The name, "BIOTECH", captures the company's emphasis on cutting edge technology in Medical Lab Analysis, Proper Reporting, and the commitment to wellness through preventative health care and achievement of Physiological balance.
At BIOTECH Medical Lab, Precision is our address, and is based on two major factors:
Technical precision: up-to-date machinery that eliminates and minimizes errors due to human interference by total automation of the process.
Manpower precision: Special and highly precise protocols are followed in both proceeding as well as reporting of tests, furthermore, health providers are consulted for many test requests for the sake of having the exact righteous requirements of a lab service, continuous on-the-spot training and follow ups done by providers of the devices.
Useful Information
Endocrine function
Most hormones work through interactions with the brain and have either a direct or indirect influence on each other. The main glands involved in hormone secretion and activity include: the hypothalamus (gland at the base of the brain), pituitary (gland in the middle of the brain), gonads (ovaries and testes), adrenals (glands located above the kidneys), and thyroid gland (located beneath the voicebox), as well as the pancreas and liver . Testing for individual hormone levels that are produced by various hormone-producing glands can identify irregularities that can produce negative effects on menstrual and reproductive function.
ACTH (Adrenocorticotropic Hormone)
Too much ACTH can result from congenital (a medical condition present at birth) adrenal hyperplasia (CAH ), the enlargement of the adrenal glands. CAH results from inadequate production of glucocorticoids (a class of hormones produced by the adrenal gland). Glucocorticoid precursors accumulate in these persons and are converted to androgenic steroids. These androgenic steroids can lead to infertility. Male hormones produced by the adrenal gland (called androgens) which, when found in excess, may lead to fertility problems in both men and women. Excess androgens in the woman may lead to the formation of male secondary sex characteristics and the suppression of LH and FSH production by the pituitary gland. Elevated levels of androgens may be found in women with polycystic ovaries, or with a tumor in the pituitary gland, adrenal gland, or ovary. May also be associated with excess prolactin levels.
Aldosterone
A hormone in the blood made by the adrenal glands that helps regulate sodium and potassium levels. More specifically, it helps control blood pressure and the balance of fluids and electrolytes in the blood. M easuring the amount of aldosterone released into the body by the adrenal glands can identify a tumor in the adrenal glands, find the cause of high blood pressure or low potassium levels.
C-Peptide
C-peptide can serve as a valuable index to insulin secretion. Low C-peptide levels are expected when insulin secretion is diminished, as in insulin dependent diabetes, or suppressed, as a normal response to exogenous insulin; whereas elevated C-peptide levels may result from the increased ß-cell activity observed in insulinomas. C-peptide determination can be used to supplement insulin measurements as an index to pancreatic activity in the differential diagnosis of hypoglycemia.
CA-125
A protein found on the surface of many ovarian cancer cells and small amounts of normal tissue. The test measures the amount of CA-125 in the blood. It may be used for women with an ovarian cyst, to help identify endometriosis or to track the progression of endometriosis.
Cortisol
Known as the stress hormone because it is produced in response to stress. As an indicator of adrenocortical function, measurement of blood cortisol level is useful in the differential diagnosis of Addison’s and Cushing disease, hypopituitarism, adrenal hyperplasia and carcinoma. Abnormal cortisol concentrations have been shown to exist in patients with acute infections, severe pain, diabetes mellitus or heart failure, and in women either pregnant or on estrogen therapy.
Growth Hormone
Is typically ordered for patients with symptoms of growth hormone abnormalities, as a follow-up to other abnormal hormone test results, or to help evaluate pituitary function. GH is made by the pituitary gland and plays an important role in how the body uses food for energy (metabolism). Growth hormone is also an insulin antagonist (inhibits insulin and its sugar level lowering effects) that, in susceptible individuals, can lead to elevated sugar levels in the blood and diabetes mellitus.
Insulin-Like Growth Factor Binding Protein 1 (IGFBP-1)
The production of IGFBP-1 is suppressed by high insulin levels (hyperinsulinemia), leading to an increase in free IGF-1. IGF-1 works with insulin to exacerbate hyperandrogenism (over production of male hormones) by increasing testosterone production in the ovaries. Thus, a combination of hyperinsulinemia, elevated free IGF-1 and elevated androgens found when low levels of IGFBP-1 are present likely contribute to the endometrial dysfunction, infertility, increased miscarriage rate and endometrial hyperplasia seen in PCOS.
T3 (Triodothyronine)
A blood test that checks proper thyroid function. Thyroid disorders may affect ovulation. T3 levels distinguish clearly between normal and hyperthyroid (over production of thyroid hormone) patients, since it is elevated in the latter. Thyrotoxicosis may be caused by abnormally high concentrations of T3 rather than T4. The levels of serum T4 (Thyroxin), TBG (Thyroxin Binding Globulin), TSH (Thyroid Stimulating Hormone) and other clinical findings are also used to determine an individual’s thyroid status
T4 (Thryroxine)
A blood test that checks proper thyroid and pituitary function. Thyroid disorders may affect ovulation. T4 (or Thyroxin) is the principal thyroid hormone that circulates almost entirely bound to other (carrier) proteins, chief of which is thyroxin-binding globulin (TBG). Given normal levels of thyroid-binding proteins, hyperthyroidism (over production of thyroid hormone) is characterized by increased levels of T4. Hypothyroidism (too little production of thyroid hormone) is indicated by decreased levels of T4. However, abnormal TBG levels may affect the ability of the total T4 concentration to determine thyroid status (either hyperthyroidism or hypothyroidism). An estimate of the level of circulating TBG may be determined by doing a T3 Uptake test. In disorders of thyroid function, the total T4 and T3 uptake values will both be either high or low. In normal thyroid patients with abnormal TBG levels the total T4 and T3 Uptake will deviate in opposite directions (one will be high and the other low or vice versa). The total of the T4 and the T3 Uptake values, divided by 100, is known as the Free Thyroxine Index (FTI or T7), a widely used indicator of thyroid status.
TSH (Thyroid Stimulating Hormone)
stimulates the thyroid gland to produce T4 and T3. Measurement of TSH is used primarily to determine the cause of hypothyroidism (too little thyroid production). In primary hypothyroidism, the TSH level is elevated due to impaired production of thyroid hormones. In secondary or tertiary hyperthyroidism, thyroid hormone production is low due to pituitary or hypothalamic lesions.
In hyperthyroidism (too much thyroid production), the TSH level is typically suppressed to subnormal levels. TSH can also be used to help determine if a patient has adequate levels of T4.
Thyroid Peroxidase (TPO Ab)
Detects autoantibodies directed against thyroid peroxidase (TPO), an enzyme in the thyroid gland that is very important to the production of thyroid hormones. Autoantibodies to thyroid peroxidase are produced by the body itself. TPOAb can attack the thyroid and damage thyroid function. A positive test for these antibodies prior to receiving fertility treatment indicates an increased risk for miscarriage.
