The Top Blood Tests to Check Before TTC (Beyond Just an AMH Test)
If you’re thinking about trying to conceive (TTC), getting the right blood work done ahead of time can help you identify potential roadblocks and optimize your fertility. Many women are told to only check AMH (Anti-Müllerian Hormone) to assess ovarian reserve, but this isn’t enough to get the full picture of your reproductive health.
By looking at hormones, nutrient status, blood sugar regulation, and thyroid function, you can proactively address imbalances before they affect ovulation, implantation, or early pregnancy. Here’s a breakdown of the most important blood tests to check before TTC—and what they reveal about your fertility.
Trying to conceive?
Get real answers with advanced hormone testing and expert support ⬇️
Here are the top tests to check before TTC:
1. Essential Hormone Tests for Ovulation & Cycle Health
1️⃣ AMH (Anti-Müllerian Hormone)
What It Tells You:
✅ Measures ovarian reserve (how many eggs you have left)
✅ Helps predict response to fertility treatments like IVF
Limitations:
❌ Doesn’t tell you if you’re ovulating regularly
❌ Doesn’t indicate egg quality or hormonal balance
Research shows that AMH alone is not a predictor of natural fertility—it only provides insight into egg quantity.
2️⃣ FSH & LH (Follicle-Stimulating Hormone & Luteinizing Hormone)
FSH (Follicle-Stimulating Hormone) → Stimulates egg development; high levels can indicate diminished ovarian reserve
LH (Luteinizing Hormone) → Triggers ovulation; high levels may suggest PCOS or ovulatory dysfunction
Best Time to Test:
📅 Cycle Days 2-4 to assess ovarian function.
3️⃣ Estradiol (E2)
Regulates ovulation, uterine lining, and cervical mucus
High levels can indicate estrogen dominance or poor egg quality
Low levels may signal poor ovarian function or irregular ovulation
Best Time to Test:
📅 Cycle Days 2-4 (with FSH & LH)
4️⃣ Progesterone (Confirms Ovulation)
Determines if ovulation occurred
Supports implantation and early pregnancy
Low levels may indicate luteal phase deficiency
Best Time to Test:
📅 7 days after ovulation
Low progesterone is a common cause of implantation failure and early pregnancy loss.
2. Thyroid Tests (More Than Just TSH!)
Thyroid hormones play a huge role in ovulation, progesterone production, and early pregnancy. Many doctors only check TSH (Thyroid-Stimulating Hormone), but a full thyroid panel provides a more accurate picture of thyroid function.
Comprehensive Thyroid Panel
TSH → Basic screening for hypothyroidism/hyperthyroidism
Free T3 & Free T4 → Active thyroid hormones that impact metabolism & ovulation
Reverse T3 (rT3) → Assesses thyroid conversion issues
Thyroid Antibodies (TPO & TgAb) → Detects Hashimoto’s (autoimmune thyroid disease), which can affect implantation
Studies show that even mild thyroid imbalances can impact ovulation and increase miscarriage risk.
3. Blood Sugar & Insulin Resistance Tests
Even if you’re not diabetic, insulin resistance can affect ovulation, egg quality, and implantation. Blood sugar imbalances are commonly seen in PCOS and unexplained infertility.
Blood Tests for Insulin & Glucose Balance
Fasting Insulin → High insulin levels can indicate insulin resistance
Hemoglobin A1c (HbA1c) → Measures blood sugar levels over 3 months
Fasting Glucose → Assesses baseline blood sugar levels
Insulin resistance is a common issue in women with fertility struggles—even without PCOS.
Want deeper fertility labs? I offer comprehensive testing + interpretation—learn more here.
4. Iron & Vitamin Levels for Fertility
Nutrient deficiencies can affect egg health, implantation, and early pregnancy. It’s important to test these levels before TTC to ensure optimal fertility support.
Iron Panel + Ferritin
Iron is critical for oxygen transport to the ovaries and uterus
Low ferritin levels are linked to anovulation and poor egg quality
Vitamin D
Supports hormone production and immune function
Low levels are associated with poor implantation and early pregnancy loss
Women with optimal Vitamin D levels have higher pregnancy success rates.
5️⃣ Prolactin (Checks for Ovulatory Issues)
High prolactin levels can suppress ovulation and lower progesterone
May indicate pituitary dysfunction or stress-related hormone imbalance
Elevated prolactin can be a hidden cause of cycle irregularities and luteal phase defects.
Next Steps: What blood tests should you start with?
If you’re TTC, these expanded blood tests go beyond AMH and provide real insights into your fertility. Testing now allows you to address potential issues early and create a personalized fertility plan for better success.
Want comprehensive fertility testing? Learn more about my fertility testing package!
