Is Cortisol useful for Fruchtbarkeit?

Cortisol is a stress hormone regulated by the hypothalamic-pituitary-adrenal (HPA) axis. Chronically elevated cortisol can impair fertility by suppressing gonadotropin release (LH, FSH), disrupting ovulation, and negatively affecting sperm quality. However, a single cortisol test (e.g., in saliva or blood) is not a standard part of fertility workup. Evidence comes mainly from studies linking stress and infertility, not from routine clinical panels. Elevated cortisol may indicate chronic stress, poor sleep, or adrenal pathology, but interpretation requires clinical context. Direct cortisol measurements are less relevant for fertility assessment than measuring LH, FSH, estradiol, progesterone, and testosterone. In summary: cortisol can be useful as part of a stress evaluation, but not as a standalone fertility marker. The evidence is moderate, based on physiological principles rather than large randomized trials.