Vitamin D 25OH
is the most accurate measure of the amount of vitamin D in the body. Low 25-hydroxy vitamin D levels indicate a deficiency in vitamin D that may lead to low blood calcium levels (hypocalcemia), thin or weak bones (osteoporosis and osteomalacia), and high levels of parathyroid hormone (secondary hyperparathyroidism) Vitamin D is also associated with infertility because it supports production of estrogen in men and women. Inadequate vitamin D levels are also associated with an elevated risk of pre-eclampsia (high blood pressure that develops in some women during the last half of pregnancy).
Genetics
Chromosome Analysis Karyotyping
One or both of the parents may be the carrier of an abnormal chromosome. Karyotyping is the analysis of the number and shapes of chromosomes in individual cells. Abnormal karyotypes are a significant cause of recurrent miscarriage, or infertility. Chromosomal abnormalities include: extra or missing chromosomes, alterations to the normal structure of specific chromosomes or cases where sections of one chromosome will be relocated to another chromosome where it does not belong (translocation). A chromosome analysis can identify these abnormalities and determine the anatomical, physical and physiological problems associated with it.
Cystic Fibrosis
A recessive genetic disease that is the most common lethal defect among Caucasians. This means two parents carrying the recessive Cystic Fibrosis gene have a 25% chance of having a child with the disease. If one parent is a carrier, then the couples offspring would have a 50% of being a carrier of the gene. Approximately 1 in every 2,500 births results in a baby with Cystic Fibrosis. The frequency of being a carrier is dependant upon ethnicity with 1 in every 25 being European Caucasians or Ashkenazi Jews, 1 in 46 Hispanic Americans, 1 in 65 African Americans and 1 in 90 Asian Americans.
Fragile X Syndrome
A genetic mutation found exclusively on the X chromosome, Fragile X is the most common inherited form of mental retardation. There are various degrees of this mutation: mild (premutation) and severe (full mutation). About 20-30% of women carrying the milder premutation will have premature ovarian failure (POF). Each child of a woman carrying the premutation has a 50% chance of receiving an X chromosome with the premutation. There is also a chance a child will inherit a more severe version of the X chromosome resulting in the full mutation. The full mutation affects approximately 1 in 4,000 males and 1 in 8,000 females resulting in mental retardation ranging from borderline to severe. A DNA test can be performed to determine if a woman carries the genetic mutation and which form (permutation or full mutation).
Preimplantation Genetic Diagnosis (PGD)
A test in which cells are taken from a developing embryo prior to being implanted. These cells are then screened for genetic or chromosomal abnormalities.
Y Chromosome Microdeletion
Mainly used for men who have very few (oligospermia) or no (azoospermia) sperm present in a semen sample and do not have any type of physical obstruction. This test identifies small missing segments of DNA from specific genes located on the Y chromosome. The functionality of these genes has been linked to male infertility. There are 3 basic deletions: AZFa – is rare and the most severe. There is no chance of being able to produce sperm, AZFb – there have been no documented cases of finding mature sperm with surgical procedures, AZFc – is the most common deletion. Successful extraction of sperm with surgical procedures occurs in ~ 2/3 of cases.
Immunology
A woman’s ability to successfully maintain a pregnancy is significantly influenced by a complex alteration of her immune system designed to prepare her body to host a developing embryo. There are other immunological alterations that occur to protect the developing embryo, which is essentially a foreign organism developing within a woman’s body. In some cases these mechanisms do not work as intended and, depending upon the circumstances, might cause immune system disorders that result in recurrent miscarriages, infertility, or failure to conceive following IVF. In some cases the male immune system itself can react to its own sperm as if they were invading cells. The immune system attacks the sperm and significantly impedes their ability to fertilize an egg.
Anti-Beta2 Glycoprotein 1
The presence of this antibody is an independent risk factor for thrombosis and pregnancy complications. It is a naturally occurring anticoagulant that may interact with other components involved in the blood clotting process causing abnormalities. This protein has also been shown to bind to phospholipids (major component of cell membranes) making them more susceptible to attack by antibodies. Damage done by these antibodies to cells involved in fetal implantation may cause pregnancy complications.
Antibody Screen
Detects atypical antibodies (IgG) during pregnancy. The technique is designed specifically to detect IgG antibodies, though on occasion, some other antibodies (IgM) may also be detected. Antibodies detected by the antibody screen will be subsequently identified, and further analyzed to determine if the antibody identified is considered to be clinically significant during pregnancy.
Anti-Cardiolipin Antibodies (ACA)
Cardiolipin is a phospholipid that is one of the main components of cell membranes. It is involved in essential cell functions necessary for proper embryo development. Elevated levels of antibodies to Cardiolipin may interfere with its ability to function normally and have been associated with vein or artery clotting, few blood platelets (fragments that lead to the formation of blood clots) and fetal loss.
Anti-DNA/Histone Antibodies
An assessment of a woman’s immunological reaction to broken down DNA (histones). A positive result indicates the woman’s body may see embryos as foreign organisms and mistakenly mount an immune response in an attempt to rid the body of the embryo(s).
Antimicrosomal antibody
Microsomes are small cell particles. When these particles escape from damaged thyroid cells, the body produced microsomal antibodies that attack the thryoid gland. Measuring the levels of these antibodies can help detect thyroid problems.
Antinuclear Antibody (ANA)
These are antibodies that attack the nuclei (centers) of normal cells. These antibodies can destroy cells leading to problems similar to lupus, rheumatoid arthritis or other immunological diseases associated with recurrent pregnancy loss (RPL) or infertility. The ANA antibodies cause inflammation in the body or in the uterus during implantation. Many women with high levels of these antibodies are unable to become pregnant or carry a pregnancy to term as a result.
Anti-Ovarian Antibodies (AOA)
Antibodies directed towards the various parts of the ovary. This test measures the amount of AOA in the blood of a patient. AOA is most often found in cases of premature ovarian failure (POF), but has also been associated with unexplained infertility, PCOS and endometriosis. Elevated levels of AOA may impair the body’s ability to respond to attempts at ovulation induction.
Anti-Phospholipid Antibodies (APA)
Antibodies in the blood that attach to structures on the surface of cells called phospholipids. This blood test involves 3 different forms (IgM, IgG, and IgA) of antibodies against typically 3 different phospholipids (phosphatidyl ethanolamine, phosphatidyl inositol and phosphatidyl serine). Other less common phospholipids include: phospatidic acid and phosphatidyl glycerol. Result may be reported as negative, borderline, positive, weak, moderate or high positive. Positive APA reflects an increased blood clotting tendency that can cut off blood flow to the fetus. These antibodies can also cause the placenta to attach too weakly to the uterus.
Anti-sperm antibody (male)
This test looks for antibodies in semen that can damage or kill sperm resulting in reduced motility, interfering with egg fertilisation or even infertility. Normally, the testes contain a natural barrier that acts as a protective layer by preventing immune cells from gaining access to sperm within the male reproductive tract. However, the barrier can be broken when testicles are physically injured, after a surgery (biopsy or vasectomy) or after a prostate gland infection. This allows sperm to come into contact with the immune system resulting in the production of the antibodies. If a high number of sperm antibodies come into contact with a man’s sperm, it may be hard for the sperm to fertilize an egg.
