Genesis Fertility Clinic Blog
searching: “fsh”
June 16, 2010
AMH
Fertility declines with age because egg number and quality decrease over time. This happens to all of us (unless you are a celebrity it seems! Ok, that’s a donor egg discussion I’ll leave for another entry).
To get a sense of how many eggs a women has left, and therefore how long she might be able to conceive, we test “ovarian reserve.” In general the two most commonly used and reliable tests are day 3 FSH and Estradiol levels and an ultrasound to count antral follicles (antral follicle count; AFC).
At Genesis we typically combine the information we get from the FSH level and AFC to get a sense of how many eggs are left – are you running low or do you have a good number for your age? You can read more about ovarian reserve testing elsewhere on this site.
There are other tests of ovarian reserve. It seems every few years a new one pops up, but until recently none has proven to be better than the FSH and AFC combination. Recently, anti-mullerian hormone (AMH) has been examined in large populations of women. It seems to be as good (some argue a little better) than AFC and FSH combined. I don’t think it’s better, but it can be helpful if the FSH and AFC are borderline or inconsistent.
It’s now available in BC through Lifelabs but for a fee of $225. I suspect in time it will be covered by MSP, but we’ll see.
FYI
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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April 22, 2009FSH disappointment
My relationship with my patients is very important and there is nothing better than being able to help a patient fulfill their dream. But sometimes I have to deliver bad news. One of the most difficult things I have to do as a doctor is to tell a patient she has little or no chance of conceiving because her FSH is high.
FSH (Follicle Stimulating Hormone) is a hormone that the pituitary gland in the brain releases to grow eggs. As a woman ages and the number of eggs in her ovaries declines, the pituitary gland needs to release higher and higher amounts of FSH. So, FSH is a fairly good test of ovarian age and therefore fertility (older ovaries have eggs that are less fertile than younger eggs). There are other test of ovarian age that I use, but in general a day 3 FSH is a good start.
If a woman’s FSH is high – which generally means > 12 U/L – I worry. If the level is > 20 U/L I panic as this usually means there is little to no chance of a woman conceiving with her own eggs. While lots of babies are born to women with higher FSHs the chances go down as FSH goes up.
Telling a woman that her FSH is high and what that means isn’t easy but more importantly this is very, very hard news for her to hear. I have had to deliver news of a high FSH to women as young as 16. It’s tough and many women feel angry, sad, hopeless, lost and more. Some lash out on the internet, some isolate themselves, some enter a prolonged depression. There are options for women with high FSH including donor eggs and adoption but often women need a grieving period before they are ready to look at other possibilities for motherhood. The good news is that if they do decide to use donor eggs their chances of getting pregnant are excellent.
Delivering bad news is an art… an art I am still learning.
For more information of ovarian aging you might wish to read this article
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility