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Fertility Charts

Disclaimer:Please note that all labs have their own normal values, and those presented in these charts are just an average. These charts are provided as tools to help patients have a better dialog with their doctors, not for self-diagnosis or as a substitute for good medical care.

Female Hormone Levels
Blood Glucose Levels
Glucose Tolerance Test with Insulin (GTT / IGTT)
Progesterone in Pregnancy
hCG Levels in Early Pregnancy
Oral Glucose Tolerance Test for Gestational Diabetes
Medicines (by Generic and Brand Names)

Female Hormone Levels
Hormone to Test	Time to Test	Normal Values	What Value Means
Follicle Stimulating Hormone (FSH)	Day 3	3-20 mIU/ml	FSH is often used as a gauge of ovarian reserve. In general, under 6 is excellent, 6-9 is good, 9-10 fair, 10-13 diminished reserve, 13+ very hard to stimulate. In PCOS testing, the LH:FSH ratio may be used in the diagnosis. The ratio is usually close to 1:1, but if the LH is higher, it is one possible indication of PCOS.
Estradiol (E2)	Day 3	25-75 pg/ml	Levels on the lower end tend to be better for stimulating. Abnormally high levels on day 3 may indicate existence of a functional cyst or diminished ovarian reserve.
Estradiol (E2)	Day 4-5 of meds	100+ pg/ ml or 2x Day 3	There are no charts showing E2 levels during stimulation since there is a wide variation depending on how many follicles are being produced and their size. Most doctors will consider any increase in E2 a positive sign, but others use a formula of either 100 pg/ml after 4 days of stims, or a doubling in E2 from the level taken on cycle day 3.
Estradiol (E2)	Surge/hCG day	200 + pg/ml	The levels should be 200-600 per mature (18 mm) follicle. These levels are sometimes lower in overweight women.
Luteinizing Hormone (LH)	Day 3	< 7 mIU/ ml	A normal LH level is similar to FSH. An LH that is higher than FSH is one indication of PCOS.
Luteinizing Hormone (LH)	Surge Day	> 20 mIU/ml	The LH surge leads to ovulation within 48 hours.
Prolactin	Day 3	< 24 ng/ ml	Increased prolactin levels can interfere with ovulation. They may also indicate further testing (MRI) should be done to check for a pituitary tumor. Some women with PCOS also have hyperprolactinemia.
Progesterone (P4)	Day 3	< 1.5 ng/ml	Often called the follicular phase level. An elevated level may indicate a lower pregnancy rate.
Progesterone (P4)	7 dpo	>15 ng/ ml	A progesterone test is done to confirm ovulation. When a follicle releases its egg, it becomes what is called a corpus luteum and produces progesterone. A level over 5 probably indicates some form of ovulation, but most doctors want to see a level over 10 on a natural cycle, and a level over 15 on a medicated cycle. There is no mid-luteal level that predicts pregnancy. Some say the test may be more accurate if done first thing in the morning after fasting.
Thyroid Stimulating Hormone (TSH)	Day 3	.4-4 ulU/ ml	Mid-range normal in most labs is about 1.7. A high level of TSH combined with a low or normal T4 level generally indicates hypothyroidism, which can have an effect on fertility.
Free Triiodothyronine (T3)	Day 3	1.4-4.4 pg/ml	Sometimes the diseased thyroid gland will start producing very high levels of T3 but still produce normal levels of T4. Therefore measurement of both hormones provides an even more accurate evaluation of thyroid function.
Free Thyroxine (T4)	Day 3	.8-2 ng/dl	A low level may indicate a diseased thyroid gland or may indicate a non- functioning pituitary gland which is not stimulating the thyroid to produce T4. If the T4 is low and the TSH is normal, that is more likely to indicate a problem with the pituitary.
Total Testosterone	Day 3	6-86 ng/dl	Testosterone is secreted from the adrenal gland and the ovaries. Most would consider a level above 50 to be somewhat elevated.
Free Testosterone	Day 3	.7-3.6 pg/ml
Dehydroepiandrosterone Sulfate (DHEAS)	Day 3	35-430 ug/dl	An elevated DHEAS level may be improved through use of dexamethasone, prednisone, or insulin-sensiting medications.
Androstenedione	Day 3	.7-3.1 ng/ml
Sex Hormone Binding Globulin (SHBG)	Day 3	18-114 nmol/l	Increased androgen production often leads to lower SHBG
17 Hydroxyprogesterone	Day 3	20-100 ng/dl	Mid-cycle peak would be 100-250 ng/dl, luteal phase 100-500 ng/dl
Fasting Insulin	8-16 hours fasting	< 30 mIU/ml	The normal range here doesn't give all the information. A fasting insulin of 10-13 generally indicates some insulin resistance, and levels above 13 indicate greater insulin resistance.

Blood Glucose Levels
Type of Test	Time to Test	Normal Values	What Value Means
Fasting Glucose	8-16 hours fasting	70-110 mg/dl	A healthy fasting glucose level is between 70-90, but up to 110 is within normal limits. A level of 111-125 indicates impaired glucose tolerance/ insulin resistance. A fasting level of 126+ indicates type II diabetes.
Glycohemoglobin / Glycosylated Hemoglobin (HbA1c)	anytime	< 6 %	An HbA1c measures glucose levels over the past 3 months. It should be under 6% to show good diabetic control (postprandial glucose levels rarely going above 120). Good control reduces the risk of miscarriage and birth defects.

