Hormonal Analysis for Fertility in Lahore

In women, hormones from the brain, the ovaries and the thyroid control the menstrual cycle, egg development and ovulation. In men, they control sperm production and testosterone.

A hormone analysis is a set of blood tests that shows whether these signals are working. It helps to explain irregular or absent periods, difficulty ovulating, a low sperm count with no obvious cause, and unexplained delay in conceiving.

It is not a pass or fail exam. A normal result is reassuring, and an abnormal one points to a cause that can often be treated.

A hormone analysis may be useful if:

• Your periods are irregular, very infrequent, or absent
• You have symptoms of PCOS: excess hair, acne, weight gain or hair thinning
• You are unsure whether you are ovulating
• You are over 35, or have a family history of early menopause, and want to understand your ovarian reserve
• You have had recurrent miscarriage or a long delay in conceiving
• You have thyroid symptoms or a known thyroid condition
• A man has a low sperm count, low libido, erectile problems or signs of low testosterone

If your periods are regular and nothing else points to a problem, a full hormone panel may add little. Dr. Kamran will tell you honestly if that is the case.

• AMH (anti-Müllerian hormone): reflects the number of small follicles, an indicator of ovarian reserve. It can be tested on any day of the cycle.
• FSH (follicle-stimulating hormone): rises when the ovaries are working harder to produce an egg. Best measured on days 2 to 4 of the cycle.
• LH (luteinising hormone): triggers ovulation. A baseline level is measured early in the cycle, and it is interpreted with FSH.
• Estradiol: measured with FSH, because a high early-cycle value can make FSH look falsely normal.
• Progesterone: a mid-luteal test, about seven days before your expected period, to confirm that ovulation occurred.
• Prolactin: when high, it can stop ovulation and cause irregular or absent periods.
• TSH (thyroid): an underactive or overactive thyroid can affect ovulation and pregnancy.
• Testosterone, DHEAS and 17-hydroxyprogesterone: when PCOS or another cause of excess male-type hormones is suspected.
• Fasting glucose and insulin: where PCOS or insulin resistance is suspected.

Our article Hormone Test for Fertility: Which Tests Do Women Need? goes into the detail of each.

• Days 2 to 4 of your period (day 1 is the first day of full flow): FSH, LH and estradiol
• Any day: AMH, TSH and, for most people, prolactin
• About 7 days before your next expected period: progesterone, to check ovulation
• If your periods are absent or very irregular: tests can usually be done on any day, with the timing explained in your report

If you take hormonal contraception, tell us. It can alter some results, and the plan may need to be adjusted.

• Total testosterone: measured in the early morning, and repeated if low, because levels vary through the day and between samples
• FSH and LH: show whether the problem lies in the testes or in the brain's signals to them
• Prolactin: checked when libido is low or testosterone is low
• Estradiol, SHBG or free testosterone: in selected cases only

A high FSH with a very low sperm count often points to a problem in sperm production within the testes. Low testosterone with low or normal FSH and LH suggests the cause lies in the brain's signalling, which is often treatable.

One important warning: testosterone injections, gels and anabolic steroids can switch off sperm production. Men trying to conceive should not start them without specialist advice. See male infertility assessment for the full male assessment.

PCOS (polycystic ovary syndrome) is diagnosed when at least two of three features are present: irregular or absent ovulation, signs of high androgens (clinical or on blood tests), and polycystic-appearing ovaries on ultrasound, once other causes have been excluded.

Hormone tests help in two ways: to confirm high androgens, and to rule out look-alike conditions such as thyroid disease, high prolactin and non-classic adrenal hyperplasia.

Ovulation induction and PCOS treatment is tailored to your goals. Many women with PCOS conceive with simple ovulation treatment. See PCOS and Fertility: Can You Get Pregnant with PCOS?.

An underactive thyroid can cause irregular periods, failure to ovulate and, in pregnancy, a higher risk of complications. Many fertility specialists prefer the TSH level to sit in the lower part of the normal range when trying to conceive, commonly below about 2.5 mIU/L, although targets are individualised. Treatment is a daily tablet, with regular monitoring.

High prolactin can stop ovulation. Causes include stress, certain medicines, an underactive thyroid, and a small benign pituitary growth. A repeat test is often done first, because prolactin can rise after stress, exercise or eating. If it stays high, medicines can bring it down, and further tests are discussed.

AMH measures quantity, not quality

A low AMH means fewer eggs remain, but it does not mean you cannot conceive naturally, and it does not tell you about egg quality. A high AMH is common in PCOS. AMH is mainly useful for planning IVF stimulation and for understanding how much time you have.

FSH varies from cycle to cycle

One raised FSH does not settle the question. It is read together with estradiol, AMH, your age, and an ultrasound count of small follicles.

Reference ranges differ between laboratories

Each laboratory publishes its own ranges, which depend on the method it uses. That is why we interpret your report alongside your history rather than relying on a generic chart.

• Note the first day of your period, so tests can be timed correctly
• Tell us about all medicines, including hormonal contraception, thyroid tablets and steroids
• Mention high-dose biotin (common in hair and nail supplements), which can distort some hormone results
• Fasting is needed only for certain tests, such as glucose and insulin, and we will tell you in advance
• For prolactin, avoid vigorous exercise beforehand and try to be rested
• For men's testosterone, a morning blood sample is preferred

Most hormone results are ready within a few days. We then go through them with you in a follow-up consultation, with a written next-steps plan.

• Normal results: reassurance, advice on timing intercourse, and a plan if pregnancy does not follow
• Ovulation problems: lifestyle changes and ovulation induction
• Thyroid or prolactin problems: treatment with regular monitoring
• Low ovarian reserve: an honest discussion of timing, and whether to move sooner to assisted treatment
• Male hormonal causes: treatment of the underlying problem, and guidance on avoiding anything that suppresses sperm

When assisted treatment is the right step, we explain the options clearly: IUI, IVF and ICSI, recommended only when your results support them.

The consultation fee is shown before you confirm your booking. Individual hormone tests are priced separately, and ordered only when they are clinically appropriate. We do not sell a fixed package for everyone.

You can ask for an itemised estimate during your consultation, so you can see what each test will cost before you decide.