What to expect when testing your fertility hormones with Modern Fertility
LAST UPDATED: Nov 17, 2021
13 MIN READ
HERE'S WHAT WE'LL COVER
At Modern Fertility, we believe that the more you know about your body, the better equipped you are to make decisions that impact your health and your future. Testing your fertility hormones is a great way to open up the door to powerful knowledge, important conversations, and actionable next steps to help you get to where you want to go.
But we get it: Even if you're 100% on board with the idea that “knowledge is power,” fertility hormone testing might seem overwhelming to dive into if you’re not sure what to expect from the process. So, if you’re considering testing your fertility hormones or just curious about how it works, you’ve come to the right blog post.
Here's what you'll learn by the end of this article:
Hormones are chemical messengers that help your body function in a ton of ways. By testing your fertility hormones with Modern Fertility, you can get insight into your ovarian reserve (aka egg count), thyroid health, potential outcomes for egg freezing and in vitro fertilization (IVF), and more.
Your results will show you if your levels are "high," "low," or "normal" compared to other people your age. Having a hormonal benchmark can help you understand how your fertility is changing over time. It can also help identify (but not diagnose) issues that can interfere with fertility — like thyroid conditions, PCOS, and issues with ovulation.
Fertility hormone testing won’t eliminate all unknowns about reproductive health — for example, testing your hormones won’t tell you if you’re fertile or infertile.
Proactive fertility screening isn't always covered by insurance — and (depending on your plan) it could cost $1,000+ out of pocket at traditional fertility clinics. With Modern Fertility, you can take that same panel of hormones at home for a fraction of the price.
On birth control? No problem — you can still get great insights from testing. The specific hormones you’ll test depend on the birth control you’re taking and whether or not you get a regular period.
In the following paragraphs, we’re going to demystify the process of testing your fertility hormones. You’ll also hear from real customers who have been through the process.
First things first: What are hormones again?
Hormones are chemical messengers in the body that coordinate an astounding array of body functions. They’re produced by a network of glands and organs called the endocrine system, and then secreted into the bloodstream. Hormones travel to cells and organs so they can deliver instructions for what to do. You can think of hormones kind of like operating manuals for your body.
So what are hormones up to? Name any body function and there’s a good chance hormones help make it happen. (There are actually over 50 types of hormones in humans!) Hormones play a role in controlling how hungry or sated you feel, your mood and emotions, how you respond to stress, your sex drive, sleep, and so much more.
Hormones also play a pivotal role in regulating reproduction, which is why we’re hormone super fans at Modern Fertility. Info about your hormones = intel about body systems involved in reproduction = powerful insights that can help you understand your body.
What can you learn from testing your fertility hormones with Modern Fertility?
The Modern Fertility Hormone Test is a simple at-home blood test that uses a finger prick to measure your hormones for insight into important fertility factors like ovarian reserve (aka egg count), thyroid health (which can impact conception and pregnancy), and more. It's the same test you'd take at a fertility clinic and just as accurate as a standard blood draw — but you can take it at home for a fraction of the up to $1,000+ it could cost at traditional clinics.
Fertility hormone testing (with Modern Fertility or at a clinic) is typically done through blood work because hormones travel throughout the body via the bloodstream. At the most basic level, when you test your hormones, you’ll learn if your levels are considered "low," "normal," or "high" compared to people like you. When you’re testing reproductive hormones, “people like you” usually means:
People who also have ovaries.
People who are similar to you in age.
People at the same part of their menstrual cycle (if you're getting a period).
For example, if you’re 25 it wouldn’t make sense to compare your anti-Mullerian hormone (AMH) level (which gives you insight into egg count) to someone who is 45 because AMH and egg count declines over time. A “normal” AMH result for a 25 year old and a “normal” AMH result for a 45 year old both point to average egg count for their respective ages. But remember: Since fertility declines over time for everyone, if you’re 45 and have “normal” ovarian reserve for your age, your egg quality, and therefore fertility, is substantially lower.
What counts as “low," "normal," and "high” levels? For results to be categorized for interpretation by your healthcare provider, they’re compared against what’s called a “reference range:”
Reference ranges mark cutoffs for what counts as "low," "normal," and "high" for a given laboratory assay. (An assay is a lab test that tells you how much of a hormone is in your blood.)
Reference range cutoffs can differ slightly between labs. This is because hormones are tested via extremely precise measurements, and sometimes the equipment and assays used vary between labs. Although it might seem counterintuitive, you could actually test the same exact sample at two different labs, and get two different numerical results… and have them both be accurate.
