What is the FET Test?
The FET (Fertility Evaluation Test) is a diagnostic test used to assess a woman’s fertility and ovarian reserve. It measures the levels of several key hormones involved in the reproductive process. The FET test is typically ordered for women who are experiencing infertility or who are considering fertility treatment options like IVF.
The key hormones evaluated in a FET test include:
- Follicle-Stimulating Hormone (FSH)
- Luteinizing Hormone (LH)
- Estradiol (E2)
- Anti-Mullerian Hormone (AMH)
By measuring the levels of these hormones on specific days of a woman’s menstrual cycle, doctors can gain valuable insights into her fertility status and potential.
How the FET Test Works
The FET test requires blood samples to be drawn at specific times during a woman’s menstrual cycle. Typically, blood is drawn on the following cycle days:
| Cycle Day | Hormones Tested |
|---|---|
| Day 3 | FSH, LH, E2 |
| Day 10 | E2 |
| Day 21 | Progesterone |
Additionally, the AMH level can be checked on any day of the cycle, as it remains relatively stable throughout.
The blood samples are then sent to a lab for analysis. The lab measures the amount of each hormone present in the blood. The results are reported back to the doctor, usually within a few days.
Interpreting FET Test Results
The “normal” reference ranges for the hormones tested in a FET can vary slightly between labs. However, the following are general guidelines:
| Hormone | Normal Range |
|---|---|
| FSH (Day 3) | 3-20 mIU/mL |
| LH (Day 3) | 2-15 mIU/mL |
| E2 (Day 3) | 25-75 pg/mL |
| E2 (Day 10) | 150-500 pg/mL |
| Progesterone (Day 21) | >5 ng/mL |
| AMH | 1.0-4.0 ng/mL |
Results that fall outside the normal ranges may indicate a fertility issue. Some common scenarios include:
High FSH Levels
Elevated FSH on Day 3 (>10-15 mIU/mL) suggests diminished ovarian reserve (DOR). This means the woman has fewer eggs remaining than expected for her age. High FSH is often seen in older women or those approaching menopause. It can make conception more difficult and reduce success rates with fertility treatments.
Low AMH Levels
AMH is considered one of the best markers of a woman’s egg supply. Levels below 1.0 ng/mL are considered low and also indicate a diminished ovarian reserve. Like high FSH, low AMH suggests the woman may have more difficulty getting pregnant.
Elevated LH to FSH Ratio
Normally, LH and FSH levels are similar on Day 3. But if the LH to FSH ratio is greater than 2:1, it could suggest polycystic ovary syndrome (PCOS). PCOS is a common cause of infertility characterized by irregular ovulation.
Low Progesterone Levels
Progesterone rises after ovulation. A level >5 ng/mL on Day 21 confirms ovulation occurred. If the Day 21 progesterone is low, it indicates the woman may not be ovulating regularly, or at all (anovulation). Anovulation is a common cause of infertility.
Doctors consider FET test results along with other factors like age, medical history, and physical exam to recommend appropriate next steps. Additional testing may be ordered to confirm a suspected diagnosis or rule out other issues.
When is the FET Test Ordered?
The FET test is most commonly ordered for women who are experiencing infertility. Infertility is defined as the inability to conceive after 12 months of regular, unprotected sex for women under 35, or after 6 months for women 35 and older.
Some indications your doctor may order a FET test include:
- You’ve been trying to conceive for a year or more without success
- You have irregular periods or no periods (amenorrhea)
- You have a history of miscarriage
- You have symptoms of PCOS like acne, excess hair growth, and weight gain
- You’re over age 35 and have been trying to conceive for 6 months
- You’re considering fertility treatment like IVF
The FET test can provide valuable information about your fertility status and help guide treatment decisions. For example, if your results show a diminished ovarian reserve, your doctor may recommend moving directly to IVF rather than trying other treatments first. Or if your results suggest PCOS, medications to induce ovulation may be prescribed.
When Should You Get Fertility Testing?
