What are baseline labs?
The baseline laboratory assessment used includes six specific hormonal parameters, all of which effect ovulation or implantation. These hormones are: FSH, LH, testosterone, DHEAS, TSH and prolactin.
In selected patients (with ovulation problems, obesity, or polycystic ovaries) fasting insulin and glucose levels may also be checked.
These blood test are performed during cycle day 1-3.
Why are they important?
Assessment of hormone levels can be very important in tailoring a medical regimen to normalize or optimize your cycles to enhance fertility. Specifically, if an alteration in one of these hormones is detected, treatment is aimed at that specific abnormality rather then relying on a general nonspecific fertility drug.
Elevated levels of insulin may adversely affect ovulation and egg quality. In addition, since they can also increase the likelihood of developing diabetes in the future, such levels are treated with medications.
What specifically do these hormones do?
It depends on the hormone.
TSH, for example, is a thyroid stimulating hormone which is the main hormone involved with thyroid metabolism. Many women with undiagnosed hypothyroidism may have irregular periods or abnormal ovulation as their main symptoms; infertility may be a sign of this disorder; while other symptoms include weight gain, fatigue, or depression.
Prolactin is a hormone which, when elevated, is associated with altered ovulation and miscarriage, and chiefly suggested by the persistence of a milky discharge from the nipple. The adrenal gland produces DHEAS and testosterone, and excesses in these steroid hormones can result in cycle irregularities or excessive growth; in extreme cases, balding, voice changes, hypertension and weight gain can also result.
Probably the most important baseline hormone is the FSH level, which is a critical marker of ovarian function and had particular importance in women in their late 30's and 40's. FSH levels rise as the ovary becomes less responsive, and your baseline FSH level predicts your "ovarian reserve" - i.e., how far from menopause you likely are. Specific guidelines therefore exist for treatment approaches depending on a women's baseline FSH.
Lastly, if your insulin levels are elevated, correction can significantly improve your chances of conception, often without the use of fertility medications.