Anti-sperm antibody (female)
This test looks for antibodies in blood that can damage or kill sperm resulting in reduced motility or interfering with egg fertilisation. A woman can have an allergic reaction to her partner’s semen and make sperm antibodies. This kind of immune response is not fully understood but may affect fertility.
Anti-thyroglobulin antibody
An antibody, sometimes found in the bloodstream, that attacks a protein found in the thyroid gland called thyroglobulin. These antibodies can ultimately lead to the destruction of the thyroid gland. Measuring the levels of these antibodies can help detect thyroid problems. Also, antithyroglobulin antibodies can be found in women with infertility and recurrent miscarriages. One possible effect is the release of toxins when an embryo tries to attach to the uterus (embryo implantation) resulting in a miscarriage.
Embryo Toxic Factor (ETF)
Immunological factors have been implicated in a number of recurrent pregnancy loss (RPL) cases. ETF is actually two tests in one. In each case a woman’s immune cells are exposed to trophoblast (t he outermost layer of cells of the blastocyst that attaches the fertilized egg to the uterine wall ) antigens that are normally present when a developing embryo is present. Each test then measures how the woman’s immune cells response to exposure to these antigens. If there is no reaction, this indicates the potential for pregnancy success. Conversely, a reaction would indicate a potential immunological issue.
Human Lymphocyte Antigen (HLA) DQa
These antigens are molecules on the surface of cells that determine an individual’s white blood cell type. One DQ antigen comes from the father and one comes from the mother, therefore this is a test for both males and females. It looks at the genotype of each partner. If the DQ genotypes are too similar, it indicates the potential for an adverse effect on early pregnancy due to a lack of immune diversity and protection.
Leukocyte Antibody Detection (LAD)
This test is used to determine the presence of anti-paternal lymphocyte (blocking) antibodies in the blood of pregnant women. During a normal pregnancy, the maternal immune system is down-regulated. In order for this to occur, a woman must produce blocking antibodies that prevent her immune system from attacking the embryo. These blocking antibodies are produced in response to a father’s antigens. Therefore, a positive test result demonstrating the presence of anti-paternal lymphocyte (blocking) antibodies is good.
Lupus Anticoagulant
Lupus anticoagulant testing is used to help determine the cause of an unexplained blood clotting, or recurrent pregnancy loss. It is a specific type of (antiphospholipid) antibody in the bloodstream that can cause abnormal blood clotting. Lupus anticoagulant is detected by measuring the time it takes for a sample of your blood to clot. If this process takes longer than normal, then it is likely lupus anticoagulant is in the blood.
Natural Killer (NK) Cells
A type of cell that is part of the immune system. 80% of white blood cells in the placenta are NK cells. These cells are necessary to assist with implantation of the embryo. However, when activated, these cells also have the ability to kill trophoblast (t he outermost layer of cells of the blastocyst that attaches the fertilized egg to the uterine wall ) cells of a developing embryo. An excess of NK cells in the blood and uterus is correlated with pregnancy loss and reduced IVF success. They do this by interfering with implantation and embryo survival during pregnancy.
Reproductive Immunophenotyping (RIP)
This test looks at a broad range of immune cells that, when abnormally elevated, increase the risk of recurrent pregnancy loss (RPL). When elevated these cells may, either directly or indirectly, mount an immune response against a developing embryo.
Infectious Disease screen
During the diagnostic work-up of both male and female infertility, various blood tests have to be conducted prior to assisted reproduction attempts in order to verify the presence or absence of various infectious diseases. Having one of these infections could be a contributing factor to a couple’s infertility issues thereby affecting the outcome of an assisted reproduction attempt. Another important reason for this testing is the fact that many of these infections can be passed along to the baby, potentially jeopardizing their health and the pregnancy.
Blood Grouping and Rh Typing
Group and typing of expectant mothers and newborns may indicate potential for ABO hemolytic disease of the newborn (maternal antibodies cross the placental barrier to the fetal circulation system causing the destruction of fetal red blood cells). Rh (D) typing is used to determinate Rh immune globulin candidacy for prenatal and postpartum patient. During pregnancy a small amount of the fetal blood can enter the maternal circulation system. If the mother and the fetus are different Rh factors, the mother can develop an immune response against the fetal red blood cells. This can result in another form of ABO hemolytic disease.
Chlamydia
This commonly found bacteria can cause infections in the male or female genital tract. It is important to screen for because of its potential to cause conjunctivitis and pneumonia (infections to the eyes or lungs) in a newborn. It also may present a fertility problem for some couples. These bacteria may be present without any symptoms. In some women, presence of the bacteria may result in tubal scarring. In order to screen for the presence of this bacteria, a culture is done of the woman’s cervical mucus, or the man’s semen. Chlamydia is an organism that can cause infection in the male or female genital tract. Different strains of Chlamydia can also cause infection of the eye or lung.
Cytomegalovirus (CMV)
A blood test is most commonly ordered to detect the presence or absence of antibodies to CMV. The blood test is useful in determining whether a patient is currently infected or has antibodies form a previous infection. CMV is the most common intrauterine infection affecting 1% of live-borns in the US. It is a herpes virus. Infants infected before birth are usually asymptomatic after they are born, however some can develop hearing, vision, neurological, and developmental problems over time. In a few cases symptoms do occur at birth. These can include: premature delivery, being small for gestational age, jaundice, enlarged liver and spleen, microcephaly (small head), seizures, rash, and feeding difficulties. These infants are also at high risk for developing hearing, vision, neurological, and developmental problems.
Gonorrhea
A sexually transmitted disease than can cause tubal disease and infertility. If identified early gonorrhea is easily treated with antibiotics. In addition, t reating a pregnant woman who has a gonorrhea infection can prevent an infection in her newborn. For these reasons, Gonorrhea needs to be identified and treated prior to the start of an IVF cycle.
Hepatitis B
A viral disease primarily involving the liver, which may be transmitted by contact with virally infected blood or bodily fluids. Once infected with the virus, individuals may carry the virus and infect others, through exposure to blood, bodily fluids, or at childbirth . A simple blood test is available to screen individuals for the presence of Hepatitis B surface antigen. If a woman is known to be Hepatitis B antigen positive, her child should receive special medication at the time of childbirth to prevent infection with the Hepatitis virus.
HIV
The virus responsible for Acquired Immunodeficiency Syndrome (AIDS); it compromises the bodies immune system and its ability to protect against infection. This test screens for the presence of antibodies to HIV. W omen who are antibody positive to HIV have a significant chance of transmitting this virus to their newborns.
