Expert Add-on: Hormone Bioavailability, Androgen Excess & Metabolic Depth Panel (Quest)

What this panel includes

This panel should be paired with the full Women’s Fertility Expert Panel and adds additional markers that help clarify androgen source, hormone signaling, and metabolic regulation.

Expert hormonal and metabolic assessment

• Reproductive and ovarian health: Estradiol, progesterone, total testosterone, free testosterone, DHEA S, FSH, LH, SHBG, prolactin, and Anti Müllerian hormone (AMH). Evaluates ovulation, ovarian reserve, androgen balance, hormone availability, and brain to ovary signaling.

• Thyroid function and immune regulation: TSH, free T4, free T3, TPO antibodies, thyroglobulin antibodies, and ANA panel. Assesses thyroid performance and screens for autoimmune patterns that may influence hormonal balance, metabolism, and fertility.

• Metabolic and cardiometabolic health: Comprehensive Metabolic Panel, fasting glucose, fasting insulin, hemoglobin A1c, leptin, lipid panel with ratios, lipoprotein(a), high sensitivity CRP, uric acid, and homocysteine. Provides insight into insulin sensitivity, metabolic regulation, inflammation, and cardiovascular risk factors that intersect with hormonal health.

• Blood health and systemic function: CBC with differential. Evaluates red and white blood cells and overall hematologic status.

• Nutrient and micronutrient status: Vitamin D, vitamin B12, folate, iron with TIBC, ferritin, magnesium (RBC), zinc, and selenium. Assesses nutrient levels essential for hormone production, thyroid conversion, ovulation, immune balance, and energy metabolism.

Additional markers for androgen signaling and metabolic depth

• Androstenedione: Helps differentiate ovarian versus adrenal sources of androgen production and provides additional insight into androgen signaling patterns.

• 17 Hydroxyprogesterone (17 OHP): Screens for non-classic congenital adrenal hyperplasia (NCCAH), an adrenal condition that can present with symptoms similar to PCOS.

• ACTH (adrenocorticotropic hormone): Evaluates pituitary signaling to the adrenal glands and helps clarify adrenal contributions to androgen production.

• Adiponectin: An anti inflammatory metabolic hormone that helps assess insulin sensitivity and metabolic health.

• IGF 1 (insulin like growth factor 1): Reflects growth hormone axis activity and may influence ovarian follicular signaling and metabolic regulation.

Together, these markers help clarify whether androgen excess patterns may be driven by ovarian, adrenal, or metabolic pathways and provide deeper insight into the metabolic context surrounding hormonal symptoms.

Biomarkers tested

Why patients choose this

• A deeper draw that adds specialized markers for androgen signaling, hormone availability, and metabolic regulation on top of the Women's Fertility Expert Panel.
• Helps clarify whether androgen excess patterns may be driven by ovarian, adrenal, or metabolic pathways.
• Provides deeper insight into patterns often associated with PCOS and related hormonal conditions.
• Especially useful for women with symptoms of androgen excess, suspected or diagnosed PCOS, or persistent hormonal symptoms needing more detailed assessment.

Before your test

This panel should be paired with the full Women's Fertility Expert Panel.

Cycle timing matters more for this panel than most. It is recommended that you schedule your lab draw on day 2 or 3 of a standard 28-day cycle.

Cycle timing is not always predictable. You may reschedule your lab appointment if needed, though same-week availability may be limited.

It is recommended to fast for at least 8 hours before your draw.

Important information

Why it matters: androgen excess and metabolic dysfunction are common drivers of hormonal symptoms such as irregular cycles, ovulatory dysfunction, acne, hair changes, and unexplained fertility challenges, often linked to underlying metabolic signaling, insulin resistance, or differences in how hormones are produced between the ovaries and adrenal glands.

Who it's for: especially useful for women experiencing symptoms of androgen excess, suspected or diagnosed PCOS, metabolic-related hormone disruption, or persistent hormonal symptoms that need a more detailed assessment.

This panel should be paired with the full Women's Fertility Expert Panel.

It is recommended to fast for at least 8 hours before your draw.