What’s more important than the specific number you get is the “low/normal/high” tag the lab applies to your results using their lab-specific reference range. If you’re testing with Modern Fertility and also getting your hormones checked elsewhere, these tags (and the reference ranges) can help you compare the results.
If your Modern Fertility results indicate that one or more of your hormones are outside the "normal" range for your age, the implications depend on the hormone in question and how far outside of the normal range your level falls. The Modern Fertility results dashboard includes in-depth explanations of each result, including flagging hormones that you should definitely discuss with a healthcare professional. From your dash, you’ll also be able to print a PDF of your results to bring with you to your next appointment.
If your results all come back within "normal" range for your age, you can use that as a baseline for seeing how your levels change over time. (This is why we recommend retesting once every 12 months and tracking how your levels change year over year on your Modern Fertility dashboard.)
What you can learn from specific fertility hormones
What you’ll learn from testing your hormones also depends a lot on the specific hormones you’re testing — which vary depending on your birth control and your period (more on this later!).
Here’s a breakdown of what you can learn from the up to six hormones you can test with Modern Fertility:
Anti-Mullerian hormone (AMH): AMH is the best lab proxy for ovarian reserve. It gives you insight into your overall reproductive timeline (aka if you’re likely to hit menopause around the average age) and potential outcomes for egg freezing and IVF. High AMH for your age may mean you have a higher number of eggs than is average for other people your age — and it's also sometimes found in people with polycystic ovary syndrome (PCOS). Low or slightly low levels of AMH may suggest lower ovarian reserve or fewer eggs than average for your age, and very low or undetectable AMH before the age of 40 may suggest primary ovarian insufficiency (POI).
Thyroid-stimulating hormone (TSH): TSH is a hormone that regulates your thyroid health, which plays a role in metabolism, heart function, the nervous system, bone maintenance, mood, fertility, and even sexual function. If TSH is too low or too high, that can interrupt your menstrual cycles — making it more challenging to get pregnant. If your TSH is flagged for retesting, we’ll also include fT4 (another thyroid hormone) in your retest. Low TSH, and high levels of fT4, could indicate a thyroid condition like hyperthyroidism. High TSH and low fT4 could indicate hypothyroidism. Untreated hypo- or hyperthyroidism can also cause issues during pregnancy (like miscarriage and preterm birth).
Follicle-stimulating hormone (FSH): FSH is responsible for growing follicles (which are the fluid-filled sacs that hold and develop your eggs) and starting ovulation. FSH is primarily used as a marker of ovarian reserve, but it’s less commonly used compared to AMH because it can vary more from cycle to cycle and you have to measure it on day 3 of your period. High FSH levels, often coupled with low AMH, could mean you have diminished ovarian reserve (DOR) and fewer eggs than average for your age. (If your FSH is high, it means your body is working harder to grow your follicles). Low FSH is often not a concern.
Estradiol (E2): E2 (an estrogen) plays many roles, including kickstarting the process that leads to ovulation in the first half of the menstrual cycle. FSH and E2 results are interpreted together because high E2 may suppress FSH production and disrupt ovulation. Low E2 may mean your uterine lining isn't able to get thick enough to support implantation and pregnancy — and might suggest you’re experiencing POI, or earlier menopause, when taken together with your AMH, FSH, and LH results.
Luteinizing hormone (LH): The primary role of LH is regulating the length of your menstrual cycle and triggering ovulation. LH levels outside of the normal range may indicate irregular ovulation patterns. Consistently high LH may suggest low ovarian reserve and, in combination with AMH and FSH, also POI. (LH, AMH, and FSH are better indicators of ovarian reserve than LH alone.) Consistently low LH may suggest an issue with the hypothalamus or pituitary gland.
Prolactin (PRL): Prolactin serves many functions, including milk production. A persistently high PRL may mean your body isn't getting the signal to ovulate normally or that your uterine lining may not be as well prepared as it could be for an embryo to successfully implant. Low PRL could indicate weaknesses in the immune system and potentially trouble breastfeeding/chestfeeding (but shouldn’t affect the ability to get pregnant).
Depending on your customized panel, you may need to test on day 3 of your menstrual cycle on the third day of full flow for the most accurate results — when some of the most important reproductive hormones are considered "baseline." If your test is measuring AMH and TSH only, which fluctuate less throughout your cycle, you can take it on any day for the same level of clinical insight.
What can't you learn from testing your fertility hormones?
