High FSH (Follicular Stimulating Hormone)
Testing FSH (follicular stimulating hormone) levels is one of most common fertility tests. FSH level is used as an indirect estimation of the number of eggs, the so called “ovarian reserve”.
What is FSH:
FSH stands for “follicular stimulating hormone”. It is a hormone produced by the brain that stimulates the ovaries to produce estrogen. FSH also influences the growth and maturation of the egg.
Who should be tested for FSH:
FSH is usually tested in women age 35 or older. It can also be tested in women that have low response to fertility drugs, women that underwent surgery on their ovaries (removal of ovarian cyst or endometriosis), women that received chemo therapy or radiation therapy, women that require higher dose of fertility medications as well as women that are concerned about age and would like to test their fertility.
Can FSH be tested at any day of the menstrual cycle?
No, FSH ideally should be tested between the second and third day of the menstrual cycle. FSH tested before or after that “window” of time can give an inaccurate result.
What is considered a normal FSH?
There is no “normal” or “abnormal” FSH. The FSH level and the interpretation can vary based on the laboratory that is used, the patient ‘s age and the underlying clinical diagnosis.
At the Center for Fertility and Gynecology we consider
- FSH of 10mIU/ml or below – a “good” FSH
- FSH 10mIU/ml -15 – “borderline”
- FSH > 15: “high FSH”
If I have a high FSH, does this mean that I can’t get pregnant?
A high FSH does not necessarily correlate with the ability of a woman to conceive. Patients that have higher FSH are at higher risk of not responding well to fertility treatments and are more likely to produce less eggs and embryos during an in-vitro fertilization cycle. At the Center for Fertility and Gynecology we use different fertility treatments and protocols that are especially tailored for women with high FSH such as “Natural IVF”, “Assisted hatching” “Low dose IVF” .
Where can I test my FSH level?
Most laboratories can test the FSH level. You will need a requisition from a doctor to order the test. FSH is usually ordered along with an estradiol level for a more accurate interpretation of the result. The test result should be best interpreted by a fertility specialist.
Can my FSH change over time?
Yes, FSH can change from one month to another. It also can change over time.
If my menstrual periods are regular, does that means that my FSH and/or my ovarian reserve is normal?
Most women with a high FSH have very regular periods. There is a misconception that high FSH or diminished ovarian reserve are associated with irregular periods. Most women with elevated FSH have no symptoms and are not aware of their condition.
If I’m younger than age 35, should I still test my FSH level?
While women at age 35 and older are at higher risk of having a high FSH or diminished ovarian reserve, younger women can also have accelerated “aging” of their ovaries and present with diminished ovarian reserve.
Are there any other tests other than FSH that can estimate my fertility?
Yes, there are many tests that evaluate ovarian reserve. At the Center for Fertility and Gynecology we used a combination of tests in order to estimate the fertility potential.
If you would like to test your FSH level or request more information on fertility testing, please contact us at the Center for Fertility and Gynecology.