Taking Charge of Your Health

FSH stands for follicle-stimulating hormone
it is one of the so called gonadotropins, which is released by the pituitary and as
the name says stimulates the Dr. growth of follicles. That’s its physiological function
but in reproductive medicine it has been our main diagnostic tool for many decades in assessing
how well ovaries are still functioning in a woman. Practically every gynecologist, even
if not specializing in infertility, uses FSH to get at least a first impression of where
a woman stands in terms of her reproductive capacity. The standard answer that you will
get in most textbooks and from most colleagues is that an FSH up to ten milli international
units per ml is considered normal, some people even say up to 12. We don’t believe that.
FSH increase as women get older and therefore to assume that what represents a normal FSH
level for young women, lets say for a 21 year old, is the same as what represents a normal
FSH level for a 43 year old, simply does not make sense. Yet, that is how medicine and
our specialty has been proceeding for the last thirty years. And we therefore a few
years ago established what we called, age-specific FSH levels. And we therefore, today in our
practice, use those to determine whether a woman has normal ovarian reserve or not. What
represents a maximum FSH level is relative depending on the age and other surrounding
factors. But I can say that once an FSH of 30 is reached and definitely once an FSH level
of 40 is reached, for all practical purposes becomes very difficult if not impossible,
even for young patients to conceive. The younger the patient the better our chances will be
to still achieve pregnancy with use of a woman’s own eggs, even if her FSH is high. The FSH
is not the disease, FSH is the symptom it is a reflection of what the ovary does. So
we really don’t look at the given FSH level at the particular moment. We look much more
comprehensibly at what the ovarian reserve of that patient looks. If you wait until FSH
comes down, you may be waiting through the last few months of a patient’s opportunity
to conceive. We really do not believe in waiting. We believe in waiting while medications that
we give beneficially impact the ovaries such as DHEA. But as soon as we can get going we
like to get going. Many of our colleagues believe that diminished ovarian reserve is
untreatable. Our center really does not believe that, hasn’t believe in that for a good number
of years, principally based on our experience with DHEA. Through our DHEA. experience we
have come to a new understanding of ovarian aging. One of the interesting observations
that we have made in our DHEA treated patients with very very severely diminished ovarian
reserve is that not only are we getting a surprising number of pregnancies but once
these women get pregnant our miscarriage rates are surprisingly low. Approximately one third
of women who come to us because they were told that their only chance of pregnancy is
through donor eggs, leave us pregnant with the use of their own eggs. So a minority but
still a quite significant portion of patients with very very poor ovarian reserve and usually
quite high FSH, with appropriate treatment at CHR will still have a very decent pregnancy
chance. Is a diagnosis, it basically means that that woman is prematurely aging in her
ovaries. It is very frequently not recognized that young women have lower FSH levels than
older women and that therefore the cut off of what is normal in them has to be set lower.
We call that age specific ovarian function testing, or age specific FSH in this context.
And that is a crucially important concept if one wants to make the diagnosis of premature
ovarian aging. Many younger women circulate for years amongst fertility centers with a
diagnosis of so called unexplained infertility, because no one has looked at their FSH or
AMH values in an age specific way. And once they are recognized to suffer from premature
ovarian aging than the whole treatment paradigm changes. Then you stimulate them differently,
then you approach them differently and suddenly those women who for years didn’t understand
why they didn’t conceive, suddenly they get pregnant.

43 thoughts on “High FSH Treatment

  1. Hello phyllobaby,

    It really depends. Some women develop high FSH in their twenties, while others may be 40 when that happens. The key is to identify the rising FSH levels if it's happening prematurely. For this reason, we use age-specific normal range of FSH levels at CHR, to identify the rising FSH levels early. If we know there's a problem early on, our fertility treatment will be more successful.

    Hope that helps!

  2. Thank you Dr Gleicher! Because of your research into DHEA and your attitude towards older women wanting to become mothers, I now have the most beautiful son! He is now almost 3. I had him at 40.

