyroid function controls many things in our bodies, including fertility. When the thyroid is under-functioning (hypothyroidism, or subclinical hypothyroidism), ovulation may not occur. Hypothyroidism is also associated with an increased risk of miscarriage.
Normal range? Normal range is 0.35-5.0 mIU/L, however optimal range is considered to be 1.5-2.5 mIU/L.
Cortisol
What is it? A hormone secreted by the adrenal glands, in response to stress. In order to make cortisol, the adrenal glands need progesterone. During periods of high stress – think infertility and/or miscarriage – the adrenal glands ‘steal’ the progesterone from the reproductive system to make cortisol. High levels of cortisol are associated with infertility and early miscarriage.
Normal range? Morning cortisol should be 101-536 nmol/L.
Testosterone
What is it? A type of androgen, testosterone is usually thought of as a ‘male’ hormone, but it plays a role in female fertility as well. We measure both total testosterone (total amount in body) and free testosterone (free floating and ready to stimulate tissues). Normal levels contribute to follicular development. When testosterone is high, it can inhibit FSH levels, and the development and maturation of follicles.
Normal range? Total testosterone range for females is 0.3- 4.0 nmol/L, and Free testosterone range is 0.1-8.9 pmol/L.
DHEA-s
What is it? Like cortisol, DHEA is made by the adrenal glands. DHEA is a precursor to many steroid hormones, including testosterone and estrogen. Low levels can prevent ovulation and are associated with low ovarian reserve.
Normal range?
| Age | DHEA-S (µmol/L) | DHEA-S (µmol/L) |
| Female | Male | |
| 20 to 29 years | 1.8 – 10.3 | 7.6 – 17.4 |
| 30 to 39 years | 1.2 – 7.3 | 3.3 – 14.1 |
| 40 to 49 years | 0.9 – 6.5 | 2.6 – 14.4 |
| 50 to 59 years | 0.8 – 5.4 | 1.9 – 8.4 |
| 60 to 69 years | 0.4 – 3.5 | 1.1 – 7.9 |
| 70 to 79 years | 0.5 – 2.4 | 0.8 – 4.8 |
That about does it for the hormones involved in fertility. If you are experiencing infertility and haven’t had these tests done, speak with your doctor.
