Fertility Advanced Test | ECLIA & LCMS

Fertility Advanced Test (B-245)

Advanced At-Home Fertility Hormone Testing — 10 Key Biomarkers

The Fertility Advanced Test (B-245) is an at-home dried blood spot test that measures 10 biomarkers involved in ovarian reserve, ovulation, menstrual cycles, thyroid regulation and adrenal hormone activity.

Building on the Fertility Basic profile, this advanced panel adds oestradiol, progesterone, testosterone and DHEAS, measured using liquid chromatography–mass spectrometry (LC-MS). These additional hormones provide a broader picture of reproductive hormone activity and androgen balance.

Choose early follicular testing, commonly called Day 3 testing, to explore baseline hormone levels, or luteal-phase testing, commonly called Day 21 testing, to assess hormone activity after ovulation.

Collect your sample at home using a simple finger-prick kit, without visiting a clinic for sample collection.

Analytes Included

ECLIA: Electrochemiluminescence immunoassay.
LC-MS: Liquid chromatography–mass spectrometry.

Why Test Your Fertility Hormones?

Reproductive health depends on communication between the brain, ovaries, thyroid and adrenal glands. Changes in these hormone systems can influence follicle development, ovulation and menstrual regularity.

The Fertility Advanced Test brings these measurements together to help explore:

• Ovarian reserve, using AMH alongside other relevant hormone results.
• Signals involved in follicle development and ovulation, including FSH and LH.
• Post-ovulation hormone activity, particularly progesterone when collected at the appropriate time.
• Oestrogen and androgen balance, including oestradiol, testosterone and DHEAS.
• Thyroid regulation and prolactin levels, which can affect menstrual cycles.
• Morning cortisol levels, adding information about adrenal hormone activity.

Your results can support a more informed discussion with your healthcare practitioner about fertility planning, menstrual symptoms and further investigations.

What Does This Test Measure?

Anti-Müllerian Hormone (AMH) — Ovarian Reserve

AMH is produced by small developing follicles in the ovaries. It provides information about ovarian reserve and can help inform expectations about the ovarian response to fertility treatment.

• Higher levels may reflect a larger follicle pool and can occur in PCOS.
• Lower levels may reflect reduced ovarian reserve, including age-related changes.

AMH does not measure egg quality or independently predict whether you will conceive naturally.

Follicle-Stimulating Hormone (FSH) — Follicle Development

FSH is released by the pituitary gland and signals ovarian follicles to develop.

• Higher early-cycle levels may suggest that the ovaries require stronger stimulation, which can occur with reduced ovarian reserve.
• Lower levels may reflect reduced signalling from the hypothalamus or pituitary, or the effects of hormone treatment.

Measuring oestradiol alongside FSH helps put the result into context.

Luteinising Hormone (LH) — Ovulation Signalling

LH helps regulate reproductive hormone production and triggers ovulation through the mid-cycle LH surge.

• Higher levels can occur around ovulation, with reduced ovarian function or in some PCOS patterns.
• Lower levels may reflect reduced reproductive signalling or the effects of hormone treatment.

Interpretation depends on the collection day and the other hormone results. An LH result or LH-to-FSH ratio alone does not diagnose PCOS.

Prolactin — A Hormone That Can Affect Ovulation

Prolactin is produced by the pituitary gland. Persistently elevated levels can interfere with reproductive hormone signalling and contribute to irregular or absent periods.

Higher results may be associated with medication effects, pregnancy, breastfeeding, an underactive thyroid or pituitary conditions. Unexpected elevations may require repeat testing and clinical assessment.

Thyroid-Stimulating Hormone (TSH) — Thyroid Regulation

TSH signals the thyroid gland to produce thyroid hormones, which help support menstrual regularity and reproductive function.

• Higher TSH may suggest an underactive thyroid.
• Lower TSH may suggest an overactive thyroid or the effects of thyroid medication.

Abnormal results may warrant additional thyroid testing.

Cortisol — Morning Adrenal Hormone Activity

Cortisol is an adrenal hormone involved in the stress response, metabolism and daily waking rhythm.

