Saturday, February 20, 2010

How can I reduce my FSH levels ?

Human oocyte with surrounding granulosa cells,...Image via Wikipedia

One of the key factors which influences the outcome of an IVF cycle is the number of eggs the wife grows. This depends upon her ovarian reserve and this is a key metric which IVF doctors need to track.

We can measure the ovarian reserve using three tools:
• the antral follicle count;
• the AMH level ; and
• the FSH level.

Of these, the FSH level has been the blood test which has been around for the longest and is the one most infertile women are familiar with. It often becomes a number which many women start obsessing over, just like infertile men obsess over their sperm counts. This is especially true for older women, who know that the success of their IVF cycle is often dependent upon this.

It’s important to remember that the FSH level is just a marker for ovarian reserve. This means that the high FSH level is not the problem – it simply signals the fact that you have poor ovarian reserve. In fact, it’s very easy to reduce the FSH level – just take estrogen medications , and it will go down to normal in one week. This because estrogens suppress the high FSH level ( in a mechanism called negative feedback), and bring it back to the normal range. However, using estrogens to bring the high FSH level to the normal range obviously does not improve the ovarian reserve. We know that women are born with a certain number of eggs , and this ovarian reserve gets depleted as time passes, until it reaches zero, at the menopause.

So what can you do to reduce your high FSH level ? Women are often confused because they often get conflicting information from IVF specialists. Most will say that a high FSH is not treatable and will recommend the use of donor eggs straight away. Others will recommend alternative medicines such as acupuncture and DHEA to try to improve the ovarian reserve. To add to the confusion, there are lots of anecdotal success stories and first person accounts on bulletin boards all over the internet of women who have brought down their high FSH levels using diet and detoxification . A good website which compiles a lot of this information is Unfortunately, one swallow does not make a summer – and lots of time there’s precious little we can do to affect ovarian reserve.

The major danger is the large number of websites which sell herbal medications and magic potions which claim to reduce the FSH level. Examples include Fertility Blend. They make a lot of unsubstantiated tall claims, but because they are very cleverly marketed, they find it easy to dupe thousands of desperate women who are very unhappy with their doctors who cannot help them.

It is true that FSH levels do vary from cycle to cycle, and this makes it even harder for women, because they simply cannot make sense of what causes it go down in one month and then increase in another.

So how can you make sense of your FSH levels ?

Firstly, understand that this is just one imperfect marker of ovarian reserve – and that doctors do not treat numbers, but patients.

Also, understand the inverse relationship between estradiol levels and FSH levels. It’s a good idea to check both at the same time, whenever you test your FSH level

Finally, remember that there are now better tests for checking ovarian reserve, such as AMH ( antiMullerian hormone) levels, which can be used to confirm a diagnosis of poor ovarian reserve.

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