Top 10 Fertility Biomarkers to Track for Women

Fertility is a complex and multifaceted issue that affects millions of women around the world. From menstrual irregularities to age-related decline in fertility, there are numerous factors that can impact a woman’s ability to conceive. Fortunately, there are several ways to track and monitor fertility, including fertility biomarkers and hormone testing. In this article, we will explore the top 10 fertility biomarkers to track for women.

1. Follicle-Stimulating Hormone (FSH) – FSH is a hormone produced by the pituitary gland that stimulates the growth of follicles in the ovaries. FSH levels typically rise as a woman approaches ovulation and then drop after ovulation. Elevated levels of FSH outside of the ovulation window may indicate a decline in ovarian reserve, which can impact fertility. A decrease in ovarian reserve means that a woman has fewer eggs and a lower chance of getting pregnant.
2. Anti-Mullerian Hormone (AMH) – AMH is a hormone produced by the cells in the ovarian follicles. AMH levels are typically stable throughout the menstrual cycle and decrease with age.  Generally speaking, a woman’s ovarian reserve decreases as she ages, and her AMH levels tend to decline as well. Low AMH levels may indicate that a woman has fewer eggs remaining in her ovaries, which can make it more difficult for her to conceive naturally.
3. Oestradiol – Oestradiol is a hormone produced by the ovaries that plays a key role in the menstrual cycle. Oestradiol levels typically rise just before ovulation and drop after ovulation. Oestradiol levels can help identify the underlying cause of menstrual irregularities such as irregular cycles, heavy bleeding, or absence of periods. Oestradiol levels, along with other hormone tests like AMH, can provide information about a woman’s ovarian reserve and help predict how she may respond to fertility treatments. Finally, Oestradiol levels decline as women approach menopause, and monitoring these levels can help confirm the onset of menopause or track the progression of perimenopause.
4. Progesterone – Progesterone is a hormone produced by the corpus luteum in the ovary after ovulation. Progesterone prepares the uterus for pregnancy and helps maintain the uterine lining. Low levels of progesterone may indicate an issue with ovulation or an insufficient luteal phase, which can make it more difficult to conceive.
5. Thyroid-Stimulating Hormone (TSH) – TSH is a hormone produced by the pituitary gland that regulates thyroid function. Elevated levels of TSH can indicate thyroid dysfunction, which can impact fertility by interfering with ovulation and implantation.
6. Prolactin – Prolactin is a hormone produced by the pituitary gland that stimulates milk production in breastfeeding mothers. Elevated levels of prolactin outside of pregnancy or breastfeeding can interfere with ovulation by suppressing the release of gonadotropin-releasing hormone (GnRH), which is necessary for the production of follicle-stimulating hormone (FSH) and luteinising hormone (LH). Without sufficient FSH and LH, the ovaries may not release an egg during ovulation or may release eggs irregularly.  In addition to suppressing ovulation, elevated levels of prolactin can also impact the quality of the uterine lining, making it more difficult for a fertilised egg to implant and develop into a viable pregnancy. Elevated prolactin levels may also impact the production of other reproductive hormones, such as oestrogen and progesterone, which can further impact fertility.
7. Testosterone – Testosterone is a hormone produced by the ovaries and adrenal glands. While often associated with men, women also produce testosterone, which plays a role in fertility. High levels of testosterone may indicate polycystic ovary syndrome (PCOS), which can impact fertility.
8. Inhibin B – Inhibin B is a hormone that is synthesised by specific cells within the ovarian follicles. Its primary role is to regulate the secretion of follicle stimulating hormone (FSH) by inhibiting its production. FSH, on the other hand, stimulates the growth of an egg follicle in the ovary. As women age, both the number of follicles and the hormones they produce, including inhibin B, decline. Therefore, measuring inhibin B levels can serve as a reliable indicator of a woman’s ovarian reserve or function.
9. Luteinising Hormone (LH) – LH is a hormone produced by the pituitary gland that triggers ovulation. LH levels typically surge around 24-36 hours before ovulation, which can help women identify the optimal time to have intercourse in order to increase their chances of getting pregnant.  Measuring LH levels can also be helpful in identifying certain conditions that may impact fertility, such as polycystic ovary syndrome (PCOS). In women with PCOS, LH levels are often elevated, which can interfere with ovulation and make it more difficult to conceive.
10. FSH to LH Ratio – Measuring the FSH to LH ratio can provide valuable insights into a woman’s reproductive health and help identify certain conditions that may impact fertility, such as polycystic ovary syndrome (PCOS). In a normal menstrual cycle, FSH and LH are present at specific levels and times to support proper follicle and egg development. Typically, the FSH to LH ratio is about 1:1, meaning that the levels of FSH and LH in the blood are similar. However, in women with PCOS, the FSH to LH ratio is often abnormal, with LH levels being higher than FSH levels. This can be due to an imbalance in the production of these hormones, which can interfere with ovulation and make it more difficult to conceive. In many cases, women with PCOS have a higher LH to FSH ratio, such as 2:1 or even 3:1, which can be an indicator of this condition. Measuring the FSH to LH ratio can help diagnose PCOS and guide treatment options. For example, if the ratio is abnormal, it may be necessary to take steps to regulate hormone levels through medication or lifestyle changes.