What Happens During The Test
The test for the FSH level is simple and involves the following steps:
With any procedure, a small amount of risk is involved. Slight risks include:
- vasovagal syncope, or fainting at the sight of blood
FSH levels vary based on gender and age. They also vary depending on where a woman is in her monthly cycle. Each lab has a slightly different reference range. You should discuss your results with your doctor.
Low Fsh Levels In Women
Having a low FSH level can indicate:
- You arenât making eggs
- The pituitary gland is not functioning correctly
- There is a problem with the hypothalamus
- You are underweight or have lost weight quickly
- Eating large amounts of soy
- You may have hypothyroidism
Symptoms of low FSH levels include delayed puberty, infertility, and irregular menstrual cycles.
What Produces Fsh Hormone
Both FSH and LH hormone are produced by the pituitary gland at the base of the brain. When a women goes into menopause she is running out of eggs in her ovaries. The brain senses that there is a low estrogen environment and signals the pituitary to make more FSH hormone. More FSH is released from the pituitary in an attempt to stimulate the ovaries to produce a good follicle and estrogen hormone.
Think of it like stepping on the gas pedal in the car to get going. The FSH is the gas, and the pituitary gland releases FSH to get a follicle going at the beginning of every menstrual cycle. If there are less follicles left the amount of gas has to be increased to get a follicle developing.
In a menopausal woman, the gas pedal is on the floor for the rest of her life even though there are no follicles left. The womans body never gives up trying FSH levels are permanently elevated.
Women in menopause have high FSH hormone levels above 40 mIU/ml. As women approach menopause their baseline FSH levels will tend to gradually increase over the years. When they run out of follicles capable of responding, their FSH will be high and they stop having periods.
- If this happens in a woman under age 40, we call it premature ovarian failure or primary ovarian insufficiency
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What If I Have Low Fsh Levels
Low FSH levels are not common and may indicate that there is a problem with your pituitary gland. For example, hypopituitarism is a rare condition that prevents your body from making enough hormones, which can result in low levels of FSH.
Symptoms of hypopituitarism include stomach pain, excessive thirst, excessive urination, fatigue, anemia, and weight fluctuations. To diagnose hypopituitarism, your doctor will want to check your hormone levels with a blood test. This may be followed by an MRI of your pituitary gland.
In addition to hypopituitarism, being underweight can also cause disruptions with your hormones. If you are struggling to maintain a healthy weight, its a good idea to speak with your doctor about strategies for gaining weight safely.
In Vitro Fertilization Ivf
In vitro fertilization is a treatment for infertility, not a test. However, the IVF cycle details can give useful information about egg and embryo quality. By careful examination of the eggs and embryos during in vitro culture we can get clues about why pregnancy has not occurred previously.
For example, the eggs may demonstrate poor morphology, may have problems with maturation, with fertilization, or with proper cleavage, etc..
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Purpose Of Fsh Level Test In Men
Fertility is never just a woman’s issue men can also contribute to infertility. Around 8% of American couples struggle with infertility due to the male. The following are reasons why men may need an FSH level drawn:
- Partner has not achieved pregnancy after 12 months of trying
- Experiencing: fatigue, weakness, weight loss, or decreased appetite
What Are Normal Fsh Levels
A study on day 3 FSH levels and IVF outcomes showed that women with day 3 FSH levels lower than 15 mIU/ml had a better chance of pregnancy achievement per IVF attempt when compared to women with FSH levels between 15 mIU/ml and 24.9 mIU/ml. For women with day 3 FSH levels over 25 mIU/ml, pregnancy rates per attempt were even lower.
Sometimes FSH levels are normal, but day 3 estradiol levels are abnormally high. If your estradiol is high, but your FSH levels are normal, you may still have poor ovarian reserves. High estradiol levels can suppress FSH, because FSH and estradiol work together. When estrogen levels are high, the body lowers FSH in response. If your estrogen levels are high, your FSH levels will naturally drop, but this doesnt mean your ovaries are responding to the FSH.
A normal range will vary between labs, as a normal value at one clinic may be considered abnormally high in another. Speak to your doctor for an accurate interpretation. Additionally, a comparison with your LH and estrogen levels is required to get the entire picture.
Sometimes, women want their FSH levels tested in order to get an idea of whether they should start trying to have a baby soon or if they have more time. If you get a normal result, you may think you dont have to worry about age-related infertility.
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Fsh Levels In Women: Whats Normal
Shelby Hale
Katerina Shkodzik
M.D., OB-GYN
Released by the pituitary gland, follicle stimulating hormone is a gonadotropic hormone that works alongside luteinizing hormone to regulate key reproductive processes. In women specifically, FSH is known for stimulating the early development of ovarian follicles, which eventually go on to release an egg during ovulation.
