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Controversial Fertility Topics

Women With Elevated FSH Levels Can Still Achieve Pregnancy

What is FSH?

Follicle Stimulating Hormone (FSH) is a protein hormone produced by the pituitary gland and is responsible for the stimulation of ovarian follicle development and the production of eggs.

Elevated FSH Levels

There are several schools of thought in the literature concerning an elevated FSH level:

  • Initially, an elevated FSH level was thought to indicate decreased ovarian reserve and increased ovarian resistance resulting in poor ovarian response to stimulation with fertility medication and subsequently poor follicular (egg) response rates and ultimately poor pregnancy rates. Most clinics believe in this school of thought and will cancel your cycle and recommend donor eggs as your only option, quoting poor response rates and very low pregnancy rates. Even if you want to attempt pregnancy with your own eggs, they will not try.
  • The second school of thought states that if you repeat the FSH levels and they are lower, then that is a better sign, but still an indicator of decreased ovarian function and subsequently decreased pregnancy outcome. Again, most clinics will not give you the chance to attempt pregnancy using your own eggs.
  • The third school of thought states that there is little relationship between elevated FSH levels and pregnancy and that that an elevated FSH level is not an accurate predictor of pregnancy outcome and is by no means a recommendation for the use of donor eggs.

Our Stance on Elevated FSH

Arizona Center for Fertility Studies embraces the third school of thought and actually has found little relationship between elevated FSH levels and pregnancy results. The only relationship that we have found is between elevated FSH levels and age. In other words, if you are reproductively young, there is no reason not to proceed using your own eggs. If on the other hand, you are older reproductively and have an elevated FSH level, it might, but not necessarily, indicate that you may have a decreased response to stimulation and thus have decreased pregnancy rates. Some women are just low responders. That means that they just do not produce a lot of eggs but the ones they make can still be excellent.

At Arizona Center for Fertility Studies, we have had many examples of patients, young and older, with elevated FSH levels who went on to have not only successful stimulation cycles but also good pregnancy outcomes. We are currently putting together a paper for publication looking at all patients, regardless of their age, with an elevated FSH of 15 or greater; showing pregnancy rates of around 34%.

If you have an elevated FSH level and have had a poor response to ovarian stimulation, then there is always the option of considering donor eggs. It is the experience at Arizona Center for Fertility Studies that an elevated FSH level is of little value in predicting pregnancy outcome and it is our strong recommendation and experience that you attempt pregnancy using our own eggs. You should however, understand that the stimulation response may not be successful and you may not achieve a successful outcome; but you should always have the choice. This could, in retrospect, be due to the elevated FSH level or a number of other possibilities, all of which need to be evaluated for and ruled out.

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