Lab Tests to Consider When Trying to Get Pregnant

Most people don’t think about investigating their reproductive health before they decide that they’re ready to start a family. But for many people, getting pregnant isn’t as easy as expected. In many cases, a couple needs to be actively trying to conceive for one year until a medical professional decides that it’s time to investigate each partners health further. 

At Awaken Life, we believe in supporting an individual or couple at any step of their journey. We understand the emotional, physical, social and financial challenges that come with fertility concerns, so it’s important to investigate underlying factors as soon as possible.  Often times, this includes lab work to get a better understanding of what may be contributing to a difficulty conceiving. 

When is the best time to get lab testing when trying to get pregnant?

In an ideal world, we would help patients optimize their fertility before starting a family even crossed their minds. This is because it takes around 3-4 months for a woman’s eggs to fully develop and 2.5 months for a man’s sperm to mature. So, any recommendations made to optimize the quality of the sperm and egg will take around 3-4 months to have optimal effect. 

But we often don’t see patients this early in their fertility journey – and that’s okay! There are so many things that we can do to investigate deeper into the health of the couple and provide support to optimize their chances BEFORE that one-year mark hits. The sooner the better, but we support individuals at ANY point in their fertility journey. 

What lab tests should I consider when trying to get pregnant? 

Along with a full medical history, lab testing can provide us so much information as to what may be contributing to fertility challenges. Below are a few of the lab tests that we often recommend: 

Hormonal Panel

A full hormonal panel helps us to address any underlying hormonal imbalances which may be impacting your chances of conceiving. For women, this includes looking at FSH, LH, estradiol and progesterone to start. Most people don’t know that these tests need to be completed at a specific time of the menstrual cycle, or the results will be inaccurate and difficult to interpret. FSH and estradiol should be completed on day 3 of your cycle, where day 1 is the first day of your period. Progesterone should be tested 7 days after ovulation (Ex: if you ovulate on day 14, you would test on day 21 – but not everyone ovulates on day 14! See our post on cycle monitoring for tools to help determine when you ovulate). For males, FSH and testosterone can be tested, and a semen analysis is often recommended to evaluate the quality and volume of the sperm. 

Thyroid Panel

Your thyroid is a huge piece of the puzzle when it comes to fertility. Decreased thyroid function is a predictor of infertility, increased miscarriage rates and unsuccessful IVF cycles1. During pregnancy, the demand for thyroid hormone increases as the fetus doesn’t make its own thyroid hormone until 8-10 weeks gestation, so optimal maternal thyroid function is crucial2.

Even if you do not experience symptoms of thyroid dysfunction, suboptimal levels can still have an impact on the chances of getting and staying pregnant – so it’s important to test! We often recommend a full thyroid panel including TSH, Free T4, Free T3, reverse T3, Anti-TPO and anti-TG to get the most information on how thyroid function may be affecting your chances. 

Vitamin D

It’s important to test vitamin D in every Canadian, as most of us are deficient. When it comes to fertility, having low levels of vitamin D can lead to decreased ovulation rates and pregnancies as well as increased risk of miscarriage3, 4. Vitamin D receptors are found in the endometrium, and sufficient levels play an important role in implantation5. Having optimal vitamin D levels can also increase your chances of pregnancy if undergoing an IVF cycle6. This is such a simple factor to correct, but it’s an important piece of the puzzle that may be contributing to fertility challenges.


Ferritin is the stored form of iron in the body. When levels are low, further investigation for iron deficiency anemia is warranted. Symptoms of low iron include fatigue, pale skin, dizziness, hair loss, brittle nails, fast heartbeat and shortness of breath. Ferritin is also a marker of acute inflammation. So, when it is too high it can be a sign that there is an inflammatory response occurring in the body. Therefore, having ferritin that is too low or too high can be detrimental to fertility outcomes. In females, it is common to see either low or high ferritin levels on bloodwork. So, it is important to get iron and ferritin investigated when trying to conceive.

DUTCH Testing

This stands for dried urine test for comprehensive hormones. I offer this test as a way to further investigate hormonal imbalances that can’t easily be detected by traditional means of hormone testing (i.e. blood tests). This can be helpful in situations where bloodwork does not match the patients symptom picture. For example, if estradiol is low on bloodwork but the patient is showing symptoms of estrogen dominance, the DUTCH test can tell us more about whether estradiol is converting into estrone in the body. Additionally, most of the time progesterone shows up normal on bloodwork but through the DUTCH test we can see a deficiency.  In cases where the bloodwork doesn’t match up or we need further investigations, completing a DUTCH test can be a very helpful piece to the puzzle. 

Although every test on this list is very important when it comes to overall fertility optimization, it is still very basic. Each individual is unique, and therefore additional lab tests may be recommended depending on the case. If you are planning on starting a family in the near future or have been trying for any amount of time, we would love to help you put the pieces of the puzzle together to optimize your chances of a healthy pregnancy. 

With love and in health,

Priya Prakash, Fertility Health Coach

  1. Scoccia, Bert, et al. “In Vitro Fertilization Pregnancy Rates in Levothyroxine-Treated Women With Hypothyroidism Compared to Women Without Thyroid Dysfunction Disorders.” Thyroid, vol. 22, no. 6, 2012, pp. 631–636., doi:10.1089/thy.2011.0343.
  2. Medenica S, Nedeljkovic O, Radojevic N, Stojkovic M, Trbojevic B, Pajovic B. Thyroid dysfunction and thyroid autoimmunity in euthyroid women in achieving fertility. Eur Rev Med Pharmacol Sci 2015; 19: 977-87. 
  3. Hou, W, et al. “Decreased Serum Vitamin D Levels in Early Spontaneous Pregnancy Loss.” European Journal of Clinical Nutrition, vol. 70, no. 9, 2016, pp. 1004–1008., doi:10.1038/ejcn.2016.83.
  4. Li, N., et al. “Women with Recurrent Spontaneous Abortion Have Decreased 25(OH) Vitamin D and VDR at the Fetal-Maternal Interface.” Brazilian Journal of Medical and Biological Research, vol. 50, no. 11, 2017, doi:10.1590/1414-431×20176527.
  5. Chu, Justin, et al. “Vitamin D and Assisted Reproductive Treatment Outcome: a Systematic Review and Meta-Analysis.” Human Reproduction, vol. 33, no. 1, 2017, pp. 65–80., doi:10.1093/humrep/dex326.
  6. Ozkan, Sebiha, et al. “Replete Vitamin D Stores Predict Reproductive Success Following in Vitro Fertilization.” Fertility and Sterility, vol. 94, no. 4, 2010, pp. 1314–1319., doi:10.1016/j.fertnstert.2009.05.019

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