  3. Hi my age is 31.and my FSH level is high …Doctor says that i cant conceive as my ovaries have stopped producing eggs..i m desperate to have a child is there any other way of conceiving apart from IVF

  4. It's time for our #fertility Friday video! To follow up on last weeks video about AMH levels – this week we suggest watching our video discussing FSH levels. Dr. Gleicher describes the importance of FSH for fertility and high FSH treatment:
    High FSH Treatment

  5. I'm 52 and not felt well for 3-4 years. I ask, ask, and ask to have more indepth test on my Thyroid and hormones. Instead, I was just give anti-depressants. I recently found an Internal medicine physician after relocating to a different state. My FSH level was 117 and now on progesterone. It seemed to help initially, however did not help my symptoms significantly. Now I'm gaining weight. I need to have the level checked again. Not sure how to proceed. This health challenge has set me back from never being sick to costing my job.

  6. My FSH was checked 3 months ago and it was a 7 and my progesterone was an 8. Can you tell me what that would mean for my age? I am 43 and I'm hoping to conceive on my own naturally. My HSG showed no blockages but my concern is my fiancé just had his semen analysis done for count which was 150 but the motility is slow. Is there anything that he can do to help with motility?

  7. Hello, i was diagnosed with POF when I was ariund 15. my first FSH reading was 88, I'm now 33 and my readings usually come in around 60+ now. I have been under various UK specialists and have had various test son my bones due to almost none existant estrogen and also my geynes tested too.

    Over the years, I have struggled with hot flashes, sleepless nights and have been on an emotional roller coaster. Everyone I have been under find me a bit of a mystery because I do have spradic periods. I can go a year or so with and miss a few months or vice versa. Various HRT prescribed and also contraception pills with anti depressants as I was never offered councling at the beginning. I still struggle on a daily basis to keep my both my hot flashes and emotions in check.

    It can be horrible when you are feeling low or can't wear certain clothes because eof hot flashes but if there's anything good to come out of all of this, it is that I have become a stronger person who is also able to discuss this condition with people who are not aware when saying so how many children do you have or do you not want any. years ago I would have broken down , now I explain that I have Pof and some people are happy to ask questions which I can now answer with dry eyes and confidence.

    stay strong x

  8. my FSH level 17.5 mlu/ml
    and LH 12 mlu/ml
    and testo 21 so now to reduce my FSH and LH
    and also may prolactin 1046 mlu/l

  9. When I was diagnosed, we were told that my case was bad enough, if we wanted our own baby we could try IVF but realistically we would really need a surrogate to be able to carry for me.

    please, i request your address email.
    thank you very much

  11. Hi I'm 37 and was told at the age of 16 I don't overlate and no eggs I was told i was going throw early menopause and the only way was to have a egg doner I never did any fertility treatments or any drugs is there so something you can advise me your help me on I'm from London England then I went to a lot of doctors and specialists and they told me to go on HRT and I can never have a child I'm going through early menopause perimenopause and there's nothing they can do for me

  12. Hi my IVF cycle was cancelled due to poor response about 4 weeks ago. My RE prescribed a medication to bring on my cycle. I asked her to test my FSH and she said it wasn't important. I would like to know if I could get it tested on day 3 of the medically induced cycle or should I wait for the next natural cycle?

  13. Respected Doctor,
    I am 42 years old male person and I have azoospermia with FSH – 26.11(1.4 – 15.4), LH – 8.34(1.2 – 7.8) and Testosterone (t) – 2.43(0.26 – 10), TSH – 0.93(0.45 – 4.5). Testicular USG (HR) is also normal but, Bilateral Smaller Volume Testis(R= 3.29cc & L= 3.23cc).
    Sir, I want to know that in this situation how much treatable my abnormalities and may able to treat my problem by any medicine to get my fertility?

  14. Respected doctor
    My fsh level is 26.6 and lh level is 23.12 and sr. Tesesterone level is >13.6 have any treatment sir please give me reply sir.

  15. Sir, do you provide consultation from abroad or can you lead the protocol from abroad? I am living in Europe and have no chance to come to your clinic.
    Thank you

  16. Eliminate gluten, night shade vegetables, dairy, sugar completely from diet. Avoid eating after 8 pm. Walk daily for 1 hour. Do Maya abdominal massage and fertility yoga asana. Take calcium and vitamin d3 supplements. Be positive and pray and manifest. See the magic of GOD

Leave a Reply

Your email address will not be published. Required fields are marked *