This panel measures cortisol in a morning blood spot sample. It adds context to your reproductive hormone assessment, but a single measurement does not describe your full daily cortisol pattern or establish a diagnosis of an adrenal disorder.

Oestradiol (E2) — Ovarian Activity and Uterine Preparation

Oestradiol is the main oestrogen produced by the ovaries during the reproductive years. It helps regulate reproductive signalling and supports the growth of the uterine lining.

• During early-cycle testing, oestradiol helps interpret FSH. An unexpectedly elevated result can suppress FSH and make it appear reassuring.
• During luteal-phase testing, it provides information about ovarian hormone activity after ovulation.

Results must be interpreted against the correct menstrual phase.

Progesterone (Pg) — Evidence of Recent Ovulation

Progesterone rises after ovulation and helps prepare the uterine lining for pregnancy.

An appropriately timed luteal-phase measurement can help establish whether ovulation has recently occurred. A low result may reflect collection before or after the progesterone peak, or a cycle without ovulation.

Progesterone is normally low during early follicular testing. A single result does not establish the quality of the entire luteal phase.

Testosterone (T) — Androgen Balance

Testosterone contributes to normal ovarian function and sexual wellbeing.

• Higher levels may indicate androgen excess and can occur alongside irregular cycles, acne, excess facial or body hair, and PCOS.
• Lower levels may occur with reduced androgen production or hormone treatment and should be interpreted alongside symptoms and other results.

DHEAS — Adrenal Androgen Production

DHEAS is produced mainly by the adrenal glands and acts as a precursor for other sex hormones.

• Higher levels may indicate increased adrenal androgen production and can contribute to the assessment of androgen excess.
• Lower levels may reflect age-related changes, medication effects or reduced adrenal androgen production.

Together, DHEAS and testosterone help your practitioner assess the pattern of androgen activity.

When Should You Collect Your Sample?

Choose your collection timing according to the question you want to explore. Early follicular and luteal-phase testing provide different information.

Option 1: Day 3 — Baseline Fertility Hormones

Collect on Days 2–4 of your menstrual cycle while you are still experiencing menstrual flow. If your bleeding is short, collect on Day 2.

Day 1 is the first day of full menstrual bleeding, not spotting.

Early follicular testing is particularly useful for:

• Assessing ovarian reserve markers, including AMH and baseline FSH.
• Interpreting FSH alongside oestradiol.
• Evaluating baseline LH and androgen patterns.
• Establishing a reproductive hormone baseline.

Option 2: Luteal Phase — Hormones After Ovulation

Luteal-phase testing focuses on hormone activity after ovulation, particularly progesterone.

“Day 21” is a general label; the appropriate day depends on your cycle. The laboratory’s collection instructions provide these windows:

If you track ovulation, the laboratory’s testing guide recommends aiming for approximately seven days after ovulation. Ask your practitioner for guidance if your ovulation date and the calendar-based window do not align.

Irregular or Infrequent Periods

If your cycles are unpredictable, the laboratory permits collection on any non-bleeding day. However, assessing progesterone after ovulation requires suitable timing.

Record your cycle information on the requisition form. If possible, use ovulation tracking and practitioner guidance to choose the collection day.

Each collection represents one point in your cycle. If your practitioner recommends both early follicular and luteal-phase testing, arrange the required separate collections before starting.

Who Should Consider This Test?

This panel may be useful for women who:

• Are exploring reproductive hormone health as part of fertility planning.
• Have irregular, infrequent or absent periods.
• Want information about ovarian reserve.
• Have concerns about whether ovulation is occurring.
• Experience acne or excess facial or body hair alongside menstrual changes.
• Need a broader hormone assessment when investigating possible PCOS.
• Want to explore thyroid, prolactin or androgen factors affecting their cycles.
• Are undergoing a practitioner-led fertility assessment.

Benefits of the Fertility Advanced Test

• 10 biomarkers in one panel, covering reproductive, thyroid-regulating and adrenal hormones.
• Convenient at-home finger-prick collection.
• Includes LC-MS measurement of oestradiol, progesterone, testosterone and DHEAS.
• Flexible collection timing for baseline or post-ovulation assessment.
• Broader context for your symptoms and cycle history.
• Supports informed decisions with your healthcare practitioner.

