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Endocrine assessment is the name used for hormone tests performed as a part of initial investigations on women and men seeking fertility treatment. Initial endocrine assessment or endocrine profile is a blood test to check for blood levels of hormones including Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Oestradiol, Progesterone, Prolactin, Testosterone, Thyroid function test and Anti-Müllerian-Hormone (AMH).
Various lifestyle factors can impact hormone levels such as abnormal body weight (below BMI 19 or above BMI 25), stress, strenuous physical activity, or lack of sun exposure to the skin. These issues can result in menstrual dysfunction, impacting the egg maturation process and ovulation as well as implantation of pregnancy. More importantly any direct or indirect health condition affecting the functioning of reproductive organs, mainly ovaries and testes can result in disturbance in hormone levels and therefore indicate the individuals’ inability to release egg or produce healthy sperm.
Role of different hormones in reproduction
· Follicle Stimulating Hormone (FSH): It induces growth of follicles (and eggs contained in them, normally one egg per follicle) from small to mature ones.
· Luteinizing Hormone (LH): This hormone has an important role in maturation and release of eggs.
· Oestradiol (Oestrogen): It is produced from the growing follicle. Oestradiol level is higher when the follicle is bigger and good quality.
· Progesterone: It creates a suitable environment for embryo implantation or for pregnancy to settle in the womb.
· Prolactin: Prolactin level is found to be higher in breastfeeding women. Certain conditions like chronic stress, thyroid function problems and certain small tumours in the brain called prolactinomas can commonly elevate the prolactin level, which might interfere with ovulation or releasing the eggs.
· Anti-Müllerian hormone (AMH): This hormone is one of the best tests to evaluate ovarian reserve. It is nearly universally tested before starting fertility treatments including assisted conception or IVF.
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