Hormonal balance is really important for proper growth and development of the body. When it comes to the anatomy of women, hormones play a vital role in maintaining the reproductive health. Certain hormones like FSH, Progesterone and E2 maintain the fertility in women ensuring that they are healthy to conceive a baby. Read on this blog to know more about these hormones and the significance of their interpretation.
Day 2- E2 and FSH measurement
Many times this regards as Basal FSH measurement but it describes better as FSH measurement during basal of E2 (during period time).
What’s FSH?
Abbreviated as FSH, Follicle Stimulating Hormone secretes by brain with the help of pituitary gland. It stimulates the follicles to grow in ovary. When brain realises that E2 is low, further follicles group start recruiting another cycle. As a result the level of FSH increases but not more 9iu/l.
In case the level heightens up, the brain will realise development of follicles stimulation and it needs more level of FSH. It happens mainly because of follicles number in ovary is low and other problems may occur which FSH should overcome for stimulating the menstrual cycle normally.
What’s E2?
E2 is steroid hormone that secretes from cells lining of ovarian follicles with respect to FSH. A very high level of E2 between the follicles will nourish to mature the egg. Sometimes E2 transfers to blood which results in growing of uterus lining with ovulatory cervical mucus secretion.
It also provides feedback to pituitary and brain regarding the development of follicles cohort post recruitment. FSH level drops down because of E2’s negative feedback.
What is the need to measure on day 2?
If you undergo estrogen blood test during this time, estrogen remains lowest and FSH highest. In case the level of E2 on 2nd day is less than 200pmol/l then the follicle growth will already have commenced. But you cannot rely in the FSH measurement as E2 is already high. Even it starts suppressing the FSH level. It mainly occurs in aged women.
Considering the functional perspective, early growth of follicle means endometrium doesn’t get sufficient time for development prior to ovulation because of asynchronity within the endometrium and egg. So, the probability of implantation reduces by half.
Possible result interpretations
- FSH<9iu/L; E2<200pmol/l-Normal level of FSH and function or basal follicle will stimulate ovarian follicles.
- FSH >9 iu/l; E2<200 pmol/l-Brain always responds to the lower ovarian reserve by generating more FSH for recruiting the follicle. It means brain will produce its fertility drug by considering that there is something wrong with the development of follicle.
- FSH<9 iu/l; E2>250 pmol/l-If you undergo estradiol E2 test and ovary races ahead the follicle development then you cannot obtain the correct measurement of FSH due to E2 isn’t basal.
- FSH>9 iu/l; E2>250 pmol/l-When ovary races ahead of the follicle development, the FSH interpretation result gets compromised due to estradiol. If estradiol is basal that is <200pmol/l then FSH will be higher than ever.
Day 21- progesterone measurement
Corpus luteum is a gland which forms in ovary due to ovulated follicles. It helps in secreting progesterone and E2 to blood resulting in uterine lining secretive. The level of progesterone in blood during luteal phase is less than 30nmol/l helps in determining whether the endometrial effect is sufficient or not.
Accordingly it can assist in implanting the embryo to the uterus. Even it fees the pituitary ensuring the secretion of FSH in small amount. So taking the measurement of E2, FSH and LH hormone simultaneously is baseless on day 21. In case the progesterone is at peak then the interpretation of other two will be valueless because of being in mid-luteam phase.
What is the need to test on day 21?
This day is selected on assumption that women will have 26-30 days of cycle. With normal luteal phase it will last for 10-14 days post ovulation. Then ovulation is within 12016 days. Day 21 is middle of luteal phase when progesterone production remains at peak from corpus luteum in the ovulatory cycle.
On becoming pregnancy, hCG will protect the corpus luteum from dying by secreting more progesterone. In case ovulation takes place after the assuming days then test is possible to perform after a couple of days. Also if it happens earlier than 12th day then early progesterone test on day 18 is necessary.
Interpretation of progesterone level must take place to days’ number prior the onset of next period. Function of luteal and ovulation will not be able to assume if period commences after less than 5 days or greater than 9 days after blood test.
Possible result interpretations
- Progesterone>30nmol/l- If ovulation takes place then corpus luteum will secrete enough progesterone for inducing sufficient secretion changes in endometrium for assisting implantation.
- Progesterone 3-30nmol/l- In case ovulation takes place less than 10 days ago or above 5 days ago or even if ovulation occurs 5-10 days ago, it is not possible to obtain endometrial growth for the satisfactory implantation.
- Progesterone>120nmol/l- The recruitment of 2 or more follicles.
- Progesterone<3nmol/l-No ovulation for 14 days.
So, when you are planning of a pregnancy and want to check if you have maintained the reproductive health well or not you can undergo the necessary test. Just look for a clinic for oestrogen blood test in UK to confirm that everything is normal. Accordingly, you can plan to get pregnant and enjoy parenthood.
