TTC? Fertility Labs Your Doctor Isn’t Ordering (But Should Be!)
If you're trying to conceive (TTC) and feel like you're not getting clear answers from your doctor, you're not alone. Many standard fertility workups miss key markers that could be impacting your ability to get pregnant.
Most doctors may check AMH, FSH, and TSH, but fertility is more than just ovarian reserve and thyroid function—it’s about hormone balance, blood sugar regulation, inflammation, and nutrient status.
By running a more comprehensive set of labs, you can uncover hidden fertility issues and take a proactive approach to support ovulation, egg quality, and implantation. Here’s a breakdown of the fertility tests your doctor might not be ordering—but should be!
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Fertility labs to check:
1. Comprehensive Hormone Testing (Beyond Just AMH & FSH)
Most doctors only test AMH (Anti-Müllerian Hormone) and FSH (Follicle-Stimulating Hormone) to assess ovarian reserve, but these don’t give the full picture of hormonal balance or ovulation health.
Key Hormone Tests to Ask For:
Estradiol (E2) → Needed for ovulation, egg quality, and uterine lining health
Progesterone → Confirms if you’re ovulating and if your luteal phase is strong enough for implantation
LH (Luteinizing Hormone) → Imbalances can indicate PCOS or ovulatory issues
Prolactin → High levels can suppress ovulation and lower progesterone
Testosterone & DHEA-S → Important for egg quality and PCOS screening
Low progesterone and high prolactin are common causes of early pregnancy loss and implantation failure.
🩸 When to Test:
FSH, LH, and Estradiol → Cycle Days 2-4
Progesterone → 7 Days After Ovulation (Luteal Phase)
2. A Full Thyroid Panel (Not Just TSH!)
Thyroid function plays a huge role in ovulation and implantation, but most doctors only check TSH (Thyroid-Stimulating Hormone)—which doesn’t tell the whole story.
🔬 Full Thyroid Panel to Request:
TSH (Thyroid-Stimulating Hormone) → Basic screening test
Free T3 & Free T4 → Measures active thyroid hormone levels (critical for metabolism & egg quality)
Reverse T3 (rT3) → Can indicate thyroid conversion issues
Thyroid Antibodies (TPO & TgAb) → Screens for Hashimoto’s, an autoimmune thyroid condition linked to miscarriage
Even mild thyroid dysfunction can delay ovulation and increase miscarriage risk.
🩸 When to Test:
Any time in the cycle, but best in the morning while fasting.
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3. Insulin & Blood Sugar Testing (Often Overlooked!)
Even if you don’t have PCOS or diabetes, blood sugar imbalances can impact ovulation, egg quality, and implantation. Many women with unexplained infertility have insulin resistance, even if they don’t fit the traditional profile.
Blood Sugar & Insulin Labs to Request:
Fasting Insulin → Detects insulin resistance (not tested in a standard glucose panel)
Hemoglobin A1c (HbA1c) → Measures long-term blood sugar levels
Fasting Glucose → Basic screening for blood sugar dysregulation
Insulin resistance is linked to ovulatory dysfunction and poor egg quality—even in women without PCOS.
🩸 When to Test:
Best in the morning while fasting.
4. Inflammation & Autoimmune Markers (Often Ignored in Fertility Testing)
Chronic inflammation can disrupt ovulation, implantation, and hormone balance—but it’s rarely checked in standard fertility workups.
Inflammation & Immune Markers to Ask For:
High-Sensitivity CRP (hs-CRP) → Measures chronic inflammation
Homocysteine → Elevated levels can affect egg quality and increase miscarriage risk
Antinuclear Antibodies (ANA) → Screens for autoimmune activity linked to implantation issues
Chronic inflammation has been linked to reduced embryo implantation and recurrent pregnancy loss.
🩸 When to Test:
Any time in the cycle.
5. Key Nutrient Tests for Fertility (Often Overlooked!)
Nutrient deficiencies can impact ovulation, egg quality, and implantation. Checking these levels before TTC ensures your body has the right building blocks for pregnancy.
Essential Nutrient Labs to Request:
Iron Panel + Ferritin → Low ferritin is linked to poor egg quality and anovulation
Vitamin D → Critical for implantation and hormone balance
Vitamin B12 & Folate (MTHFR status optional) → Needed for healthy egg development and early pregnancy
Magnesium, Zinc, & Copper → Key minerals for hormone production and stress resilience
Vitamin D and iron deficiencies are linked to reduced fertility and increased miscarriage risk.
🩸 When to Test:
Best in the morning, fasting is preferred for iron.
Next Steps: should you get these labs before ttc?
If you’ve been trying to conceive without success, or you simply want to ensure your body is hormonally balanced before TTC, running these labs can provide real answers. Many of these tests aren’t included in standard fertility workups, but they can help uncover underlying issues affecting ovulation, egg quality, and implantation.
Want comprehensive fertility testing? Learn more about my fertility testing package!
