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High FSH: an Excuse to Send Patients Away

Catherine McDiarmid-Watt | Wednesday, October 10, 2007 | 0 comments

It is really hard, if not impossible to become pregnant with a high FSH level. The number of quality eggs is just too low. But some people defy the odds.

Many fertility centers don’t like to treat women with elevated FSH levels because the odds of pregnancy are lower, thus lower statistics, and it’s frustrating for the physician to deal with failure. But I believe there needs to be a little more wiggle room when it comes to FSH levels.

Some doctors say once there is one elevated FSH, it's over. This is not true. FSH levels go up and down from cycle to cycle (could be by a few points), so one elevation, along with other levels that are in the normal range, does not mean sterility. Therefore, I always repeat levels when the first reading is high. (I do have to say that repeatedly high levels are a very bad sign and should not be ignored.)

Here are today’s examples.

A 43 year old woman came back after having her first baby with IVF. Her FSH was 14.6, over the 12.4 limit at NYU. I repeated the level and it was 12.1. We started an IVF cycle with a level of 12.8, slightly over my limit, but I felt there was wiggle room and wanted to give her a shot. She had a successful cycle.

Unfortunately, not all of the stories are as hopeful.

A 39 year old had a day 3 FSH level of 10. This is borderline but good enough. I started her IVF cycle with a level of 12.5, very slightly over my limit. Despite 7 days of high dose fertility drugs, she didn’t make one egg and was cancelled.

The point I want to emphasize is that FSH is a far from perfect predictor of outcome. A low level does not guarantee pregnancy. An elevated level may be bad news, however women should not be overly discouraged when a single blood test shows a high level. Repeating the test is very important, as is making attempts at pregnancy when the levels are borderline.

Next time I want to clarify the estradiol level and give my opinion on protocols to lower FSH levels.


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About Catherine: I am mom to three grown sons, two grandchildren and two rescue dogs. After years of raising my boys as a single mom, I remarried a wonderful man who had never had a child of his own. Unexpectedly, I found myself pregnant at 49!
Sadly we lost that precious baby at 8 weeks, and decided to try again. Five more losses, turned down for donor egg, foster care and adoption due to my age and losses - we have accepted that there will be no more babies in our house.

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