If you have been told by a fertility doctor that your FSH levels are high, you may have got the sense that this is not good news. Unfortunately, it's true: if you have high FSH levels, the probability of your conceiving a child with your own eggs is low. A high FSH number suggests that your ovarian reserve--the number of eggs left in your ovaries--is low, and that your remaining eggs are of poor quality. However, despite the low odds, some women with high FSH levels are able to get pregnant.
What is FSH?
During the first few days of a woman's menstrual cycle, the pituitary gland (a small region in the brain) releases a hormone called Follicle Stimulating Hormone (FSH). This hormone stimulates the ovaries to mature an egg. Once the egg has been selected and the maturing process begun, the ovaries send a different hormone to the pituitary gland to stop releasing FSH. When a woman's ovarian reserve is low, the ovaries often fail to respond to FSH. The pituitary gland then increases its output of FSH, hoping to spur maturation. This is why some women, particularly those over the age of 38, have high FSH levels.
FSH Test for Ovarian Reserve
You can have your FSH level (and thus your ovarian reserve level) assessed by a simple blood test. Generally, your doctor will have you take a test on the second or third day of your menstrual cycle to determine what level your FSH is on that day. Your FSH level will then be compared with a baseline number. In general, women with an FSH level of 9 are considered to have a normal ovarian reserve, those with levels of 9 to 25 are believed to have a borderline reserve, and anyone scoring over 25 is considered to have a poor reserve. However, baseline numbers vary from lab to lab, so be sure to confirm the relevant baseline FSH levels at the lab where your test was performed. Also, note that while FSH numbers can change from test to test, it is generally considered that your ovarian reserve is only as good as your worst test result.
FSH and Assisted Reproductive Technology
If you are found to have high FSH levels, depending on your age and any other reproductive conditions, your doctor may want to start you on aggressive fertility treatments as soon as possible. However, even aggressive fertility treatments will not help most women with high FSH levels to become pregnant. This is because a key component of most advanced fertility treatments is using increased amounts of FSH to stimulate egg maturation. As women with high FSH levels already have excess FSH in their system, adding more usually does not help, although in a few cases it can. Further, women with high FSH levels that do fall pregnant often miscarry because their eggs were of poor quality. Most women with high FSH levels have success with assisted reproductive technology if they use donor eggs.
FSH and Alternative Therapies
While there are no formal studies showing that FSH can be lowered through alternative therapies such as change in diet or acupuncture, there is substantial anecdotal evidence that suggests that such therapies may make a difference. Dr. Randine Lewis of the National Infertility Association (RESOLVE), believes that women can lower their FSH and improve their egg quality by making strict dietary changes and undergoing a specific acupuncture regime (see, for example, RESOLVE link in Resources).
If you have a high FSH level and want to get pregnant with your own eggs, join an online support community to keep abreast of the latest treatment options and to chat with others facing similiar obstacles. See Resources below for relevant links.
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