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Module 1

Fertility Lab Work Request Sheet

Bring this to your doctor — know what to test and what results mean

Female Fertility Panel

TestWhen to TestOptimal RangeWhy It Matters
AMH (Anti-Müllerian Hormone)Any day1.0-3.5 ng/mLOvarian reserve indicator
FSH (Follicle-Stimulating Hormone)Day 3 of cycle3-9 mIU/mLHigh = diminished reserve
Estradiol (E2)Day 3 of cycle25-75 pg/mLHigh day-3 = poor response
LH (Luteinizing Hormone)Day 3 of cycle2-6 mIU/mLLH:FSH ratio matters for PCOS
Progesterone7 days post-ovulation>10 ng/mLConfirms ovulation
TSH (Thyroid)Any day1.0-2.5 mIU/LTighter range for fertility
Free T4 & T3Any dayMid-rangeFull thyroid picture
Thyroid antibodies (TPO, TG)Any dayNegativeRule out Hashimoto's
Vitamin D (25-OH)Any day40-60 ng/mLLow = implantation issues
FerritinAny day>40 ng/mLLow even with normal hemoglobin affects fertility
Fasting insulinAny day, fasting<8 mIU/LInsulin resistance disrupts ovulation
DHEA-SAny day150-350 µg/dLAdrenal androgen marker
ProlactinMorning, fasting2-29 ng/mLHigh = disrupts ovulation

Male Fertility Panel

TestWhen to TestOptimal RangeWhy It Matters
Semen analysis2-5 days abstinenceSee WHO criteria belowFoundation of male workup
Total testosteroneMorning (before 10am)500-900 ng/dLOptimal, not just 'normal'
Free testosteroneMorning15-25 pg/mLMore meaningful than total
FSHAny day1.5-8 mIU/mLHigh = testicular issue
LHAny day1.8-8.6 mIU/mLPituitary function
EstradiolAny day10-40 pg/mLHigh E2 impairs sperm
ProlactinMorning, fasting2-18 ng/mLElevated = pituitary issue
TSHAny day1.0-2.5 mIU/LThyroid affects sperm production
Vitamin DAny day40-60 ng/mLLow correlates with poor motility
Zinc (RBC or serum)Any day80-120 mcg/dLEssential for sperm production

WHO Semen Analysis Criteria (2021)

Volume

≥1.5 mL

Concentration

≥16 million/mL

Getting Started

How to use this: Print this sheet and bring it to your doctor. Ask them to order these tests. If your insurance won't cover all of them, prioritize AMH, TSH, ferritin, and vitamin D for women; semen analysis, testosterone, and vitamin D for men.

Reading Your Results

When you get results, compare to the 'Optimal Range' column — not just the lab's reference range. Lab ranges show what's statistically common, not what's ideal for fertility.

If your doctor says results are 'normal,' ask for the actual numbers. Lab reference ranges are based on population averages — 'normal' is not the same as 'optimal' for fertility.

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