What It Is
Levels of follicle stimulating hormone (FSH) are an indication of how many eggs are left in a woman’s ovaries. A high level means a woman doesn’t have a lot of eggs left, because the body producing more and more FSH in an attempt to stimulate the ovaries. FSH levels rise as a woman approaches and enters menopause.
Who Gets It
High FSH is usually found in “older” women as they reach the end of their procreative years. But even younger women can have a high FSH level. And while it might mean they’ll experience menopause early, it may still be possible for them to get pregnant. Risk factors for diminished ovarian reserve are age, single ovary, family history of early menopause, or prior chemotherapy or pelvic radiation treatment. Eventually, every woman reaches menopause and has highly elevated FSH levels throughout the menstrual cycle.
None, apart from a woman’s age.
How It's Diagnosed/Detected
A simple blood test can indicate an FSH level, but since the levels may vary, it’s more accurate to do a clomiphene challenge test, in which women have their FSH levels measured on days 3 to 5 of their cycle, then take the drug (brand name Clomid, Serophene) on days 5 through 9, and have FSH levels retested on day 10. This test can provide an earlier warning of diminished ovarian reserve than baseline testing alone.
How It Affects Fertility
Even women with high FSH have a diminished number of eggs, the quality of the eggs that remain could still be good. Doctors say they’ve seen patients in their early thirties with significantly elevated FSH levels who have still been able to have babies. Age is an important factor – a woman in her early 40s with moderate FSH levels may still not become pregnant, because the quality of her eggs is no longer good enough.
Higher FSH levels are a natural process of aging, and there is currently no treatment to undo the effects of aging on a woman’s ovaries. However, in vitro fertilization (IVF) treatment (often combined with ICSI, intracytoplasmic sperm injection of eggs) may still offer a woman with elevated FSH levels a chance at motherhood, often via donor eggs (which means she is not the biological mother of the child she gives birth to).
High FSH levels make conception and a healthy delivery less likely. Infertility specialists usually give patients three options: (1) They can either continue to attempt conception using their own eggs. If preliminary testing is substantially abnormal, the probability of conception with IVF or ICSI is generally less than 5 percent per treatment cycle. The delivery rate is likely less than 1 to 2 percent per treatment cycle. (2) Couples can opt for in vitro treatment with donor eggs. The pregnancy rates achieved by leading teams generally exceeds 50 percent per cycle, and delivery rates average about 45 percent per cycle. (3) The couple may choose to use donor embryos, if available.
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