Human T-cell Lymphotropic Virus (HTLV)
Is a retrovirus that is in the same class of virus as AIDS and can be passed from infected mother to her child. HTLV infects T cells (a type of white blood cell) causing Adult T-cell leukemia/lymphoma (ATLL), or inflammation of the nerves of the spinal cord (causing stiffness and weakness of legs, backache, weak bladder and constipation. HTLV may also cause inflammation of the eye, joints, muscles, lung and skin.
RPR (Rapid Plasma Reagin)
A blood test for syphilis that looks for an antibody that is present in the bloodstream. Syphilis usually results in a rash, sore throat, swollen glands and sometimes sores. When left untreated syphilis can lead to infertility as well as other serious health problems including psychological impairment.
Rubella (German measles)
Is used to confirm the presence of adequate protection against the rubella virus and to detect a recent or past infection. It can also be used to identify those who have never been exposed to the virus, or have not been vaccinated. This test is ordered on all pregnant women and those planning to become pregnant to verify that they have a sufficient amount (titer) of rubella antibodies to protect them from infection. If contracted during pregnancy, this disease may have severe effects on the developing fetus, including: blindness, heart defects, hearing defects, musculoskeletal defects, and mental retardation.
T. palladium (FTA) Antibody
A blood test used to detect antibodies to the bacteria Treponema pallidum, which causes syphilis. It is used as a confirmatory test for syphilis after a reactive RPR is found to determine if there truly is an infection. It is also useful in confirming the diagnosis in late stage syphilis in which the RPR is often negative.
Varicella (chicken pox)
Is used to determine if a woman has antibodies to the virus because it can cause birth defects of illness to a baby depending on when during the pregnancy the infection occurs. Most pregnant women have already been exposed to the virus and therefore are immune . For those women who do not have antibodies, they can be immunized. However, it is highly recommended to avoid getting pregnant at least 3 months following the vaccination.
Male infertility
Any condition that interferes with a male’s ability to initiate a pregnancy with the female partner. Essentially it is due to the fact that a man has too few healthy sperm in their semen that are capable of fertilizing an egg through sexual intercourse. There are a wide range of causes that can be tested for and are due to genetics, hormonal disorders, sperm function or sperm quantitative/qualitative features.
Acrosome Reaction
Assesses the ability of sperm to penetrate an egg. In the fertilization process, sperm must first fuse to, then penetrate, the female egg in order to fertilize it. Typically fusing to the egg is not an issue, but penetrating the egg’s hard shell (zona pellucida) can be difficult for sperm. For this reason, sperm cells go through a process known as acrosome reaction. Shortly before penetration of the egg, the tip of the head of a sperm cell (the cap) will rupture releasing enzymes responsible for breaking down the eggs hard shell in order to gain access to the egg and fertilize it. In cases where sperm fail to undergo the acrosome reaction, they typically have a severely reduced chance of penetrating an egg. This information may be used to help determine the most appropriate ART (Assisted Reproductive Technology) procedure.
Anti-sperm antibody (male)
This test looks for antibodies in semen that can damage or kill sperm resulting in reduced motility, interfering with egg fertilisation or even infertility. Normally, the testes contain a natural barrier that acts as a protective layer by preventing immune cells from gaining access to sperm within the male reproductive tract. However, the barrier can be broken when testicles are physically injured, after a surgery (biopsy or vasectomy) or after a prostate gland infection. This allows sperm to come into contact with the immune system resulting in the production of the antibodies. If a high number of sperm antibodies come into contact with a man’s sperm, it may be hard for the sperm to fertilize an egg.
Chromosome Analysis Karyotyping
One or both of the parents may be the carrier of an abnormal chromosome. Karyotyping is the analysis of the number and shapes of chromosomes in individual cells. Abnormal karyotypes are a significant cause of recurrent miscarriage, or infertility. Chromosomal abnormalities include: extra or missing chromosomes, alterations to the normal structure of specific chromosomes or cases where sections of one chromosome will be relocated to another chromosome where it does not belong (translocation). A chromosome analysis can identify these abnormalities and determine the anatomical, physical and physiological problems associated with it.
Estradiol (male)
A small amount of estradiol is produced by the male testes. It has been reported that high levels of estradiol in men is associated with infertility characterized by low sperm production and quality.
Follicle Stimulating Hormone (FSH-male)
A hormone produced by the pituitary gland that is located in the brain. It plays a key role in the development and release of sperm in the testes. If the reason for the azoospermia is testicular failure, then this is reflected in a raised FSH level. This is because, in these patients, the testis also fails to produce a hormone called inhibin (which normally suppresses FSH levels to their normal range). A high FSH level is usually diagnostic of primary testicular failure, a condition in which the seminiferous tubules ( a coiled mass of tubes which makes up the bulk of the testes ) in the testes do not produce sperm normally, because they are damaged.
Hyaluronan Binding Assay (HBA)
Hyaluronan is a naturally occurring protein found in all human cells, including the gel layer surrounding the oocyte (egg). This test is based on the ability of mature, but not immature, sperm to bind hyaluronan. A low level of sperm binding to hyaluronan indicates a low proportion of mature sperm in the sample. The results of the HBA assay may provide information as to the most appropriate ART (Assisted Reproductive Technology) procedure.
Inhibin B (Male)
A hormone test used to assess the reproductive capacity of males. This hormone is a direct product of the testes and is found to be higher in those men with normal fertility and lower in those who have abnormal sperm production. Inhibin B levels can be used to distinguish between obstructive (normal levels) and non-obstructive (low levels) causes for a lack of sperm. In the case of an obstruction, men typically have normal sperm production but their pathway is blocked due to some physical obstruction. In non-obstructive cases there is no physical obstruction, sperm production is simply low or nonexistent. Non-obstructive lack of sperm is typically due to some type of genetic abnormality.
LH (Luteinizing Hormone – male)
In the man LH is necessary for spermatogenesis (sperm production) and stimulates the testicles to produce testosterone (Leydig cell function). Low levels of LH indicate a hormonal cause for low sperm production.
Prolactin (male)
A hormone involved in the production of testosterone. Too much of this hormone in the blood stream can cause infertility by: interfering with the pituitary production of FSH and LH, adversely affecting the function of testicles, causing decreased testosterone levels, or causing abnormal sperm. High prolactin levels can be caused by tumors or certain medications. Prolactin levels are used with other tests, to help: Diagnose prolactinomas (tumors of the pituitary gland that produce prolactin), investigate potential infertility issues and erectile dysfunction in males.
Semen Analysis
The examination of semen under the microscope. The purpose of this assessment is to measure the volume of semen, approximate number (sperm count), morphology (shape of the sperm) and motility (how well they swim). White blood cells are also measured to detect any possible infection.
Sperm DNA Decondensation (SDD)
Used to assess how well a population of sperms DNA functions once it has fertilized an egg. Once a sperm has fertilized an egg, there are several processes its DNA goes through in order for it to pair up with the egg’s DNA. There are many factors that may impair this process. An abnormal results indicates the general sperm populations DNA will not act normally once inside the egg. This test may provide useful information that will direct couples to the most appropriate ART (Assisted Reproductive Technique) procedure.
