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High FSH: Diagnosis
High levels of follicle stimulating hormone (FSH) and poor ovarian reserve (poor responders) go hand in hand. If you’re having infertility problems, it could be due to a decline in the number and quality of your eggs. This decline is indicated by high levels of FSH.
Day 3 FSH Test
The most common measure of ovarian reserve is a simple blood test called the Day 3 FSH level. Day 3 is the third day of menstrual bleeding. A high FSH level indicates poor ovarian reserve or possibly ovarian failure.
You should get the test results a day or two after the test. If you need follow up tests, they are conducted on cycle days 4 and 5.
There are three things to keep in mind about a FSH test:
- Although high levels of FSH usually mean you have poor egg quantity and quality, a normal level doesn’t necessarily mean you’re fertile. This is especially true if you’re in your 40’s.
- Your ovarian reserve is based on your highest FSH level. Even if a subsequent test results in a lower number, it doesn’t mean your egg quality is improving.
- Different laboratories use different systems to assess FSH so have one lab do all the work so you can accurately compare results.
Clomiphene Challenge Test
The clomiphene challenge test (CCT) provides an earlier measure of declining ovarian reserve than the FSH test. After measuring day 3 FSH levels, you take the medication Clomid or Serophene from days 5 to 9 and then re-measure FSH levels on day 10. A FSH level that is higher on day 10 than on day 3 suggests poor ovarian function and predicts poor ovarian response.