Tests for infertility and related disorders

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PCO tests:
The tests that I would use to check for PCO include the following: FSH, LH, prolactin, T4, T4, free T, total T, progesterone, SHBG, HbA1C, 17-hydroxyprogesterone, dexamethosone challenge test (for adrenal androgens), vaginal ultrasound of the ovaries, fasting glucose and fasting insulin, the ratio of insulin to glucose. Note that it is possible to have normal levels of blood hormones and still have PCO. Also make sure to note whether or not you are on any medications that can affect the results: SPECIFICALLY the birth control pill and where you are at in your menstrual cycle at the time of the tests. I would also add what you ate and when you ate it for insulin/glucose type tests. When you want to do an insulin resistance test, the best on is the 'clamp' test. Its so expensive that a 5 hr GTT is a lot better. It usually takes until the 3rd or 4th hour to see a drop in the glucose level. The current tests we have are not as sensitive as they could be to really prove one way or another whether you are or are not.

Test lists used to treat PCO:

Diagnosing diabetes

Diabetes: the Glycated Hemoglobin Test

Evaluation tests

PCO ultrasound test

Glycosated hemoglobin

Hormone Levels

Another set of evaluation tests

Tests (more invasive)

Dr. Ehrmann has a PCO workup to include: T, free T, total T, progesterone, SHBG, HbA1C, LH, FSH, 17-hydroxyprogesterone, dexamethosone challenge test (for adrenal androgens)

Dr. Leon Speroff, "Clinical Gynecologic Endocrinology and Infertility" Lippincott, Williams & Wilkins; ISBN: 0683078992

Pg 489: Tests for prolactin should be done for everyone who isn't ovulating!

Pg 512 The upper limit of normal in fasting insulin is 10 to 20 mL. The ratio of glucose to insulin that is less than 4.5 is IR.

Lab Tests Interpretations:

PathIT©: INTERPRETATION OF LAB TEST PROFILES

How to review your blood test results

Lab Test Interpretations

laboratorytest.html

CONVERSION TABLE FOR HORMONES CONCENTRATION UNITS

PITUITARY HORMONES LEVELS IN HUMANS

STEROIDS LEVELS IN HUMANS

The Hormone Balance Test

Normal Values for endocrine tests

Comments on tests from different sources and what they are for.
Test comments from Kim in Virginia, a 20 yr lab tech: There is a strong link between what they call insulin resistance (IR) and PCOS. When doctors treat you for your insulin resistance, most of the time, your pcos problems will start to diminish greatly. Tests run are: CBC, hemoglobin A1c (that's the same as glycosylated hemoglobin), TSH, 17-OH-progesterone, free testosterone, total testosterone, and %free testosterone and SHBG. The hemoglobin A1(the number 1) c is a good measure of how your blood glucose has been doing over the past three months. This is because three months is about the life cycle of a red blood cell, and they measure the glucose in the red cells. TSH is the thyroid stimulating horomone. The 17-OH progesterone is good for a baseline measurement. Often in PCOS, it is low. As you begin treating the IR, it will *likely* come back to within normal range. The testosterones are a key in PCOS. They (depending on age/severity of PCOS) will often be elevated, or at least one of the three. This excess is responsible for the hirsutism, although some women may just be ultra sensitive to androgens in general, and therefore respond by the excess hair, acne and other lovely things that androgen excess or sensitivity can cause. The link between IR and testosterones is this: the IR causes an excess of insulin in your body. In a woman with PCOS, the ovaries respond to this excess insulin by producing testosterone - hence the elevated levels. Along with the elevated testosterone(s), the Sex Horomone Binding Globulin (SHBG) will be low, because it is binding to the excess of testosterone. Other tests to choose from are: a 5 hr GTT. You are given a measured dose of glucose when fasted, and then blood drawn for glucose measurements during the test. A 5 hr. GTT will denote the traditional IR/Hypoglycemic drop in blood glucose at the 3rd to 4th hours (it doesn't always show up til hour 4, so you want to go for the 5 hr. if you do this!). One on this list, her dr. does a measurement of c-peptide, and the closer it is to 1.0, the better you are. Some also have a 5 hr. GTT with insulin levels drawn. This way your doc can see how the insulin is reacting during the test. Other tests include an FSH/LH ratio. Depending on which type of doctor you see, some are more partial to certain tests than are others. Some of us don't have an imbalance in this area, however. Other diagnostic tools like an ultrasound to check for cysts are used as well. Check Nestler article for more info. Kim in Va.
Test comments from an anonymous source: glycohemoglobin, also called glycoslyated hemoglobin or hemoglobin A1C, is a measure of how well a patient has been controlling his or her sugars for the past 3-4 months. This test works because certain proteins in your body are affected by high sugar levels, and they undergo a chemical change in the presence of a high sugar. Since hemoglobin is an easy protein to get at (just draw some blood), it's the one they use for the test. It only tells you about the last 4 months because 120 days is the average lifespan of a red blood cell. They do this test in diabetics because a lot of them will "cheat" on their diets until a week or so before their appointments. If you just check the blood sugar, it may be well controlled on the day of the appointment, but the glycohemoglobin tells you the real story.

C Peptide levels

Another article on C Peptide levels

Infertility tests

Diagnostic methods in female infertility

Infertility Testing

Fertility Treatment Fertility Tests

FertilityPlus Hormone Levels & Fertility Bloodwork

SEMEN ANALYSIS IN HUMANS

Hormonal Disorders

Complete Infertility Guide to Tests, Drugs, and Procedures for Infertility

Dr. Leon Speroff, "Clinical Gynecologic Endocrinology and Infertility" Lippincott, Williams & Wilkins; ISBN: 0683078992

See pages 434 and 530.