Six hormones to see ovarian function

We all know that many women with gynecological diseases will choose to have a checkup on the day of menstruation, because many problems can be detected during menstruation. The six hormone tests are the most basic tests, and the six hormone tests are generally used to check the uterine and ovarian functions of women. Doctors will check where the patient needs to be adjusted based on the patient's specific data. So how do the six hormone tests check the ovarian function?

Sex hormones can be checked at any time during menstruation, as the normal values ​​for each period are different. However, when diagnosing and treating infertility, it is necessary to understand the basic hormone level. First of all, the test should be done on the 2nd to 5th day of menstruation, which is called the basic hormone level. It is best to measure it on the 3rd day. If it is confirmed that it is the third day of menstruation, you only need to check 5 sex hormones. You do not need to check progesterone, which should be checked during the luteal phase (21 days after menstruation or 7 days after ovulation).

Follicular phase detection: It is to measure the sex hormones in the serum within the 2nd to 3rd day of the menstrual cycle in order to understand the "basal state" of the ovaries.

The test content includes all six items, which are indispensable. Because each sex hormone can reflect different situations.

If the follicle-stimulating hormone (FSH) is too high, it means that the ovarian reserve function is poor. At this time, you can first use medication to increase ovarian reserve and protect the hormone receptors in the ovaries.

If estradiol (E2) is too high, the patient may have residual follicles, which suggests that ovulation induction treatment is not appropriate.

If the luteinizing hormone (LH) is too high, it will affect the quality of follicles, reduce the energy of follicles, and increase the miscarriage rate. LH lowering treatment can be used first.

If prolactin (PRL) is too high, it will also affect ovulation and corpus luteum function. At this time, bromocriptine can be used mainly for symptomatic treatment.

If testosterone (T) is too high, it will affect the development of follicles, causing countless small follicles to compete and develop slowly or not develop at all.

If FSH, LH, and E2 are all too low, it may be hypothalamic-pituitary dysfunction, and gonadotropin replacement therapy may be considered.

How to judge whether the ovarian function is good or bad by six hormones

Clinical significance of six hormones

1 Estradiol (E2):

E2 is the most active female hormone, mainly produced in the ovarian follicles and placenta, and in small amounts in the adrenal glands and testicles.

Serum E2 determination is a very useful indicator for evaluating various menstrual abnormalities:

Such as early or delayed puberty in girls, primary or secondary amenorrhea, premature ovarian failure, etc.

In infertile patients, serum E2 monitoring is very useful for monitoring ovulation induction and subsequent treatment, such as treatment with clomiphene, LH-releasing hormone (LHRH), or exogenous gonadotropins.

During in vitro fertilization (IVF), when ovarian hyperstimulation is performed, serum E2 concentrations are usually measured daily to optimally adjust human chorionic gonadotropin (HCG) administration and oocyte collection.

2 Progesterone (P): Progesterone is mainly produced by the ovaries and placenta in women.

The main function of progesterone is to promote the thickening of the endometrium and glandular proliferation in preparation for the implantation of the fertilized egg.

The rise and fall of progesterone concentration can be used to infer the activity of ovarian follicles and corpus luteum. Therefore, the determination of progesterone in blood is clinically used to monitor the pregnancy of pregnant women.

The normal function of ovulation and corpus luteum in pregnant women, monitoring of progesterone therapy and evaluation of early pregnancy are particularly important in judging the functional status of the corpus luteum. It can help find the cause for infertile women and women with recurrent miscarriages. During the menstrual cycle, the concentration of progesterone is: follicular phase: 0.14～1.61μg/L.

It rises significantly after ovulation, reaching 2.41-31.2 μg/L during the luteal phase, paralleling the increase in E2 in the blood.

At full-term pregnancy, it can be as high as 150-200 μg/L.

Elevated serum progesterone: seen in hydatidiform mole, mild pregnancy-induced hypertension syndrome, diabetic pregnant women, multiple births, secondary hypertension, congenital 17-a hydroxylase deficiency,

Congenital adrenal hyperplasia, ovarian granulosa cell tumor, ovarian lipoid tumor.

Decreased progesterone: seen in threatened abortion, luteal dysfunction, fetal growth retardation, stillbirth, and severe pregnancy-induced hypertension syndrome.

On the 18th to 26th day of the menstrual cycle, measure blood P three times. If the levels are all less than 15.9 nmol/L (5ng/ml), it can be diagnosed as corpus luteum dysfunction.

3. Testosterone (T): T is the most important androgen in the human body.

In women, it mainly comes from the adrenal cortex, and the ovaries can also secrete a small amount. High levels of testosterone in women are commonly seen in conditions such as hirsutism, virilization, polycystic ovary syndrome, ovarian tumors, adrenal tumors, and adrenal hyperplasia.