Test Details

Understand more about your reproductive hormone patterns with the Fertility Advanced Test — a convenient starting point for a more informed fertility discussion.

B-245 Fertility Advanced Test — Collection Instructions

AMH, LH, FSH, TSH, Prolactin, Cortisol, Oestradiol, Progesterone, Testosterone and DHEAS

Sample type: Dried Blood Spot (DBS)

View the Fertility Sample Collection Instructions

Read the full instructions supplied with your kit before collection.

1. Check Suitability and Choose Your Collection Day

Follow the early follicular or luteal-phase schedule above.

The laboratory does not recommend this kit for individuals using hormonal contraceptive pills, patches, vaginal rings, injections or implants.

Testing is permitted with a progestin IUD, although measurable progesterone may be reduced.

Do not stop prescribed contraception or hormone treatment to take this test without advice from your prescriber.

2. Prepare Before Collection

Three Days Before

Following the laboratory’s instructions, avoid:

• Biotin/vitamin B7 supplements, including hair and nail formulas.
• Anti-ageing or anti-wrinkle facial creams.

If biotin has been prescribed, check with your prescriber before withholding it.

If You Use Hormone Treatment

Record all hormones, medicines and supplements on your requisition form.

• Continue prescribed hormones.
• For topical, swallowed, troche or sublingual hormones, the laboratory advises taking any evening dose at least 12 hours before morning collection. Its instructions allow oral progesterone to be taken at bedtime.
• For topical hormones, use gloves or an applicator for at least two days before collection. Avoid applying hormones to the face, lips or neck.
• For prescribed non-contraceptive patches, rings, pellets or injections, follow the laboratory’s guidance on collecting midway between doses. Ask your prescriber if the appropriate timing is unclear.
• If taking hydrocortisone, prednisone or other glucocorticoids, ask your healthcare practitioner about collection timing.

To reduce contamination from topical hormones, change sheets, pillowcases and towels the night before collection, and avoid surfaces that may contain hormone residue.

3. Collect Within One Hour of Waking

Stay well hydrated, without excessive fluid intake.

• Write your name, collection date and collection time on the blood spot card.
• Wash your hands with soap and warm water and dry them with a clean towel.
• Warm your hands to encourage blood flow.
• Open the card and fold the cover away from the filter paper. Do not touch the collection circles.
• Place the card on a clean, flat surface below waist level.
• Select the middle or ring finger of your non-dominant hand.
• Clean the finger with the alcohol pad and let it air dry.
• Use the lancet as instructed and wipe away the first blood drop with sterile gauze.
• Keep your hand below your waist and gently encourage blood flow without excessive squeezing.
• Allow a large drop to fall onto the centre of each circle. Apply a dressing when finished.

Each blood spot should:

• Fill as much of the printed circle as possible.
• Soak through so blood is visible on the back.
• Contain a single drop, without overlapping layers.

Aim to fill all circles where possible. Several well-formed spots are preferable to many small or poor-quality spots.

4. Dry the Card

Leave the card open to air dry for at least four hours.

Once completely dry, close the cover and keep it in a cool, dry place away from direct sunlight until shipment.

Do not package a damp card.

5. Complete the Paperwork

Complete the requisition form fully, including:

• Collection date and time.
• Menstrual-cycle information.
• Current medicines and supplements.
• Hormone treatments and dosing information.

Incomplete information may delay processing or limit interpretation.

6. Package and Send Your Sample

Place the completely dried card and completed requisition form inside the kit box. Close it securely and place it in the return packaging.

Your purchase includes the laboratory testing fee. Customers are responsible for the cost of posting their sample to the laboratory.

Send promptly, following the return instructions supplied with your kit.

If you cannot ship within 24 hours, the laboratory instructs you to freeze the dried sample inside its sample bag. Samples must reach the laboratory within 30 days of collection to avoid rejection.

Collection Checklist

• Correct collection day selected.
• Sample collected within one hour of waking.
• Card labelled with name, date and time.
• Blood spots soaked through without overlapping drops.
• Card dried for at least four hours.
• Requisition form completed.
• Sample packaged and shipped promptly.