In general, you should consider getting fertility testing if:
- You’re under 35 and have been trying to conceive for 1 year
- You’re 35-40 and have been trying for 6 months
- You’re over 40 and have been trying for 3 months
- You have irregular cycles or signs of a hormone imbalance
- You have a history of pelvic inflammatory disease, endometriosis, or reproductive surgery
- Your male partner has a known fertility issue like low sperm count
It’s important not to delay seeking help if you’re struggling to conceive. Fertility declines with age, so waiting too long can make treatment more difficult. If you have any concerns about your fertility, don’t hesitate to discuss them with your doctor.
What Other Tests May Be Ordered?
The FET test is just one part of a complete fertility evaluation. Depending on your situation, your doctor may recommend additional tests such as:
Hysterosalpingogram (HSG)
An HSG is an x-ray test that checks for blockages or abnormalities of the fallopian tubes and uterus. Dye is injected through the cervix and an x-ray is taken to see if the dye flows freely through the reproductive organs.
Transvaginal Ultrasound
An ultrasound uses sound waves to create images of the ovaries and uterus. It can detect problems like ovarian cysts, fibroids, and polyps. The antral follicle count (AFC), which predicts ovarian reserve, can also be determined.
Hysteroscopy
A hysteroscopy allows the doctor to visualize the inside of the uterus using a thin, lighted scope. It can diagnose uterine abnormalities like scar tissue, septums, and polyps.
Laparoscopy
Laparoscopy is a minimally invasive surgical procedure. The doctor makes small incisions in the abdomen and inserts a scope to examine the pelvic organs. It’s used to diagnose and treat endometriosis, pelvic adhesions, and other abnormalities.
Semen Analysis
A semen analysis evaluates a man’s sperm count, motility (movement), and morphology (shape). Male factor infertility is found in 40-50% of infertile couples, so testing the male partner is crucial.
FAQS
1. What do abnormal FET test results mean?
Abnormal FET results can indicate various issues like diminished ovarian reserve, anovulation, or PCOS. However, an abnormal result doesn’t always mean you can’t get pregnant. Your doctor will use the results in conjunction with other factors to make a diagnosis and recommend treatment.
2. Can I still get pregnant with high FSH levels?
Yes, it’s possible to get pregnant with high FSH, but it may be more difficult. High FSH indicates a lower egg supply and potentially lower egg quality. However, as long as you’re still ovulating, natural conception can occur. IVF with donor eggs may be an option if your own eggs are not viable.
3. What can I do to improve my FET test results?
To some degree, FET results (particularly FSH and AMH) reflect your natural ovarian reserve, which declines with age. There’s no proven way to change that. However, living a healthy lifestyle with regular exercise, a balanced diet, no smoking, and minimal alcohol may help optimize your fertility. Managing stress and maintaining a healthy weight are also important.
4. How often should I get a FET test?
Most women only need to get a FET test once, at the beginning of their fertility assessment. Occasionally, if results are borderline or inconclusive, the test may be repeated in a few months. Once you have a diagnosis, there’s usually no need to recheck levels unless your situation changes significantly.
5. Are there any risks to the FET test?
The FET test is a simple blood test, so risks are minimal. You may have some brief discomfort or bruising at the needle site. There is always a slight risk of infection any time the skin is broken, but this is very rare. Overall, the FET test is considered a safe and routine part of fertility testing.
The Bottom Line
The FET test is a valuable diagnostic tool for evaluating female fertility. By measuring key reproductive hormones, it provides insight into a woman’s ovarian reserve and can help diagnose issues like diminished reserve, anovulation, and PCOS.
If you’re struggling to conceive, don’t hesitate to talk to your doctor about getting a fertility assessment, including the FET test. Identifying any issues early on can help you get the treatment you need to achieve your dream of parenthood.
Remember, knowledge is power when it comes to your fertility. The more you understand about your body and your reproductive health, the better equipped you’ll be to make informed decisions and advocate for yourself on your fertility journey.
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