If there’s one thing you get familiarized with very quickly during fertility treatments, it’s hormones. How much you have, what you’re lacking, what you need, and what your protocol will include. It can feel like one big acronym soup: What’s your AMH? Have you checked your FSH? Are you testing your LH on day 14 of your cycle? What’s the 411 on your estradiol levels?
To help simplify things, we’ve compiled a guide on the five key fertility hormones, what they do, how they do it, and why they’re important. It can feel overwhelming at first, but with a little bit of homework, you’ll have these mastered in no time!
5 Key Female Reproductive Hormones To Know
1. LH (Luteinizing Hormone)
Luteinizing hormone (LH) is produced by the pituitary gland, a pea-sized gland at the base of the brain. Despite its size, the pituitary gland is the major endocrine gland responsible for growth and development, as well as telling the other endocrine systems how to function.
Usually, the pituitary gland releases LH at low levels throughout a normal menstrual cycle until a developing follicle is ready for ovulation. LH levels then surge, acting as a catalyst to trigger ovulation. An egg is released approximately 24-36 hours later.
LH is crucial because the LH surge marks the beginning of your fertile window, and it’s what you’re testing for when you pee on ovulation predictor kits (OPKs). If you’re testing for ovulation in hopes of getting pregnant, it’s a good idea to start testing around cycle day 12 or 13 using your first-morning urine. Once you get a positive ovulation test, have intercourse sometime in the next 24-48 hours to give yourself the best odds of conceiving.
It’s also important to note here that not everyone ovulates on day 14, which is why tracking your cycle is so critical. After a few months, you should have a better idea of what ‘normal’ looks like for you and your body, enabling you to better pinpoint ovulation and improving your chances of getting pregnant.
2. FSH (Follicle Stimulating Hormone)
Follicle stimulating hormone (FSH) is another hormone produced by the pituitary gland. FSH is involved in sexual development and functioning, and it also stimulates the eggs in the ovary to grow prior to being released during ovulation.
An FSH test is typically conducted on day three of the menstrual cycle, and the higher your FSH number, the less ideal. High FSH levels can indicate Diminished Ovarian Reserve or perimenopause, but it’s only one piece of the puzzle, so don’t panic just yet. It’s important to look at the full picture with your healthcare provider before making any assumptions about your future fertility.
3. AMH — Anti-Mullerian hormone
AMH is commonly known as the hormone that can be indicative of a woman’s ovarian reserve, or how many eggs she has remaining in her ovaries. Unlike LH and FSH, AMH is produced by the granulosa cells in the ovarian follicles. The granulosa cells produce AMH when follicles are being produced, which is why low AMH – paired with high FSH – can be a sign of Diminished Ovarian Reserve.
AMH is the one fertility hormone that remains consistent throughout the menstrual cycle, and it can be especially useful in helping doctors predict how many eggs you might produce during an IVF cycle, as well as the dosage of medication needed to stimulate your ovaries.
Average AMH levels per age group:
45 years old: 0.5 ng/mL
40 years old: 1 ng/mL
35 years old: 1.5 ng/ mL
30 years old: 2.5 ng/mL
25 years old: 3.0 ng/mL
If your AMH levels come back lower or higher than ‘normal,’ ask your doctor what this means for you when it comes to your fertility.
4. Estradiol
Estradiol is a specific kind of estrogen made by the ovaries, and it’s one of the two major female sex hormones. Estradiol is involved in menstrual and reproductive cycle regulation, development of female sexual traits, as well as the development and maintenance of female reproductive tissues.
Estradiol is mainly produced within the follicles of the ovaries, but it can also be produced in other tissues like the adrenal glands, fat, liver, breasts, and brain. Estrogen is made from cholesterol and undergoes a series of reactions before being converted into Estradiol.
Estradiol levels are usually tested on day 3 of the menstrual cycle, along with FSH. At this time, Estradiol levels are typically low and then rise gradually, rising sharply two to three days before ovulation. Estradiol levels peak just before the surge of luteinizing hormone (LH) and follicle stimulating hormone (FSH), which triggers ovulation. Then, Estradiol levels decline, gradually starting to increase again during the luteal phase, peaking, and then dropping off to another low before the onset of the next menstrual cycle.
Overall, estradiol levels in women vary based on factors such as age, pregnancy, and menstrual cycle phases.
5. Progesterone
Progesterone is the other major female sex hormone and is produced in the corpus luteum, a hormone-secreting structure that develops in an ovary after an egg has been released but degenerates after a few days unless pregnancy has begun.
Progesterone’s main functions are to regulate menstruation and thicken the uterine lining for implantation of an embryo. It also supports pregnancy, giving it the nickname “the pregnancy hormone.” until the placenta takes over with creating progesterone in the second trimester.
When it comes to fertility treatments, estrogen and progesterone supplementation are typically used to help facilitate the implantation of an embryo during a medicated cycle.
The 411 On Your Hormones When TTC
Whether you’re trying to get pregnant or just want to learn more about your reproductive health, these five fertility hormones are a good place to start: LH, FSH, AMH, Estradiol, and Progesterone. Know that it’s never too early to ask your doctor for an initial fertility workup so that you can find out your options and plan accordingly. There are also great at-home testing options available. Here’s to feeling empowered to be your own health advocate!
Kristin Diversi is a writer and versatile creative. She is passionate about reproductive health and justice and lives in Longmont, Colorado, with her husband and their son.