Testing your fertility hormones can give you a lot of info, but it’s important to remember that hormones are only one piece of the puzzle — and they’re not a crystal ball into your future fertility. Here are some things that hormone testing can't tell you:
If you’re “fertile” or “infertile”: There’s no absolute predictor for fertility (aside from having a baby). Hormone testing can help identify "red flags" that might make getting pregnant more difficult, but it won’t provide a “yes/ no” answer about your fertility.
Whether or not you’ll be able to conceive right now and how long it'll take: Many factors tie into conception, including anatomy (e.g., blocked fallopian tubes) and the sperm quality from your partner or donor. And ovarian reserve, for example, is more indicative of your overall reproductive timeline — less about your ability to get pregnant today.
How likely you are to experience pregnancy loss, or provide insight into past pregnancy loss: Checking your fertility hormone levels can’t explain why you may have experienced pregnancy loss in the past, but it can help inform your TTC process going forward. (Read more about the factors that can contribute to miscarriage here.)
Uncertainty around health and fertility can be a lot to carry. While there’s no test that can remove all of the unknowns from reproductive health, having a benchmark on your hormones is a great way to make sure you have as much info as possible. And if you’re looking to connect with other people who are navigating fertility and discussing reproductive health, we’d love to have you join our online Modern Community.
How can you test your fertility hormones with Modern Fertility?
Here's a step-by-step guide to testing at home with the Modern Fertility Hormone Test:
You'll order your Fertility Hormone Test and choose to test at home or at your local Quest Diagnostics lab. (The next steps are for testing at home.)
You'll get everything you need to test your hormones at home delivered right to you, in discreet packaging.
If your test includes prolactin, your testing instructions will specify fasting for 8 hours before your test. (Testing in the morning makes this easy!)
Before you begin, drink lots of water to help with blood flow.
You'll activate your test kit. (Don’t forget! This is how we know who you are when your sample arrives at the lab.)
You'll lay out all your supplies on a clean, dry surface, then write your name, date of birth, and today’s date on your sample collection card(s). Depending on the number of hormones you’re testing, you’ll either have one or two collection cards.
Get your blood flowing: Wash your hands in hot water for 1 whole minute and dry completely. Do some jumping jacks or have a solo dance party to get your heart rate up.
Clean your middle or ring fingertip with an alcohol prep pad.
You'll remove the protective tip of the lancet by twisting and pulling it, place the tip of the lancet slightly off center against the pad of your middle or ring finger, and press the lancet down until you hear a click. You'll hold it there for 1-2 seconds.
You'll extend your arm down and let the drops of blood fall onto the box on the left side of the sample collection. Keep dropping blood in the left box until it reaches the first line in the right box. Make sure to not touch your finger to the card. You'll repeat steps 7 through 9 if you don't get enough blood from one finger.
You'll let your sample dry completely (for at least 60 minutes, although it can take longer.)
You’ll place one card in each blood sample return bag (without removing any of the bags' contents), and send in your sample using the included shipping label. Drop it in the mail within 24 hours of testing.
(For a glimpse at the testing process IRL, watch Carly Leahy, our co-founder take the test live!)
About 10 days after you send in your sample, you'll get your results delivered in a personalized digital dashboard — along with in-depth, personalized results based on your hormone levels on topics ranging from ovarian reserve to egg freezing or IVF outcomes (get a sneak peek of what they look like here). You'll also get the chance to schedule a complimentary 1:1 consultation with a fertility nurse, an invite to our free online Modern Community, access to our weekly webinar, and a free tool to help you plan next steps in your reproductive journey.
Can you test your fertility hormones if you're on birth control? What about other meds?
If you’re on birth control, you can still get some really powerful insights about your body by testing fertility hormones. The hormones included in your test depend on the type of birth control you’re on (if any) and the regularity of your period. On all types of hormonal birth control, however, you can test for AMH (which gives you insight into ovarian reserve, aka roughly the amount of eggs you have) and TSH (a hormone that tells you about your thyroid, which can have implications for general wellness and fertility). To see which hormones would be included in your test, take our quiz here.
Why can’t you test all of the hormones in the Modern Fertility Hormone Test panel on birth control?
Hormonal birth control works by manipulating certain hormone levels to prevent pregnancy, many through blocking ovulation. This means that measuring those particular hormones while on birth control will be influenced by your birth control and wouldn’t be reflective of your body’s usual levels. Think of it like this: If you had the heat running in your house, you wouldn't measure that heated temp to see what the actual weather of the day was.
