Question 1

How LH test results are interpreted in women?

Accepted Answer

In women, there are two types of ovarian failure, primary and secondary. This test helps to analyze LH and FSH levels which can in turn help to differentiate between the two types of ovarian failure. Primary ovarian failure is when the problem is within the ovaries or there is a lack of ovarian development. However, secondary ovarian failure occurs due to disorders of either the pituitary gland or the hypothalamus.
 
Primary ovarian failure: In this, the levels of LH and FSH rise. The following can be some causes of primary ovarian failure:
·       Developmental defects: Failure to develop ovaries (ovarian agenesis)
·       Chromosomal abnormality: Turner syndrome
·       Defect in steroid production by the ovaries such as 17 alpha-hydroxylase deficiency
·       Premature ovarian failure due to exposure to radiation, chemotherapy, and autoimmune disease
·       Chronic failure to ovulate (anovulation) due to polycystic ovary syndrome (PCOS), adrenal disease, thyroid disease, and ovarian tumor
·       Menopause: In this, a woman's ovaries cease to function; thus, it results in increased levels of LH.

Secondary ovarian failure: In this, low levels of LH and FSH are observed which indicates a problem with the pituitary gland or hypothalamus. Here, LH response to GnRH can help differentiate between secondary dysfunction and tertiary disorder (a problem involving the hypothalamus). Following baseline level of LH measurement, a dose of GnRH is given by injection. A subsequent increase in LH level shows that the pituitary gland responded to the GnRH and indicates a disorder involving the hypothalamus. However, a reduced level of LH shows that the pituitary gland did not respond to the GnRH and suggests a disease involving the pituitary gland.

Question 2

How LH test results are interpreted in men?

Accepted Answer

Primary testicular failure: High levels of LH may indicate primary testicular failure. The following can be the causes:
·       Developmental defects: Failure to develop gonads (gonadal agenesis)
·       Chromosomal abnormality such as Klinefelter syndrome
·       Testicular failure: Viral infection (mumps), Trauma, Exposure to radiation, Chemotherapy, and Autoimmune disease
·       Germ cell tumor
·       Testicular injury
Secondary failure: Low levels of LH and FSH can be seen in case of secondary failure of the testicles. This may indicate a problem with the pituitary gland or hypothalamus.

Question 3

How LH test results are interpreted in children?

Accepted Answer

In young children, high levels of LH and FSH with the development of secondary sexual characteristics at an unusually young age are an indication of precocious puberty. Usually, this premature development is due to impaired functioning of the central nervous system. It can also have a few different underlying causes such as:
·       Central nervous system tumor
·       Brain injury, trauma
·       Inflammation within the central nervous system (e.g., meningitis, encephalitis)
·       Brain surgery
Normal prepubescent levels of LH and FSH in children showing some signs of pubertal changes may indicate a condition called "precocious pseudopuberty". The signs and symptoms are caused by elevated levels of the hormones estrogen or testosterone. This may be caused by:
·       Hormone-secreting tumors
·       Adrenal gland tumors
·       Ovarian tumors or cysts
·       Testicular tumors
However, normal FSH and LH levels with a few signs of puberty can also indicate a benign form of precocious puberty, with no underlying or discernible cause, or may just be a normal variation of puberty.
 
In delayed puberty, LH and FSH levels can be normal or below considerable range. The test for LH response to GnRH in addition to other tests may help to diagnose the reason for the delayed puberty. Some of the underlying causes of delayed puberty can include:
·       Failure of the ovaries or testicles
·       Hormone deficiency
·       Turner syndrome
·       Klinefelter syndrome
·       Chronic infections
·       Cancer
·       Eating disorder (anorexia nervosa)

Question 4

Is there any special preparation required before taking LH test?

Accepted Answer

You may be required to stop taking certain medications that can affect the results such as birth control pills, hormone therapy, testosterone, and dehydroepiandrosterone supplements. Birth control or other hormone pills may be required to be stopped for up to four weeks before the test. You may be asked to avoid eating or drinking for up to eight hours before the test, just like any other blood test. Inform your physician, if you have had any type of test/procedure with a radioactive substance within seven days before the LH blood test. The reason being that, these substances can interfere with the results of your test.

Question 5

What additional tests can be advised by the doctor other than LH test to check infertility?

Accepted Answer

Besides LH level, FSH test and body temperature tracking (rises slightly during ovulation) may be required. Other hormonal tests, as well as a postcoital (after intercourse) examination, may also help to check infertility. A hysterosalpingogram (image of fallopian tubes) may be advised to see whether fallopian tubes are blocked. Even partner’s semen sample may be asked for analysis.

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