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The Hidden Role of Blood Tests in Fertility and Hormone Health

PBTT

Private Blood Tests Team

Clinical Team

29 Dec 202510 min read

When couples think about fertility, they often focus on lifestyle factors, timing, or even stress levels. But behind the scenes, hormones orchestrate the entire reproductive process — from egg development and ovulation to sperm production and successful implantation. When hormones are out of balance, fertility can suffer, often without obvious symptoms.

Blood tests provide a window into this hidden hormonal world, revealing imbalances that may be affecting your ability to conceive. Whether you are just starting your fertility journey or have been trying for some time, understanding what your blood tests can reveal is empowering.

The Hormonal Orchestra of Fertility

Reproduction depends on a complex interplay of hormones working in precise coordination. In women, the monthly cycle involves carefully timed rises and falls of multiple hormones. In men, steady hormone levels are essential for continuous sperm production.

When any part of this system is disrupted, fertility can be affected — sometimes dramatically, sometimes subtly.

Key Fertility Hormones in Women

### Follicle-Stimulating Hormone (FSH)

FSH stimulates the ovaries to develop follicles (eggs). It is a key indicator of ovarian reserve — the quantity and quality of remaining eggs.

What FSH levels indicate:

  • Normal levels — Suggest adequate ovarian reserve
  • Elevated levels — May indicate diminished ovarian reserve or approaching menopause
  • Very low levels — May suggest pituitary problems
  • When to test: Day 2-4 of the menstrual cycle for baseline assessment.

    ### Luteinising Hormone (LH)

    LH triggers ovulation. The mid-cycle LH surge causes the mature egg to be released from the ovary.

    What LH levels indicate:

  • Elevated baseline LH — May suggest polycystic ovary syndrome (PCOS)
  • Abnormal LH:FSH ratio — Can indicate hormonal imbalances
  • Absent LH surge — May explain anovulation
  • ### Oestradiol (E2)

    Oestradiol is the primary form of oestrogen during reproductive years. It promotes follicle development and prepares the uterine lining for implantation.

    What oestradiol levels indicate:

  • Low levels — May suggest poor ovarian response
  • Very high levels early in cycle — May indicate declining ovarian reserve
  • Appropriate rise mid-cycle — Suggests normal follicle development
  • ### Anti-Müllerian Hormone (AMH)

    AMH is produced by developing follicles and provides the most direct measure of ovarian reserve.

    What AMH levels indicate:

  • Higher levels — Suggest good ovarian reserve
  • Lower levels — May indicate diminished reserve
  • Very high levels — May be associated with PCOS
  • Advantage: AMH can be tested at any point in the menstrual cycle.

    ### Progesterone

    Progesterone rises after ovulation and is essential for maintaining early pregnancy.

    What progesterone levels indicate:

  • Elevated mid-luteal phase — Confirms ovulation has occurred
  • Low levels — May indicate anovulation or luteal phase defect
  • When to test: Day 21 of a 28-day cycle (7 days post-ovulation).

    ### Prolactin

    Prolactin is primarily associated with breastfeeding, but elevated levels can suppress ovulation.

    What elevated prolactin may indicate:

  • Pituitary adenoma (usually benign)
  • Medication side effects
  • Stress response
  • Hypothyroidism
  • Key Fertility Hormones in Men

    ### Testosterone

    Testosterone is essential for sperm production, libido, and overall male reproductive health.

    What testosterone levels indicate:

  • Low levels — May impair sperm production and libido
  • Very high levels — May actually suppress sperm production (as seen with steroid use)
  • ### FSH and LH in Men

    In men, FSH stimulates the testes to produce sperm, while LH stimulates testosterone production.

    What levels indicate:

  • Elevated FSH — May suggest testicular damage or failure
  • Low FSH and LH — May indicate pituitary problems
  • ### Prolactin in Men

    Elevated prolactin in men can suppress testosterone and impair fertility.

    Thyroid Function and Fertility

    Thyroid hormones profoundly affect fertility in both men and women. Even subtle thyroid dysfunction can impair conception.

    In women:

  • Hypothyroidism can cause irregular cycles and anovulation
  • Hyperthyroidism can affect implantation
  • Thyroid antibodies may increase miscarriage risk
  • In men:

  • Thyroid dysfunction can affect sperm quality
  • May reduce libido
  • For comprehensive thyroid information, read our guide to private blood tests for thyroid problems.

    Other Important Tests

    ### Vitamin D

    Vitamin D receptors are found in reproductive tissues, and deficiency has been linked to reduced fertility in both sexes.

    ### Iron and Ferritin

    Iron deficiency can affect ovulation and may increase miscarriage risk.

    ### Insulin and Glucose

    Insulin resistance is closely linked to PCOS, a leading cause of female infertility. For more information, read our guide to understanding the A1C blood test.

    ### Inflammation Markers

    Chronic inflammation can affect fertility. Testing CRP and other markers may provide useful information. Learn more in our overview of the C-reactive protein test.

    When to Consider Fertility Blood Tests

  • Before trying to conceive (baseline assessment)
  • After 6-12 months of unsuccessful attempts
  • If you have irregular periods
  • If you have symptoms of hormonal imbalance
  • Following miscarriage
  • Before fertility treatments
  • If you are over 35 and want to assess ovarian reserve
  • For comprehensive information about hormone testing, read our article on hormone imbalance symptoms you should not ignore.

    Understanding Your Results

    Fertility hormones must be interpreted in context:

  • Cycle timing matters — Many hormones must be tested on specific cycle days
  • Patterns matter — Single tests provide snapshots; sometimes serial testing is needed
  • Reference ranges vary — Optimal fertility ranges may differ from standard reference ranges
  • Individual factors matter — Age, medical history, and symptoms all inform interpretation
  • Fertility Hormone Testing in London

    At Private Blood Tests London, we offer comprehensive fertility hormone panels for both women and men at our CQC-registered clinic in South Kensington. Our tests provide detailed insights into your reproductive hormone health, helping you understand your fertility and plan accordingly.

    For related testing, explore our [thyroid function tests](/thyroid-test) and [comprehensive health screening packages](/health-screening).

    Whether you are planning ahead or actively trying to conceive, knowledge is power. Book your fertility hormone test today.

    Ready to Book Your Test?

    Visit our CQC-registered clinic in South Kensington for professional blood testing services.