Sperm DNA Fragmentation (SDFA)
A test used to assess the quality of DNA in sperm by measuring the amount of “breaks” or “fragmented” DNA in a sample. These DNA “breaks” are indicative of damaged DNA. Significant DNA damage may indicate the general sperm populations reduced ability to fertilize an egg. It also may provide information as to the most appropriate ART (Assisted Reproductive Technique) procedure to be selected.
Sperm Penetration Assay (SPA, Hamster Test)
A test of the ability of sperm to penetrate a hamster egg that has been stripped of the Zona Pellucida (outer membrane of the egg). This is another test used to examine the relative health, fitness and fertilizing ability of sperm.
Testosterone
this hormone is produced by the testicles and is responsible for the development and release of sperm, secondary physical characteristics and sex drive. It is present in two forms: free and bound to Sex Hormone Binding Globulin (SHBG).
The amount of testosterone in a man’s body is controlled by the pituitary gland. At low levels, the pituitary gland typically releases luteinizing hormone (LH), which tells the testicles to make more testosterone. In cases where this process is impaired, consistently low testosterone levels can lead to low sperm counts and quality. There are several reasons for low testosterone levels including:
hypothalamic or pituitary disease, damage to the testes (such as alcoholism, physical damage, or viral diseases), genetic diseases, or testicular failure. Total testosterone measurement does not indicate a problem until end stage testicular failure is reached. Free testosterone is an earlier indicator and more informative.
Y Chromosome Microdeletion
Mainly used for men who have very few (oligospermia) or no (azoospermia) sperm present in a semen sample and do not have any type of physical obstruction. This test identifies small missing segments of DNA from specific genes located on the Y chromosome. The functionality of these genes has been linked to male infertility. There are 3 basic deletions: AZFa – is rare and the most severe. There is no chance of being able to produce sperm, AZFb – there have been no documented cases of finding mature sperm with surgical procedures, AZFc – is the most common deletion. Successful extraction of sperm with surgical procedures occurs in ~ 2/3 of cases.
Ovarian reserve
A term used to determine the capacity of the ovary to provide eggs. Essentially egg quantity is what is being measured and gives an estimation of the number of eggs a woman has remaining for future use. Each ovary has a predetermined number of follicles (fluid-filled sacs that develop into eggs) that are potentially available during the course of a woman’s reproductive life. The actual number varies from individual to individual. During a normal monthly menstrual cycle one egg is released by either one of the two ovaries while approximately one thousand additional follicles are lost due to atresia (a process in which immature eggs or follicles degenerate and are resorbed). There are tests of ovarian reserve done by fertility specialists to help estimate a woman’s remaining egg supply. In turn these tests help the physician determine the likelihood a woman will conceive using her own eggs. In general, the greater the number of eggs remaining, the better the chances for conception. Conversely, low ovarian reserve greatly diminishes the chance for conception. It is worthy to note that a normal or good ovarian reserve does not guarantee a woman will conceive.
Anti-Mullerian Hormone (AMH)
A hormone produced by cells located in developing eggs (preantral and early antral follicles). As the follicles develop into mature eggs or die off (a normal process called atresia), they no longer produce AMH. By measuring the amount of this hormone in a woman’s body, a physician can get a good estimate as to supply of eggs remaining or ovarian reserve. This information can be used to determine odds for success with various IVF procedures and help to determine the optimal ovarian stimulation protocol. This test is different from other tests used to measure ovarian reserve since it does not fluctuate throughout a woman’s menstrual cycle. It has also shown to be a tool that can aid in the diagnosis of PCOS (Polycystic Ovarian Syndrome).
Clomiphene Citrate Challenge Test (CCCT)
Provides an additional assessment of ovarian reserve. On day 3 FSH and estradiol levels are measured. On days 5-9 Clomiphene citrate, a drug prescribed to stimulate or regulate ovulation, is taken. FSH levels are measured again on day 10. An elevated FSH level on either day 3 or 10 is considered abnormal. This indicates a reduced ovarian reserve and a decreased response to ovarian stimulation by FSH injection during an assisted reproductive cycle attempt.
Estradiol
A hormone produced in the ovaries by cells that surround a developing egg (follicle). In terms of ovarian reserve, this test is used to confirm the results of a day 3 FSH. A high estradiol level may artificially lower (or mask) what otherwise would be a higher (potentially abnormal) FSH. The other two uses of this test are: 1.) for the diagnosis of amenorrhea (the absence of a menstrual period) and 2.) to monitor progress during ovulation induction.
Exogenous FSH Ovarian Reserve Test (EFORT)
A hormone test used to assess a woman’s egg production potential by measuring the response of the ovaries to Gonadotropin (FSH) stimulation. On day 3 of a woman’s menstrual cycle her blood is tested for Inhibin B levels. The woman is then injected with FSH and 24 hours later a second Inhibin B level measurement is done. This test may be useful in predicting a woman’s response to IVF cycle stimulation.
Follicle Stimulating Hormone (FSH-female)
A hormone produced by the pituitary gland that is located in the brain. It plays a key role in the development of follicles (immature eggs) into mature eggs. FSH also plays an important role in telling the ovaries when it is time to release a mature egg (ovulation). A normal FSH level indicates a woman has a good supply of eggs (ovarian reserve) and is a good candidate for ovarian stimulation in IVF. As a woman gets older and the number of eggs she has remaining becomes low it takes more FSH to produce an egg. Therefore a high FSH score indicates a low or declining egg supply (ovarian reserve). FSH values can fluctuate from one cycle to the next, so when looking at multiple FSH values the highest value is the one that is considered to be the most accurate. For example if a woman had an initial FSH of 9 and had another FSH a month later with an FSH of 5 it does not mean her ovarian reserve had improved. Her true score is still considered to be an FSH of 9.
Inhibin B (Female)
A hormone test typically done to assess a woman’s ovarian reserve. This test is performed on day 3 of a woman’s menstrual cycle. A high level of this hormone indicates a woman has a good ovarian reserve and typically will respond well to stimulation during an IVF cycle. Conversely, a low Inhibin B level correlates with diminished ovarian reserve and a diminished ability to produce eggs during an IVF cycle.
LH (Luteinizing Hormone, lutropin – female)
Serum LH determinations have been very useful in the diagnosis and treatment of infertility in women. A midcycle rise is a good indication that ovulation will occur approximately 24 hours later. Subfertile couples, and women being treated with gonadotropin for infertility, can be informed that ovulation is imminent. In the woman LH is necessary for the production of estrogen. When estrogen reaches a critical peak, the pituitary releases a surge of LH (the LH spike), which releases the egg from the follicle.
Progesterone
Progesterone is a steroid hormone secreted by the ovary during the second half of the menstrual cycle (luteal phase). It plays an important role in the preparation for and maintenance of pregnancy. Daily progesterone levels are considered the most accurate means for documenting a defective luteal phase.
