Hormonal Evaluation

The two main female hormones are estrogen and progesterone. The amount of these hormones in the blood stream varies at different times during the menstrual cycle. Estrogen is produced throughout the cycle, however progesterone is produced only after ovulation.

No progesterone will be produced in women who do not ovulate. Therefore, if a woman is suspected not to be ovulating, a progesterone level measured around day 22 of the menstrual cycle will show if she ovulated or not. In women on Clomid (used to induce ovulation) a day 22 progesterone is commonly checked to make sure the dose of Clomid does not need to be increased.

In some women, there is inadequate amount of progesterone produced after ovulation. In these women, an endometrial biopsy will show abnormal changes before the onset of the menstrual cycle. These women may benefit from being placed on some supplemental progesterone during the later part of the cycle. Also, Clomid has been shown to increase the amount of progesterone produced after ovulation, and some doctors treat this inadequate progesterone production by using Clomid.

Estrogen levels are not very useful to measure in most infertility patients. In patients that are on high power drugs to make them ovulate (Pergonal), then estrogen levels are commonly checked.