Top 10 Functional Lab Tests Every Woman Should Consider Before Trying to Conceive
When you’re planning for a pregnancy, it’s natural to want to do everything "right," e.g. eat better, sleep more, take your prenatal vitamins. But another powerful, often overlooked tool is lab testing for true insight into your body's function. Moreover, these labs support far more than just fertility.
Functional lab testing can provide a fuller picture of your overall health including your energy level, mood, metabolism, inflammation, and how your body handles stress. This is immensely helpful because when your whole body is well, conception becomes much more likely, and your body can more easily support a baby.
Below are ten lab tests I often recommend to women preparing for pregnancy and why they are important in both reproductive and general health.
1. Comprehensive Thyroid Panel (Not Just TSH)
What it shows: A full look at your thyroid function, including TSH, Free T3, Free T4, Reverse T3, and thyroid antibodies.
Why it matters: Your thyroid affects ovulation, energy, metabolism, and the ability to carry a pregnancy. Even mild dysfunction can interfere with conception.
Fertility + Health Connection: A healthy thyroid helps regulate your cycle but it also plays a major role in mood, temperature regulation, and digestion. If you’re always cold, your hair is brittle or falling out, or you’re tired and constipated, this is more reason to get tested.
2. Hemoglobin and Hematocrit
What it shows: The concentration of red blood cells in your blood.
Why it matters: These markers can detect early signs of anemia or oxygen transport issues.
Fertility + Health Connection: You need robust red blood cells to nourish your reproductive organs, but also to support brain function, energy, and tissue repair. Consider this test especially if you have low energy, tire easily, or have heavy menstrual cycles.
3. Iron Panel + Ferritin
What it shows: Ferritin reveals how much iron you’ve stored; a full iron panel shows how well you’re transporting and using it.
Why it matters: Iron supports ovulation, egg health, and a thick uterine lining (important for implantation). Low ferritin can exist even when hemoglobin is normal, which is why it’s important to look at both.
Fertility + Health Connection: Iron is essential for making healthy eggs and building the uterine lining but also for your immune system and brain health.
4. Hemoglobin A1C (± Fasting Insulin and HOMA-IR)
What it shows: A1C reflects your average blood sugar over 2–3 months. If it’s elevated, insulin markers help determine how your body is managing blood sugar.
Why it matters: Blood sugar imbalance is one of the most common, yet silent, disruptors of hormone health.
Fertility + Health Connection: Stable blood sugar supports ovulation and healthy hormone rhythms. It also protects your energy, weight, and long-term metabolic health.
5. Vitamin D (25-Hydroxy)
What it shows: Your body’s vitamin D status.
Why it matters: Vitamin D acts like a hormone and supports ovary function, immune balance, and healthy implantation. Many women are deficient without knowing it.
Fertility + Health Connection: Vitamin D is vital for reproductive health, and also for bone strength, immunity, and mood stability.
6. Omega-3 Index
What it shows: The percentage of anti-inflammatory omega-3 fats (EPA and DHA) in your red blood cells.
Why it matters: These fats are key for egg quality, hormone production, and reducing inflammation.
Fertility + Health Connection: Omega-3s support regular cycles and hormone balance, but also brain health, cardiovascular health, and skin integrity.
7. Homocysteine and MTHFR Genotyping
What it shows: Homocysteine is a marker of methylation and inflammation; MTHFR tells you how your body uses folate.
Why it matters: High homocysteine can interfere with embryo development. MTHFR variants may mean you need a different form of folate (like methylfolate).
Fertility + Health Connection: These markers help ensure your body is metabolizing B vitamins properly which is important for reproductive health but also for detoxification, brain health, and cardiovascular function.
8. DUTCH Hormone Test
(Recommended if you have irregular cycles, hormone-related symptoms, or difficulty conceiving)
What it shows: A detailed map of estrogen, progesterone, testosterone, and cortisol including how your body processes them.
Why it matters: This is one of my favorite tests, and I have seen it be life-changing for some women. This test can uncover patterns like estrogen dominance or cortisol dysregulation that might be affecting ovulation, sleep, or PMS.
Fertility + Health Connection: DUTCH testing offers a deeper look into hormone dynamicsnot just for fertility, but for mood, metabolism, stress resilience, and long-term hormonal health.
9. Stool Microbiome Testing
(Recommended if you have digestive issues, frequent infections, or unexplained inflammation)
What it shows: The health of your gut microbiome and whether you have inflammation, imbalance, or hidden infections.
Why it matters: Gut health has been in the media and trending for a number of years now, and for good reason. Your gut influences hormone metabolism, nutrient absorption, and immune balance, all important for reproductive health.
Fertility + Health Connection: A healthy gut helps your body absorb nutrients, regulate hormones, and keep inflammation low. It’s foundational not just for conception but for lifelong wellness.
10. Organic Acids Test (OAT)
(Recommended if you’re dealing with fatigue, brain fog, or complex fertility issues)
What it shows: How your mitochondria are working, how well you’re detoxing, and whether or not your nutrients and neurotransmitters are in balance.
Why it matters: This is my other favorite test. It identifies subtle roadblocks to fertility like B-vitamin deficiencies or oxidative stress that may not show up on routine labs.
Fertility + Health Connection: These metabolic insights can guide support not only for conception, but for energy, focus, and whole-body function.
Final Thoughts
You don’t need all these tests to begin. The key is picking the right ones for your history, symptoms, and goals. Some of them, like thyroid, hemoglobin and hematocrit, iron, and vitamin D are foundational for nearly everyone. Others, like the DUTCH or OAT, offer deeper insight when cycles are irregular or the path to conception hasn’t been straightforward.
Functional testing can often provide valuable clarity, enabling you to take the most supportive and effective next steps with greater confidence. Whether you’re just beginning your journey or already facing fertility challenges, these comprehensive tools can help you feel more informed, empowered, and fully prepared to move forward with a clear sense of purpose.