Measurements of serum progesterone have also been used to check the effectiveness of ovulation induction, to monitor progesterone replacement therapy and to detect and evaluate patients at risk of abortion during the early weeks of pregnancy.
Prolactin
A hormone that stimulates the production of milk in breastfeeding women. Increased prolactin levels in women not breastfeeding may interfere with ovulation and fertility. Prolactin has become an important tool in the investigation of amenorrhea (absence of menstruation), galactorrhea (abnormal milk production at times other than when nursing) and hypothalamic-pituitary disorders. Prolactin is a stress hormone, surgery; venipuncture, an interview, etc. may cause a transient rise.
Polycistic ovarian syndrome (PCOS)
A condition found in women who typically don’t ovulate, characterized by excessive production of androgens (male sex hormones) and the presence of cysts in the ovaries. Follicles go through the normal maturation process but fail to become eggs due to the hormonal imbalance. PCOS can range from mild to serious, and so can the symptoms. Some of the symptoms might include: excessive weight gain, acne, diabetes and excessive hair growth.
17-OH progesterone
A blood test is used to identify why an adult female may be infertile or have excess hair growth (hirsuitism). Deficiencies may increase androgen levels leading to masculine characteristics and interfering with ovulation. Many women with PCOS have exaggerated ovarian 17-OH progesterone secretion. It can also be used to identify possible disorders in the adrenal gland such as Congenital Adrenal Hyperplasia (a group of inherited disorders associated with abnormal metabolism of adrenal gland hormones).
Androstenedione (ASD)
Measurement of ASD provides a useful tool for androgen (male hormones) biosynthesis. Elevated ASD levels have been demonstrated in congenital (a medical condition present at birth) adrenal hyperplasia (CAH – the enlargement of the adrenal glands). They are also increased in polycystic ovary syndrome (PCOS), ovarian stromal hyperthecosis, 3ß-hydroxysteroid dehydrogenase deficiency, and other causes of hirsutism (excessive facial or body hair) in women. Levels are normal in idiopathic hirsutism. Male hormones produced by the adrenal gland (called androgens) which, when found in excess, may lead to fertility problems in both men and women. Excess androgens in the woman may lead to the formation of male secondary sex characteristics and the suppression of LH and FSH production by the pituitary gland. Elevated levels of androgens may be found in women with polycystic ovaries, or with a tumor in the pituitary gland, adrenal gland, or ovary. May also be associated with excess prolactin levels.
Comprehensive Metabolic Panel (CMP)
A blood test that evaluates organ function and checks for conditions such as diabetes, liver disease and kidney disease. Specific items measured include: blood sugar level, electrolyte and fluid balance, kidney function, and liver function. Abnormal results, and especially combinations of abnormal results, can indicate a problem that needs to be addressed.
DHEA-S (Dehydroepiandrosterone sulfate, DHEA-SO 4 )
Measurement of DHEAS, an adrenal steroid, is important to investigations of abnormal hair growth (hirsutism) in women. DHEA sulfate is performed in conjunction with free testosterone as an initial screen for hyperandrogenism (elevated levels of male hormones) in hirsutism. At least one of these two hormones is likely to be elevated in the great majority of cases. Sometimes DHEA-SO 4 is the only hormone circulating at a level above normal, and is more likely to be elevated during the early stages of hirsutism than most other androgens. High DHEA-SO 4 levels are often encountered in PCOS (Polycystic Ovarian Syndrome), showing that adrenal hyperandrogenism is a fairly typical part of this syndrome. Male hormones produced by the adrenal gland (called androgens) which, when found in excess, may lead to fertility problems in both men and women. Excess androgens in women may lead to the formation of male secondary sex characteristics and the suppression of LH and FSH production by the pituitary gland. Elevated levels of androgens may be found in women with polycystic ovaries, or with a tumor in the pituitary gland, adrenal gland, or ovary. There also may be association with excess prolactin levels.
Estradiol
A hormone produced in the ovaries by cells that surround a developing egg (follicle). In terms of ovarian reserve, this test is used to confirm the results of a day 3 FSH. A high estradiol level may artificially lower (or mask) what otherwise would be a higher (potentially abnormal) FSH. The other two uses of this test are: 1.) for the diagnosis of amenorrhea (the absence of a menstrual period) and 2.) to monitor progress during ovulation induction.
Fasting Glucose
Used to identify patients with either normal glucose, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or if they are suspected of having diabetes. Glucose levels in the normal ranges indicates insulin resistance with high insulin levels. Moderately high glucose levels indicate Impaired Glucose Tolerance (IGT). Very high glucose levels indicates type 2 diabetes Women with PCOS have a much higher risk of developing diabetes than non-PCOS women.
Fasting Insulin
Insulin is a hormone that helps the body use and control the amount of glucose in blood Normally, blood glucose levels increase slightly after consuming carbohydrates. This increase causes the pancreas to release insulin so that blood glucose levels do not get too high. However, some women with PCOS tend to have chronically high levels of insulin that do not drop back to normal levels (hyperinsulism). Fasting insulin measures insulin between meals, when it should be at its lowest and is used to determine if a patient is insulin resistant. This test is done in conjunction with glucose testing to evaluate a patient’s metabolic status. Insulin resistance is thought to be one of the main causes of PCOS (Polycystic Ovarian Syndrome).
Follicle Stimulating Hormone (FSH-female)
A hormone produced by the pituitary gland that is located in the brain. It plays a key role in the development of follicles (immature eggs) into mature eggs. FSH also plays an important role in telling the ovaries when it is time to release a mature egg (ovulation). A normal FSH level indicates a woman has a good supply of eggs (ovarian reserve) and is a good candidate for ovarian stimulation in IVF. As a woman gets older and the number of eggs she has remaining becomes low it takes more FSH to produce an egg. Therefore a high FSH score indicates a low or declining egg supply (ovarian reserve). FSH values can fluctuate from one cycle to the next, so when looking at multiple FSH values the highest value is the one that is considered to be the most accurate. For example if a woman had an initial FSH of 9 and had another FSH a month later with an FSH of 5 it does not mean her ovarian reserve had improved. Her true score is still considered to be an FSH of 9.
Glucose Tolerance
Done to check the body’s ability to process sugar. The test begins with blood being drawn in the morning after fasting overnight. The patient then consumes a special drink prepared with 75 grams of glucose (sugar). Blood is then drawn at various intervals over a period of several hours. An abnormal result in PCOS women may suggest the presence of diabetes or a pre-diabetic condition. Abnormal findings may also indicate other problems such as reactive hypoglycemia.
Hemoglobin A1c
Red blood cells in the body contain a protein responsible for carrying oxygen called Hemoglobin. Glucose attaches to Hemoglobin to form a compound called “Hemoglobin A1C” or Glycosylated Hemoglobin. Red blood cells have a life span of about 3 months. At the end of their life span, the red blood cells are destroyed and new ones made. As a result, the amount of Hemoglobin A1C in the red blood cell is an indicator of your average blood sugar over the past 3 months giving a long-term, big picture look at blood sugar levels.