To help you better understand how this hormone works and what levels you can expect it to be throughout your menstrual cycle and beyond, heres a closer look at what FSH is, what it does, and what are considered normal FSH levels. Well also cover what it may mean if your FSH levels are too high or too low, and how you can have your FSH levels tested.
While FSH is produced by both men and women, please note that this article focuses on the role that FSH plays in the female reproductive process.
How Do Fsh Levels Affect Fertility
Medically Reviewed by Dr. Kevin J Campbell, MD, a fellow in Male Reproductive Medicine and Surgery at Bayor College of Medicine in Houston, TX, with Dr. Larry Lipshutlz.
Normal FSH levels in adult males are typically between 1.5 to 12.4 mIU/mL. A high FSH level in a male may mean the testicles are not functioning correctly. While low FSH levels in males may indicate problems with the pituitary gland in the brain or medications that suppress the brains ability to make your sex hormones.
FSH in Males
Follicle stimulating hormone is a hormone released by the pituitary gland in the brain. In men, it stimulates testicular growth and helps produce a protein that plays a vital role in male fertility by aiding in the creation of normal sperm cells and maintaining them until they are ready to be released. Without normal FSH levels, it may be difficult or impossible to create normal sperm, leading to infertility.
FSH levels can be detected using a simple blood test. Normal FSH levels in adult males are typically between 1.5 to 12.4 mIU/mL .
High FSH Level
A high FSH level in a male may mean the testicles are not functioning correctly. Causes of this may include damage to the testicles , genetic problems, advancing age, hormonal disorders, certain medications , diseases such as HIV/AIDS or Type 2 diabetes, or tumors of the pituitary gland.
Low FSH
Low FSH levels in males may mean the pituitary gland in the brain is not functioning properly.
Treatment for Abnormal FSH Levels in Men
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Day 3 Estradiol Testing
A blood estradiol level on day 3 of the menstrual cycle is a way to potentially discover some of those women with a normal day 3 FSH that may in fact have decreased egg quantity and quality.
What we want on day three is a low FSH level in conjunction with a low estradiol level. If the FSH is normal but the estradiol level is elevated, the elevated estradiol will often be artificially suppressing the FSH level down to the normal range.
The idea of using day 3 estradiol levels as an adjunct in evaluating egg quantity and quality is relatively recent. Clearly defined cutoff values for normal are not well established. We like to see the day 3 estradiol less than about 80. We repeat borderline or abnormal results in another menstrual cycle to try to get a true FSH.
There is some evidence that an elevated day 3 estradiol indicates a problem with ovarian reserve. This is sometimes the case, but often the issue is just that the elevated estrogen level is masking the potential for detecting low reserve by suppressing FSH into the normal range.
Amh May Be More Useful Than Fsh
What makes the universal FSH cut-off approach even more problematic is the fact that themost up-to-date medical literature suggests that FSH is not as specific as it was once thought. Anumber of papers published by CHR’s physicians suggest that AMH is actually more specificthan FSH in assessing ovarian reserve and pregnancy chances with IVF. Better AMH specificitymakes sense because AMH reflects the smaller follicles, which represent a majority of awoman’s ovarian reserve. Given the superiority of AMH, IVF treatment decisions based on the FSH level alone, appearsoutdated.
While tests to check AMH and FSH levels are important in assessing ovarian reserve, both havelimitations. Neither result can, indeed, categorically determine whether a woman can or cannotconceive, unless she has very high FSH levels. In addition, women can get pregnant with IVFeven when AMH is completely undetectable, as over 50 pregnancies established so far at CHR inwomen with undetectable AMH levels clearly demonstrate. Therefore, placing too muchemphasis on high FSH and low AMH can be misleading. It can also be harmful, as somephysicians make patients wait for low FSH levels to magically appear in the next blood testbefore starting an IVF cycle–a practice that wastes precious time and makes no physiologicalsense.
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Norbert Gleicher Md Facog Facs
Norbert Gleicher, MD, leads CHRs clinical and research efforts as Medical Director and ChiefScientist. A world-renowned reproductive endocrinologist, Dr. Gleicher has published hundredsof peer-reviewed papers and lectured globally while keeping an active clinical career focused onovarian aging, immunological issues and other difficult cases of infertility.
Fsh Levels Before Pregnancy
Before pregnancy, FSH levels typically range between 1.4-9.9 mIU/mL during the follicular phase, and 1.1-9.2 mIU/mL during the luteal phase.
During the follicular phase, FSH helps to stimulate the development of the ovarian follicle, so that it can eventually develop an egg and ovulate. During the luteal phase, FSH levels drop slightly but continue to stimulate the ovaries to produce estrogen and progesterone.
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What Is A Follicle
This test measures the level of follicle-stimulating hormone in your blood. FSH is made by your pituitary gland, a small gland located underneath the brain. FSH plays an important role in sexual development and functioning.