That said, there are important distinctions for AMH and TSH:
Different forms of birth control do impact your AMH to varying degrees, but the past research looking into this had small sample sizes and different reported effects. Modern Fertility’s own research team conducted the largest-ever study examining birth control's effects on AMH and was able to pinpoint more precise estimates of the effects of different birth control types. We learned that the amount that AMH is affected by birth control, for most people, won’t change the clinical interpretation of the result.
TSH, on the other hand, is more stable throughout the menstrual cycle and less impacted by hormonal fluctuations — whether they're induced by hormonal birth control or not.
For both AMH and TSH, the benefits you can get from proactively testing outweigh the possible impact of birth control on your hormones. Identifying any issues that could affect fertility (like very low AMH or out-of-range TSH levels) before going off birth control gives you more time to take action prior to conception.
Can any other medications (or supplements) impact your results?
Birth control isn’t the only type of medication that can impact the results of fertility hormone tests. If you’re currently taking any medication that involves hormones (like hormone replacement therapy medications, thyroid meds, or ovarian hyperstimulation drugs), it’s a good idea to check with your prescribing doctor for more information on what impact (if any) your medication might have on your fertility hormones.
When it comes to vitamins and supplements, there isn’t much research out there about the effect on fertility hormones. While there isn’t any strong reason to believe that most supplements would impact your test results, in absence of published studies showing they have no effect on hormones, we can't be totally certain.
What's it really like to take the Modern Fertility Hormone Test?
Below, Modern Fertility customers share what it was like to take the Fertility Hormone Test and how they felt about their results.
"The more you know about your health, the better decisions you can make.”
“I’ve always assumed as long as I had kids in my 30s that it would be fine. Recently I wanted to gain more insight into my fertility to be able to make more informed decisions on the timing of starting a family. The sample collection was easy and I received my results quickly. One of my levels came back high. I contacted Modern Fertility and they gave me a lot of information regarding the specific hormone and even mailed me another kit to retest since it could have just been stress causing it to be elevated. I was so thankful to have the option to retest, free of charge, before pursuing a follow-up with my doctor. I would encourage anyone who is on the fence to give it a shot. The more you know about your health, the better decisions you can make.” — Liz
"The results were so informative."
“The test instructions were easy to follow. I was worried about having to prick my finger to collect the blood, but it ended up being super painless and quick and easy. The results were so informative. It really broke down each hormone in an easy to understand way without being overwhelming. I would definitely recommend anyone to use this kit. Even if you’re not trying for kids or ready to have kids, just knowing your results will give you peace of mind.” — Angel
"I appreciate having the knowledge of what to expect when I am ready."
“The process could not be more simple, and I received my results much faster than I expected. Having no medical or fertility knowledge whatsoever, I was worried I wouldn't be able to interpret my results. I was far from being right. My dashboard not only gave me an overview of my fertility, but I could dive deeper into every section and learn about what my results mean to me, and why it is important when it comes to fertility. I appreciated the suggested next steps, and shared these with my doctor upon my next visit, to have a better discussion on my life plan. Although I am not ready to start a family yet, I appreciate having the knowledge of what to expect when I am ready. I highly recommend Modern Fertility. It’s never too early to understand what is going on in your body.” — Lauren
"My results laid a great foundation for conversation and tests to confirm I do have PCOS."
“Modern Fertility testing has been a great way for me to feel empowered in my own care! I struggled with physicians minimizing my symptoms for a long time before taking a home test and being able to bring results into a new doctor's office. My results laid a great foundation for conversation and tests to confirm I do have PCOS. Knowing what was going on meant I could start managing my symptoms and living my life again! Now I use tests as quick progress check-ins and love how Modern Fertility displays my results graphically over time so I can keep tabs on my fertility.” — Amy
The bottom line
Testing your fertility hormones is a great step towards understanding your body, and the Modern Fertility Hormone Test makes the testing process simple — a test you can take at home (on your terms!) and lots of support every step of the way.
In addition to your fertility hormone test results, you’ll also have access to:
A complimentary 1:1 consultation with a fertility nurse
A customized fertility planning tool based on your goals and timeline
A weekly results webinar ("egginar") to learn about resources and next steps
A community of people with ovaries who talk openly about fertility, women's health, and whatever else is on their minds
The Modern Fertility team is here to support you every step of the way.
This article was reviewed by Dr. Sharon Briggs, PhD, Modern Fertility's head of clinical product development.
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.