High Sensitivity C Reactive Protein (hs-CRP)
Is most often used to help predict a healthy person’s risk of cardiovascular disease. The higher the value, the greater the risk of cardiovascular disease and vice versa. hs- CRP may differentiate between those PCOS women who are at higher risk of developing type II diabetes and CVD.
LH (Luteinizing Hormone, lutropin – female)
Serum LH determinations have been very useful in the diagnosis and treatment of infertility in women. A midcycle rise is a good indication that ovulation will occur approximately 24 hours later. Subfertile couples, and women being treated with gonadotropin for infertility, can be informed that ovulation is imminent. In the woman LH is necessary for the production of estrogen. When estrogen reaches a critical peak, the pituitary releases a surge of LH (the LH spike), which releases the egg from the follicle.
Lipid Panel
Is a check of cholesterol types (examples include HDL, LDL) and triglycerides to assess cardiovascular risk, particularly among women who are obese. Women with PCOS frequently have high cholesterol and triglycerides. Consequently these women also have an increased risk for cardiovascular disease.
Prolactin
A hormone that stimulates the production of milk in breastfeeding women. Increased prolactin levels in women not breastfeeding may interfere with ovulation and fertility. Prolactin has become an important tool in the investigation of amenorrhea (absence of menstruation), galactorrhea (abnormal milk production at times other than when nursing) and hypothalamic-pituitary disorders. Prolactin is a stress hormone, surgery; venipuncture, an interview, etc. may cause a transient rise.
Sex Hormone Binding Globulin (SHBG)
This protein is responsible for binding the majority of testosterone in the blood into a specific complex. Low levels of SHBG indicate insulin resistance and provides an explanation for elevated levels of Free Testosterone. Symptoms associated with hyperandrogenism such as PCOS (Polycystic Ovarian Syndrome) may be due to decreased levelsSHBG.
Testosterone – (Total)
Indicates the degree of hyperandrogenism (over production of male hormones) in women. Mild to moderately high levels are associated with conditions such as: PCOS (Polycystic Ovarian Syndrome), HAIRAN, or adrenal hyperplasia. Persistently high levels of total testosterone indicate androgen-producing tumors in the ovaries.
(Free) elevation of testosterone levels is a sign of hyperandrogenism (over production of male hormones). It causes an increase in luteinizing hormone (LH) that leads to an increase in the ratio of LH to FSH. An elevated LH:FSH ratio results in major changes to a woman’s cycle and fertility functions.
TSH (Thyroid Stimulating Hormone)
Stimulates the thyroid gland to produce T4 and T3. Measurement of TSH is used primarily to determine the cause of hypothyroidism (too little thyroid production). In primary hypothyroidism, the TSH level is elevated due to impaired production of thyroid hormones. In secondary or tertiary hyperthyroidism, thyroid hormone production is low due to pituitary or hypothalamic lesions.
In hyperthyroidism (too much thyroid production), the TSH level is typically suppressed to subnormal levels. TSH can also be used to help determine if a patient has adequate levels of T4.
Premature ovarian failure
A condition found in women who typically don’t ovulate, characterized by excessive production of androgens (male sex hormones) and the presence of cysts in the ovaries. Follicles go through the normal maturation process but fail to become eggs due to the hormonal imbalance. PCOS can range from mild to serious, and so can the symptoms. Some of the symptoms might include: excessive weight gain, acne, diabetes and excessive hair growth.
17-OH progesterone
A blood test is used to identify why an adult female may be infertile or have excess hair growth (hirsuitism). Deficiencies may increase androgen levels leading to masculine characteristics and interfering with ovulation. Many women with PCOS have exaggerated ovarian 17-OH progesterone secretion. It can also be used to identify possible disorders in the adrenal gland such as Congenital Adrenal Hyperplasia (a group of inherited disorders associated with abnormal metabolism of adrenal gland hormones).
Androstenedione (ASD)
Measurement of ASD provides a useful tool for androgen (male hormones) biosynthesis. Elevated ASD levels have been demonstrated in congenital (a medical condition present at birth) adrenal hyperplasia (CAH – the enlargement of the adrenal glands). They are also increased in polycystic ovary syndrome (PCOS), ovarian stromal hyperthecosis, 3ß-hydroxysteroid dehydrogenase deficiency, and other causes of hirsutism (excessive facial or body hair) in women. Levels are normal in idiopathic hirsutism. Male hormones produced by the adrenal gland (called androgens) which, when found in excess, may lead to fertility problems in both men and women. Excess androgens in the woman may lead to the formation of male secondary sex characteristics and the suppression of LH and FSH production by the pituitary gland. Elevated levels of androgens may be found in women with polycystic ovaries, or with a tumor in the pituitary gland, adrenal gland, or ovary. May also be associated with excess prolactin levels.
Comprehensive Metabolic Panel (CMP)
A blood test that evaluates organ function and checks for conditions such as diabetes, liver disease and kidney disease. Specific items measured include: blood sugar level, electrolyte and fluid balance, kidney function, and liver function. Abnormal results, and especially combinations of abnormal results, can indicate a problem that needs to be addressed.
DHEA-S (Dehydroepiandrosterone sulfate, DHEA-SO 4 )
Measurement of DHEAS, an adrenal steroid, is important to investigations of abnormal hair growth (hirsutism) in women. DHEA sulfate is performed in conjunction with free testosterone as an initial screen for hyperandrogenism (elevated levels of male hormones) in hirsutism. At least one of these two hormones is likely to be elevated in the great majority of cases. Sometimes DHEA-SO 4 is the only hormone circulating at a level above normal, and is more likely to be elevated during the early stages of hirsutism than most other androgens. High DHEA-SO 4 levels are often encountered in PCOS (Polycystic Ovarian Syndrome), showing that adrenal hyperandrogenism is a fairly typical part of this syndrome. Male hormones produced by the adrenal gland (called androgens) which, when found in excess, may lead to fertility problems in both men and women. Excess androgens in women may lead to the formation of male secondary sex characteristics and the suppression of LH and FSH production by the pituitary gland. Elevated levels of androgens may be found in women with polycystic ovaries, or with a tumor in the pituitary gland, adrenal gland, or ovary. There also may be association with excess prolactin levels.
Estradiol
A hormone produced in the ovaries by cells that surround a developing egg (follicle). In terms of ovarian reserve, this test is used to confirm the results of a day 3 FSH. A high estradiol level may artificially lower (or mask) what otherwise would be a higher (potentially abnormal) FSH. The other two uses of this test are: 1.) for the diagnosis of amenorrhea (the absence of a menstrual period) and 2.) to monitor progress during ovulation induction.
Fasting Glucose
Used to identify patients with either normal glucose, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or if they are suspected of having diabetes. Glucose levels in the normal ranges indicates insulin resistance with high insulin levels. Moderately high glucose levels indicate Impaired Glucose Tolerance (IGT). Very high glucose levels indicates type 2 diabetes Women with PCOS have a much higher risk of developing diabetes than non-PCOS women.
