Infertility Workup

You're trying to conceive (TTC), and before you move on to see a Reproductive Endocrinologist (RE) you want your OB/GYN to run some of the blood work for you to get a basic idea of what's going on.

But first, what happens when you go to see an RE?

The first thing they will do is sit you down and go over your TTC history. Have you had a semen analysis (SA)? Have you had any of your cycle day 3 (CD3) hormone levels drawn? Have you had your thyroid levels (TSH) drawn? Have you tried any infertility treatments? What CD are you currently on? Do you take your basal body temperature (BBT) every morning? Use ovulation predictor kits (OPKs)? Do you smoke, drink, or do illegal drugs?

Then you'll feel like a pin cushion as they siphon out about a quart of your blood, or so it seems.

Many RE offices have labs inside their practice that will run your blood work quickly and proficiently, but it may be really costly. If you want to get some of these labs done before going in, you can request them from your OB/GYN at what is usually a much more affordable rate as they're sent out to Labcorp.

So now you want to know, what blood tests should you look at?

BEFORE YOU DO THIS: Please, PLEASE, get a semen analysis first!!! It takes 3 months to treat any possible problems with males. In those 3 months, you could get the blood tests done and then come up with a plan. It takes 2 semen analysis results to determine MFI (male factor infertility).

You never really know how far you're going to have to go with infertility treatments, so you should treat yourself like you're going to go for IUI (inter uterine insemination). Individual RE offices require different things, but you should come pretty close if you follow this list:

FSH
LH
Estradiol
Testosterone
17-OH progesterone
Prolactin
TSH (preferably a full thyroid panel with t3 and t4)
CBC
Lipid panel
and blood glucose (fasting)
AMH
Vitamin D deficiency
Titers for measles, mumps, rubella, chicken pox, etc
Blood type
RH factor
STD testing including: HIV I & II, HTLV I & II, Hep B, chlamydia, gonorrhea, plus anything else your doctor asks for.
7dpo (days post ovulation) progesterone check


Before beginning treatment, an HSG is a very useful test to tell you if your tubes are open and clear. A SHG looks at the inside of the uterus to see if there are any complications there.

If you have had multiple losses, an RPL (repeat loss) panel should be done to make sure there isn't an underlying blood clotting disorder causing early losses.

It's controversial, but many RE's will also want a MTHFR test done for RPL.

In addition to all of that, a CD3 ultrasound is helpful to check AFC (antral follicle count). This number is actually more important than AMH (which tests your ovarian reserve) in regards to how you will respond to medication.

The results from all of these tests will give you an idea of which way to go.

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