What You Should Have Checked if You're Trying to Conceive
If you’re trying to conceive, you’ve likely been told to “just relax” or “give it time.” Maybe you’ve even had some basic bloodwork done, only to be told everything looks “normal.” Yet, month after month, you’re left with more questions than answers.
I see this all the time in my practice. Patients come to me frustrated, having spent months (or even years) trying to decode their fertility without real guidance. The truth is, most doctors only order a handful of tests, often missing key markers that can make or break your fertility journey.
That’s why I created Optimizing Fertility: Essential Lab Tests for Women Trying to Conceive Ebook—to empower you with the knowledge you need to advocate for yourself, understand your results, and take actionable steps toward a successful pregnancy. Let’s dive into what conventional testing often misses and how a more comprehensive approach can change everything.
Case Study 1: The “Normal” Hormone Panel That Wasn’t
Patient: Emily, 32 years old
Concern: Trying to conceive for over a year, irregular cycles
Doctor’s Response: “Your labs are normal. Keep trying.”
When Emily came to me, she had already been through a basic fertility workup. Her OB-GYN had checked her FSH (Follicle-Stimulating Hormone) and LH (Luteinizing Hormone) and declared her fertile. But her cycles were erratic—sometimes 28 days, sometimes 45. Something wasn’t adding up.
I ordered a comprehensive hormone panel, including:
✳️ Estradiol & Progesterone – To confirm ovulation and luteal phase health
✳️ DHEA-S & Testosterone – To check for androgen imbalances
✳️ Thyroid Panel (TSH, Free T3, Free T4, Reverse T3, and Thyroid Antibodies) – Because undiagnosed thyroid dysfunction is a major cause of infertility
✳️ Prolactin – Elevated levels can suppress ovulation
The results?
Emily had low progesterone, subclinical hypothyroidism, and mild elevations in androgens—none of which had been checked in her original workup. By addressing these imbalances with targeted nutrition, supplements, and lifestyle shifts, Emily's cycles regulated.
Key Takeaway:
A basic hormone panel is not enough. You need a full picture to understand your fertility potential. Optimizing Fertility: Essential Lab Tests for Women Trying to Conceive walks you through exactly which tests to request and how to interpret them.
Case Study 2: The Misdiagnosed PCOS Patient
Patient: Sarah, 29 years old
Concern: Irregular cycles, acne, unexplained weight gain
Doctor’s Diagnosis: PCOS (Polycystic Ovary Syndrome)
Sarah had been labeled as having PCOS based solely on her irregular cycles and symptoms. She was told to take birth control until she was ready to conceive and to “lose weight” if she wanted to improve fertility.
But something wasn’t right. Sarah didn’t have the classic insulin-resistant PCOS profile, and her ultrasound didn’t show polycystic ovaries.
I ordered a more in-depth metabolic and hormone panel, including:
✳️ Fasting Insulin & Glucose – To check for insulin resistance
✳️ HbA1c – A marker for long-term blood sugar control
✳️ Sex Hormone Binding Globulin (SHBG) – A key marker often overlooked in PCOS
✳️ Cortisol & Adrenal Function Tests – Because chronic stress can mimic PCOS
Her results?
She didn’t actually have PCOS—her irregular cycles were due to adrenal dysfunction (HPA axis dysregulation) and undiagnosed hypothyroidism. By addressing her stress response and supporting her thyroid, her cycles regulated within three months, and she increased her chances of conceiving.
Key Takeaway:
Misdiagnosis is common in fertility struggles. Optimizing Fertility: Essential Lab Tests for Women Trying to Conceive explains how to differentiate PCOS from other conditions and what tests can confirm (or rule out) a diagnosis.
Case Study 3: The Unexplained Infertility Mystery
Patient: Jessica, 35 years old
Concern: Two early miscarriages, “unexplained infertility” diagnosis
Doctor’s Response: “It’s just bad luck. Consider IVF.”
Jessica had been through multiple rounds of testing, and everything looked “normal.” But I knew from experience that “unexplained” infertility often just means “not thoroughly investigated.”
We expanded her workup to include:
✳️ Comprehensive Autoimmune Panel – To check for underlying immune reactions
✳️ Homocysteine & MTHFR Gene Mutation Test – Because methylation issues can affect egg quality and pregnancy maintenance
✳️ Advanced Thyroid Testing – Since even mild thyroid imbalances can increase miscarriage risk
✳️ Nutrient Testing (Vitamin D, B12, Folate, Omega-3s, and Iron) – Deficiencies can impact egg quality and implantation
Her results?
Jessica had elevated thyroid antibodies, a mild MTHFR mutation affecting folate absorption, and low Vitamin D. We optimized her thyroid, switched her prenatal to one with methylated folate, and boosted her vitamin D levels. She conceived naturally within the year and carried to term.
Key Takeaway:
Many cases of “unexplained infertility” have an explanation—if you know where to look. Optimizing Fertility: Essential Lab Tests for Women Trying to Conceive helps you dig deeper into potential root causes.
Navigating fertility testing can be overwhelming. Doctors often don’t have time to explain your results in detail, and many tests that could be game-changers aren’t even offered unless you know to ask.
That’s exactly why I created Optimizing Fertility: Essential Lab Tests for Women Trying to Conceive. Inside, you’ll find:
✅ A breakdown of essential fertility tests – What they measure, why they matter, and when to get them done
✅ Step-by-step guidance on how to interpret your results – No more “your labs are normal” confusion
✅ Actionable recommendations – Learn how to improve your numbers naturally
✅ Sample lab request templates – So you can confidently ask your doctor for the right tests
If you’re ready to take control of your fertility journey, this guide will be your roadmap to clarity, confidence, and conception.
Your Next Step: Take Control of Your Fertility Today
If you’re ready to stop feeling confused and start feeling empowered about your fertility, this ebook is for you.
⚡ Understand your labs
⚡ Optimize your hormones
⚡ Take charge of your reproductive health
Because your fertility isn’t just about numbers—it’s about having the knowledge and tools to make the best decisions for your body.
I've helped women increase their chances of getting pregnant just by running the appropriate markers.
Invest in this guide today and take charge of your TTC (trying to conceive) journey.
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More Related Articles:
Are Your Fertility Labs Really "Normal?" What Your Doctor Might Not Be Telling You
Hormonal Acne, Insulin Resistance, Liver Health
The Gut-Hormone Connection Explained
How to Balance Hormones Naturally
Managing PCOS with Lifestyle Shifts
Managing PCOS with Supplements
How Sleep Affects Hormones
Natural Birth Control Methods
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*Dr. Francesca works only with patients physically located in California.*
*Disclaimer: Although I am a doctor, I may not be your doctor. The information contained within the pages of this site is for educational purposes only and should not be used to treat conditions. Please consult with your doctor before implementing any of the treatments, diets, supplements, etc. mentioned in this blog.*