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Follicle Stimulating Hormone (FSH) Test

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What it FSH?

FSH is a hormone produced by the pituitary gland. FSH causes follicles - the sacs in your ovaries that contain eggs - to grow. FSH is the primary hormone responsible for producing eggs.

In men, FSH is necessary for sperm production.

When Should You Have FSH Levels Checked?

  • You would have your FSH levels checked if your menstrual cycle has stopped or become irregular to see if you have entered menopause.
  • If you are having trouble becoming pregnant, FSH is checked as part of the standard fertility workup.
  • In men, FSH is checked if sperm counts are low and/or if the female partner is having trouble becoming pregnant.

When Are FSH Levels Checked?

You should have your FSH level checked on day 3 of your menstrual cycle. This is because FSH starts the ovulation process by getting a follicle growing. The FSH level provides information about how hard your body has to work to get this process started. If your ovarian reserve (how many eggs you have left) is low, your body will have to work much harder and FSH levels will be higher.

What Does the FSH Test Look For?

FSH levels are used to evaluate ovarian reserve, which is how many eggs you have left. It doesn’t provide information about the quality of these eggs, however.

What Do FSH Test Results Mean?

If you are in your late 30s to age 40, high FSH levels are not normal. High FSH levels indicate poor ovarian reserve. In this condition, you may have either relatively few eggs left in the ovaries or impaired development or recruitment of the eggs. Recent research suggests that this condition may be a precursor to premature ovarian failure.

There are also some congenital or genetic conditions that can result in high levels of FSH, such as Turner Syndrome or Congenital Adrenal Hyperplasia. Also, extremely rarely, high FSH levels could be the result of a pituitary tumor.

Low levels of FSH may be associated with polycystic ovary syndrome (PCOS) and disorders of the pituitary gland or hypothalamus.

In men, high levels of FSH may indicate testicular failure. Low levels of FSH may indicate failure of gonadal function.

The bottom line is that abnormally high or low levels of FSH are, unfortunately, an indicator of infertility or decreased fertility in both men and women.

Fertility Treatment and FSH Levels

If your FSH levels are abnormal, the first step is to find out if there is an underlying cause and treat it if possible. In most cases, however, there is not an underlying cause—your body simply isn’t producing the right amounts. The next step will also be determined by the results of other hormone tests. For example, if FSH is low but estradiol is high, then the estradiol may be artificially suppressing the FSH.

You may be offered a clomiphene challenge test if your FSH level is normal but you are having trouble getting pregnant. This can help to discover some cases of poor ovulation.

If your FSH levels are normal, then you will probably respond well to ovarian stimulation. As FSH levels rise, you see less response to ovarian simulation. If your FSH levels are very high, you will probably not be given fertility drugs because virtually no response would be expected.

If you are unable to become pregnant or to obtain sufficient eggs for IVF due to FSH levels, you may choose to use a donor egg with IVF.

Learn more about High FSH myths and facts here.

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Comments (111)

I have had all vertility tests as I have been struggling to fall pregnant, mt last test I was told for my age(31) I have low follicles, what does the mean???

Hi Kelly,

It could mean that you have low ovarian reserve. As we age, the number of eggs in our ovaries diminish. If your FSH level and Antral Follicle Count (AFC) suggest a decreased number of eggs/follicles at age 31, you could have premature ovarian failure. Are you working with a fertility doctor currently? He or she will be able to advise you on the best course of treatment.
Best,
Kim

My level came at 35 does this mean that I am in menopau stage, I have not gotten my period for a month. thankyou

im 40 and never been able to conceive just been told by my doctors receptionist im premenopausal and my doctor wants to talk to me about the other blood tests i have had ive had an fsh test aswell could there be anything else wrong or do you think this is standard procedure after being told im premenopausal the receptionist said my doctor will talk to me about the results but im worried still why do you think my doctor wants to talk to me about my other blood test results

I am 37 and trying to have my last child and it is proving difficult. I had my FSH level checked the 3rd day of my cycle and it was 53.2 my LH was 18.7. Is this bad?

I have been having irregular periods for about 3 years now. I have a healthy almost 5 year old boy, but since then, despite having unprotected sex for 4 years, I have not gotten pregnant. I spoke with my family doctor and he ordered an FSH level test. My levels are at 2.7 which are indicated as prepubertal levels according to my lab results. What does this mean? Am I nearing infertility? Should I be concerned? I am very scared

Hi Amanda,

Typically an FSH less than 9 means you should respond well to a fertility treatment cycle. It is when FSH reaches above 15 that it is a concern. Your fertility doctor obviously has a better overall picture based on all of your hormone levels and the fact that you have irregular cycles.

Best,
Kim

hi my sister in law lives in africa and has had problems conceiving after having an ectopic pregnancy a few years ago. she had a blood test last week the results show her fsh level as 118.6 and LH level 73.1. i cant understand how this could be?? any help would be great thanks

Hi Nonni, Unfortunately, young women can have high FSH. It is a sign that their ovarian reserve is diminishing. She would benefit from working with a fertility doctor to see what options she has for getting pregnant. Best of luck to her! Kim

Is it true that you are as good as your highest fsh? I had my test done again after a few months came back at 7.5

Hi Pie,

I have heard that you are only as good as your highest FSH, but that does not mean that there are not treatments to address high FSH. You should work with a fertility doctor who can design an IVF protocol that will yield the highest number (and best quality) eggs.

Best,
Kim

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