- In women, FSH helps control the menstrual cycle and stimulates the growth of eggs in the ovaries. FSH levels in women change throughout the menstrual cycle, with the highest levels happening just before an egg is released by the ovary. This is known as ovulation.
- In men, FSH helps control the production of sperm. Normally, FSH levels in men do not change very much.
- In children, FSH levels are usually low until puberty, when levels begin to rise. In girls, it helps signal the ovaries to make estrogen. In boys, it helps signal the testes to make testosterone.
Too much or too little FSH can cause a variety of problems, including infertility , menstrual difficulties in women, low sex drive in men, and early or delayed puberty in children.
Other names: follitropin, FSH, follicle-stimulating hormone: serum
Background On Ovarian Reserve Testing
- We would like to have a reliable test to determine how many eggs a woman has remaining and how good they are at any point in time
- There are screening tests for ovarian reserve as fertility doctors call it. Is there still a good reserve of eggs remaining in the ovaries?
- This page is about day 3 FSH and estradiol testing
- See ovarian reserve for more on egg quantity and quality issues and other ovarian reserve tests.
Antral follicle counts and response of the ovaries to stimulation with injectable gonadotropins are other variables that affect the overall chance for conception when we attempt IVF in vitro fertilization.
Female age is a very important variable. However, a woman can be 42 and still have some good quality eggs , or she can be 25 with poor quality eggs and be infertile, although this is rare.
In general, egg quantity and quality tends to decline slowly starting in the early 30s, and then much faster in the late 30s and early 40s.
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Fsh Levels For Female Fertility
An FSH test is a blood test that measures follicle stimulating hormone to check whether levels are normal, and it is a common part of any infertility workup ordered at a reproductive endocrinology clinic. This hormone test is not done as a urine test.
The same blood sample is typically used for FSH testing and to measure several other fertility hormones. This information is then used as an indicator of the womans ovarian function.
A low FSH result is generally associated with better ovarian function. Higher levels are associated with diminished ovarian reserve, which makes pregnancy difficult. Most women have low FSH in their 20s, and levels increase naturally as women age. For this reason, FSH is also one of the key hormones measured in fertility lab tests online that aim to gauge a younger womans future fertility. These tests evaluate whether a woman may have premature ovarian aging .
The Power Of Information
If you are one of the 82% of women who feel less than fully informed about the menopause transition, you must be your own advocate. As the AARP survey suggests:
- Women want access to meaningful, relevant, and useful information about this important change.
- Destigmatizing perimenopause will bring greater knowledge to society as a whole. They note, With more knowledge and feeling more comfortable talking openly about it, misconceptions can be corrected, resources can be made available, products and services can be developed, and more support for women can be put in place.
- More open communication regarding aging and hormonal decline will enable women to obtain better care and restore quality of life.
Access to actionable information may mean the difference between letting nature take its course and getting the treatment needed to address symptoms and minimize the risk of dangerous health conditions.
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What If I Have High Fsh Levels
If you are in your 40s or 50s, high FSH levels may be a sign that you are approaching menopause. Typically, doctors will say that you have reached menopause if your LH levels consistently test over 30 mIU/mL for a period of time.
In addition to high FSH levels, you may also find yourself experiencing other symptoms of menopause such as fatigue, mood swings, vaginal dryness, and hot flashes. To treat these symptoms, your doctor may recommend hormone replacement therapy. Many doctors also recommend certain lifestyle changes such as trying cognitive behavioural therapy , eating a balanced diet, and exercising regularly as ways to manage menopause symptoms.
POI is another condition that may cause FSH levels to be higher than average. This condition occurs in women under the age of 40 and causes the ovaries to stop functioning properly. Symptoms of POI include irregular menstrual periods, difficulty with getting pregnant, and experiencing common symptoms of menopause.
To treat POI, doctors may recommend hormone replacement therapy. If you have POI and are trying to conceive, you may want to consider fertility treatments such as in-vitro fertilization .
What Does Having High Fsh Levels Mean
An elevated FSH indicates diminished ovarian reserve. Diminished ovarian reserve is associated with a reduced number of follicles or eggs, often of questionable quality. Statistically, the chances of a successful pregnancy for women with demonstrated and consistently high FSH levels are not good.
Fertility specialists are loath to use drug-heavy, complicated therapies such as in vitro fertilization when the likely outcome is the heartbreaking disappointment of a failed cycle. So they offer egg donation as the treatment option of choice because this increases the odds of taking home a healthy baby.
But talk of statistical evidence and the donor egg alternative only stokes the pain of women who want their shot at a genetically linked child. Infertility patients are a very rare breed. We can hear that there is a 90% rate of failure for pregnancy for our diagnosis and we hear a 10 percent chance and we want it. We are often willing to gamble.
In an atmosphere so electrified by emotion, it is often difficult for patients to discern the facts that will help them make informed decisions about infertility treatment.
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