Follicle-stimulating hormone, or FSH, is a hormone released from the pituitary gland in the brain that stimulates an egg follicle to grow each month as part of the menstrual cycle.
If your healthcare provider suspects you may have PCOS, he or she will order blood work for FSH along with other hormone levels prior to diagnosis. Older women tend to have elevated blood levels of FSH, which indicate ovarian maturing. This is because greater amounts of the hormone are required for the ovary to recruit and stimulate an egg follicle.
Throughout your menstrual cycle, levels of FSH vary. Healthcare provider s often test FSH levels on day 3 of your cycle. These are considered your baseline levels. FSH stimulates an immature follicle to grow. Once it is grown, it releases estradiol, which signals the release of GnRH and LH, prompting ovulation. Prior to ovulation, FSH levels will peak, signaling the ovary to release an egg.
Once ovulation has occurred, the levels will return to or dip slightly below the baseline. Normal baseline FSH levels are between 4. Certain medications, such as birth control pills, clomiphene, digitalis, and levodopa, can alter the test results.
Your healthcare provider will instruct you to stop taking those drugs before taking an FSH test. In the case of hormonal birth control, it should be stopped at least four weeks prior to taking the test. Since women with PCOS have low FSH levels and, therefore do not ovulate regularly, she will typically see a fertility specialist or reproductive endocrinology for help in getting pregnant when the time is right.
These specialists, known as reproductive endocrinologists, will use a variety of drugs and hormones to promote ovulation and stimulate secretion of the sex hormones in women with fertility problems. Reproductive endocrinologists will use a synthetic form of FSH such as Gonal-f, Follistim, or Bravelle to stimulate the ovaries to produce egg follicles for either intrauterine insemination IUI or in vitro fertilization IVF.
Many women are often anxious to hear that shots are needed to stimulate ovulation. While injections may be uncomfortable, it's important to keep your eyes on the bigger picture—having a baby. In women who want to become pregnant later in life, FSH levels are used to test ovarian reserve the number and quality of eggs a woman has left. Your healthcare provider will have blood work drawn on the third day of your menstrual cycle. The results are typically available within 24 hours depending on the lab.
Premature ovarian failure. My FSH level is normal, so that factor is definitely not the problem. This is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
You May Also Like. Missed Miscarriage: Causes, Symptoms, and Treatments. Does the Keto Diet Impact Fertility? Speak to your doctor for an accurate interpretation. Additionally, a comparison with your LH and estrogen levels specifically estradiol, or E2 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.
One study found that women could have normal FSH levels well past the age that difficulty getting pregnant would begin based on age. Day 3 FSH level testing is only one way to measure ovarian reserves. Your doctor is likely to look at a variety of indicators before making a diagnosis. But AMH levels can be tested at any time during the menstrual cycle. Also, research has found that AMH more accurately determines potential ovarian reserves.
Another test is an antral follicle count ultrasound exam. This is a transvaginal ultrasound exam where a technician counts the number of follicles of a specific size in the ovaries. One downside of antral follicle testing is that the results can vary based on the skill of the technician. However, the test is worthwhile and can give your doctor a better idea of your potential ovarian reserves.
But your doctor can help you determine what type of testing may be appropriate for your situation. Get diet and wellness tips to help your kids stay healthy and happy.
Waiting for an elevated FSH--too late a marker of reduced ovarian reserve? Evaluating ovarian reserve: follicle stimulating hormone and oestradiol variability during cycle days Hum Reprod. J Assist Reprod Genet. Orlowski M, Sarao MS. Physiology, follicle stimulating hormone.
In : StatPearls [Internet]. StatPearls Publishing; updated April 27, J Reprod Infertil. Premature ovarian insufficiency - aetiopathology, epidemiology, and diagnostic evaluation. Prz Menopauzalny. Follicle stimulating hormone and its rate of change in defining menopause transition stages. J Clin Endocrinol Metab. Steiner AZ. Clinical implications of ovarian reserve testing.
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