Fasting Insulin
Insulin is a hormone that helps the body use and control the amount of glucose in blood Normally, blood glucose levels increase slightly after consuming carbohydrates. This increase causes the pancreas to release insulin so that blood glucose levels do not get too high. However, some women with PCOS tend to have chronically high levels of insulin that do not drop back to normal levels (hyperinsulism). Fasting insulin measures insulin between meals, when it should be at its lowest and is used to determine if a patient is insulin resistant. This test is done in conjunction with glucose testing to evaluate a patient’s metabolic status. Insulin resistance is thought to be one of the main causes of PCOS (Polycystic Ovarian Syndrome).
Follicle Stimulating Hormone (FSH-female)
A hormone produced by the pituitary gland that is located in the brain. It plays a key role in the development of follicles (immature eggs) into mature eggs. FSH also plays an important role in telling the ovaries when it is time to release a mature egg (ovulation). A normal FSH level indicates a woman has a good supply of eggs (ovarian reserve) and is a good candidate for ovarian stimulation in IVF. As a woman gets older and the number of eggs she has remaining becomes low it takes more FSH to produce an egg. Therefore a high FSH score indicates a low or declining egg supply (ovarian reserve). FSH values can fluctuate from one cycle to the next, so when looking at multiple FSH values the highest value is the one that is considered to be the most accurate. For example if a woman had an initial FSH of 9 and had another FSH a month later with an FSH of 5 it does not mean her ovarian reserve had improved. Her true score is still considered to be an FSH of 9.
Glucose Tolerance
Done to check the body’s ability to process sugar. The test begins with blood being drawn in the morning after fasting overnight. The patient then consumes a special drink prepared with 75 grams of glucose (sugar). Blood is then drawn at various intervals over a period of several hours. An abnormal result in PCOS women may suggest the presence of diabetes or a pre-diabetic condition. Abnormal findings may also indicate other problems such as reactive hypoglycemia.
Hemoglobin A1c
Red blood cells in the body contain a protein responsible for carrying oxygen called Hemoglobin. Glucose attaches to Hemoglobin to form a compound called “Hemoglobin A1C” or Glycosylated Hemoglobin. Red blood cells have a life span of about 3 months. At the end of their life span, the red blood cells are destroyed and new ones made. As a result, the amount of Hemoglobin A1C in the red blood cell is an indicator of your average blood sugar over the past 3 months giving a long-term, big picture look at blood sugar levels.
High Sensitivity C Reactive Protein (hs-CRP)
Is most often used to help predict a healthy person’s risk of cardiovascular disease. The higher the value, the greater the risk of cardiovascular disease and vice versa. hs- CRP may differentiate between those PCOS women who are at higher risk of developing type II diabetes and CVD.
LH (Luteinizing Hormone, lutropin – female)
Serum LH determinations have been very useful in the diagnosis and treatment of infertility in women. A midcycle rise is a good indication that ovulation will occur approximately 24 hours later. Subfertile couples, and women being treated with gonadotropin for infertility, can be informed that ovulation is imminent. In the woman LH is necessary for the production of estrogen. When estrogen reaches a critical peak, the pituitary releases a surge of LH (the LH spike), which releases the egg from the follicle.
Lipid Panel
Is a check of cholesterol types (examples include HDL, LDL) and triglycerides to assess cardiovascular risk, particularly among women who are obese. Women with PCOS frequently have high cholesterol and triglycerides. Consequently these women also have an increased risk for cardiovascular disease.
Prolactin
A hormone that stimulates the production of milk in breastfeeding women. Increased prolactin levels in women not breastfeeding may interfere with ovulation and fertility. Prolactin has become an important tool in the investigation of amenorrhea (absence of menstruation), galactorrhea (abnormal milk production at times other than when nursing) and hypothalamic-pituitary disorders. Prolactin is a stress hormone, surgery; venipuncture, an interview, etc. may cause a transient rise.
Sex Hormone Binding Globulin (SHBG)
This protein is responsible for binding the majority of testosterone in the blood into a specific complex. Low levels of SHBG indicate insulin resistance and provides an explanation for elevated levels of Free Testosterone. Symptoms associated with hyperandrogenism such as PCOS (Polycystic Ovarian Syndrome) may be due to decreased levels of SHBG.
Testosterone – (Total)
Indicates the degree of hyperandrogenism (over production of male hormones) in women. Mild to moderately high levels are associated with conditions such as: PCOS (Polycystic Ovarian Syndrome), HAIRAN, or adrenal hyperplasia. Persistently high levels of total testosterone indicate androgen-producing tumors in the ovaries.
(Free) elevation of testosterone levels is a sign of hyperandrogenism (over production of male hormones). It causes an increase in luteinizing hormone (LH) that leads to an increase in the ratio of LH to FSH. An elevated LH:FSH ratio results in major changes to a woman’s cycle and fertility functions.
TSH (Thyroid Stimulating Hormone)
Stimulates the thyroid gland to produce T4 and T3. Measurement of TSH is used primarily to determine the cause of hypothyroidism (too little thyroid production). In primary hypothyroidism, the TSH level is elevated due to impaired production of thyroid hormones. In secondary or tertiary hyperthyroidism, thyroid hormone production is low due to pituitary or hypothalamic lesions.
In hyperthyroidism (too much thyroid production), the TSH level is typically suppressed to subnormal levels. TSH can also be used to help determine if a patient has adequate levels of T4.
Recurrent miscarriage/pregnancy loss
Two or three consecutive miscarriages in the first or early second trimester. Many factors can be involved in recurrent miscarriages including: genetic/chromosomal, age, hormones, metabolic abnormalities, anatomic abnormalities, immunological problems, clotting disorders and in many cases it can remain unexplained.
Activated Partial Thromboplastin Time (APTT)
This test looks at a variety of factors involved in the normal blood clotting process. If any of these factors has a defect the blood will take longer than normal to clot. The consequence of such a defect can result in hemorrhaging. In terms of pregnancy this type of deficiency has been associated with failed implantations and recurrent pregnancy loss.
Anti-Beta2 Glycoprotein 1
The presence of this antibody is an independent risk factor for thrombosis and pregnancy complications. It is a naturally occurring anticoagulant that may interact with other components involved in the blood clotting process causing abnormalities. This protein has also been shown to bind to phospholipids (major component of cell membranes) making them more susceptible to attack by antibodies. Damage done by these antibodies to cells involved in fetal implantation may cause pregnancy complications.
Anti-Cardiolipin Antibodies (ACA)
Cardiolipin is a phospholipid that is one of the main components of cell membranes. It is involved in essential cell functions necessary for proper embryo development. Elevated levels of antibodies to Cardiolipin may interfere with its ability to function normally and have been associated with vein or artery clotting, few blood platelets (fragments that lead to the formation of blood clots) and fetal loss.
Anti-Phospholipid Antibodies (APA)
Antibodies in the blood that attach to