Glucose Tolerance Test with Insulin (GTT / IGTT)
Time	Normal Glucose Values	Normal Insulin Values	What the Results Mean
Fasting	< 126 mg/dl	<10 mlU/ ml	Normal glucose results are 70-90, 111 or over is impaired, 126 or over is diabetic. Insulin levels above 10 show insulin resistance.
½hour	< 200 mg/dl	40-70 mlU/ ml	A truly normal glucose response will not exceed 150.
1 hour	< 200 mg/dl	50-90 mlU/ ml	Some want to lower the threshold on glucose to < 180 to identify early stages of diabetes. Insulin > 80 shows insulin resistance, or a level 5 times that of the fasting level (i.e., a fasting of 11 followed by a 1 hour > 55)
2 hours	< 140 mg/dl	6-50 mlU/ ml	A truly normal glucose response is 110 or lower. Insulin > 60 is IR.
3 hours	< 120 mg/dl
4 hours	< 120 mg/dl

Progesterone in Pregnancy
When	Normal Values	What Level Means
Mid-Luteal Phase	5+ ng/ml	As mentioned above, a level of 5 indicates some kind of ovulatory activity, though most doctors want to see a level over 10 on unmedicated cycles, and over 15 with medications. There is no mid-luteal level that predicts pregnancy.
First Trimester	10-90 ng/ml	Average is about 20 at 4 weeks LMP, and 40 at 14 weeks LMP. It is important to note that while a higher progesterone level corresponds with higher pregnancy success rates, one cannot fully predict outcome based on progesterone levels. Progesterone supplementation is unlikely to help if started after a positive pregnancy test.
Second Trimester	25-90 ng/ml	Average is 40 at beginning, 90 at end.
Third Trimester	49-423 ng/ml	Usually peaks at about 175.

hCG Levels in Early Pregnancy
Days Post Ovulation/ Retrieval	Weeks/Days LMP	Average Singleton Level	Average Twin Level
10	3w3d	25
12	3w5d	50
14	4w0d	100
16	4w2d	200

Please help us create a chart w/ averages -- please fill out our survey form! What is here now are just the most basic levels. For now please check http://advancedfertility.com/earlypre.htm or http://www.inciid.org/betas.html

Oral Glucose Tolerance Test for Gestational Diabetes
Time	Normal Values	Gestational diabetes is diagnosed if 2 or more levels are above the normal range. It is treated through diet, insulin injections, and sometimes with metformin.
Fasting	<105 mg/dl
1 hour	< 190 mg/dl
2 hours	<165 mg/dl
3 hours	<145 mg/dl

Adapted from FertilityPlus patient information

Medicines (by Generic and Brand Names)
Generic Name	Brand Name(S) (not all inclusive)	Form	Most Common Side Effects
Clomiphene Citrate	Clomid* Serophene*	Tablets	increased incidence of multiple births thick dry cervical mucus hot flashes, nausea, breast tenderness occasional headaches or blurred vision depression, mood swings ovarian cysts, pelvic discomfort
Metformin	Glucophage	Tablets	gastrointestinal lactic acidosis liver dysfunction
Follicle Stimulating Hormone (FSH)	Urinary derived: Bravelle^TM Recombinant DNA technology: Follistim^TM (follitropin beta) Gonal.F* (follitropin alpha)	Injection	increased incidence of multiple births increased incidence of miscarriage and premature delivery breast tenderness, swelling, or rash at injection site. mood swings, depression mild to severe hyperstimulation syndrome (enlarged ovaries, abdominal pain, and bloating)
Luteinizing Hormone (LH)	Recombinant DNA technology: Luveris* (listropin alpha)	Injection	Same as for FSH
Human Chorionic Gonadotropin (hCG)	Urinary derived A.P.L.* Pregnyl* Novarel* Recombinant DNA technology: Ovidrel* (choriogonadotropin alpha)	Injection	No known side-effects if only taking hCG
Human Chorionic Gonadotropin (hCG)	Urinary derived: Repronex* Menopur*	Injection	Same as for FSH
Dopamine agonists	Pariodel* (bromocriptine) Dostinex* (cabergoline)	Tablets	nausea, vomiting, nasal congestion headache, dizziness, fainting decreased blood pressure
Gonadotropin-Releasing Hormone (GnRH)	Factrel* Lutrepulse*	Injection	Slight chance of multiple births Mild hyper-stimulation syndrome Headache nausea
GnRH Agonists*	Lupron Depot* (Leuprotide Acetate) Synarel* (Nafarelin Acetate) Zoladex* (Goserelin Acetate)	Injection Nasal spray Injectable implant	hot flashes, headache Mood swings, insomnia Vaginal dryness Decreased breast size Painful intercourse Bone loss Symptomes occur in long-term use
GnRH Antagonists	Ganirelix Acetate Cetrolide* (cetrorelix acetate)	Injection	Same as GnRH Agonists