Understanding Elevated FSH and How It Affects Fertility
Elevated FSH (Follicle Stimulating Hormone) can be defined as a FSH value of over 10 mg/dl on day three of woman’s menstrual cycle. FSH is one of the two “gonadotropins” secreted from the pituitary gland to regulate the function of the ovary (Luteinizing Hormone, or LH, being the other). FSH stimulates the ovaries’ production of estrogen and promotes development of the follicles. The estradiol produced by the ovaries signals the brain to decrease the production of FSH. When there is not enough estrogen produced by the ovary, the brain doesn’t receive the signal and FSH production remains elevated. FSH levels predict low fertility when they are abnormal but they do not accurately predict high fertility when they are normal. Also, the cut off values are very laboratory dependent and your FSH can vary from cycle to cycle. In general, the following numbers predict:
- Less than 9: A good level and you should expect an adequate response to ovarian stimulation
- 9-10: Fair and response is between completely normal and somewhat reduced
- 10-12: Reduced ovarian reserve with a reduced response to stimulation and possibly some reduction in egg and embryo quality
- 12-17: Marked reduction in response to stimulation and more reduction in egg and embryo quality
- Over 17: Very poor response or no response to stimulation
- Over 30-40: Menopause suspected and menstrual cycles will tend to stop
Ovarian reserve is defined as the health of the ovaries and the eggs they contain. As a woman ages, the amount of eggs in reserve naturally decreases and her FSH levels increase. The amounts of eggs in reserve can only be approximated. The underlying causes of High FSH may include extreme stress, diminished blood flow to the ovaries, or lack of ovarian response to pituitary production of FSH. Typically, symptoms of High FSH may include hot flashes, night sweats, vaginal dryness, infertility, irritability, menstrual irregularity, decreased libido, and headaches. Many women with high FSH are told there is nothing that Western medicine can do to improve their chances of conception and most are advised to try in vitro fertilization (IVF) with assisted hatching, coculture, and donor eggs.
How Chinese Medicine and Acupuncture Can Reduce Elevated FSH Levels
Chinese medicine and acupuncture doesn’t believe in elevated FSH levels or poor ovarian reserve. It views these symptoms as a result of poor reproductive health rather than an inability to conceive. This is why women, who have previously been told they are too old, poor responders, and have no options due to elevated FSH, can become pregnant after their bodies achieve a state of balance and their reproductive health is restored. In our clinic, we use acupuncture, Chinese herbs, Reproductive Organ Massage, and Nutritional guidelines to restore your reproductive health and balance your system, which will increase your chances of conceiving both naturally and through artificial reproductive technologies.
Acupuncture increases the blood flow to the ovaries to nourish the developing follicles and create better egg quality and stronger embryos. It also normalizes the function of the Hypothalamus-Pituitary-Ovarian axis to regulate and improve the body’s natural hormonal production which in turn improves ovarian function and egg quality. And, acupuncture relaxes the body and reduces stress levels (elevated stress can prohibit conception by blocking blood flow to the reproductive organs and causing an imbalance in hormonal production, thus resulting irregular menstrual cycles, lack of ovulation, high FSH levels, poor ovarian production, and diminished egg quality).
Chinese herbs build strong, nutrient-rich blood for the ovaries which will better nourish the developing follicles and create better egg quality and stronger embryos. The herbs also normalize the function of the Hypothalamus-Pituitary-Ovarian axis to regulate and improve the body’s natural hormonal production which in turn improves ovarian function and egg quality. And, Chinese herbs nourish the spleen, liver, and kidney systems which are responsible for our reproductive health.
Reproductive organ massage (ROM) is a highly specialized form of therapeutic massage that manipulates the fascia of the pelvic cavity to unblock any obstructions in the reproductive organs and improve the blood flow to these organs. The result is a balance of hormonal production, improved ovarian production and ovulation, regular menstrual cycles, lower FSH levels, better egg quality, and stronger embryos.
Nutritional guidance is customized for each patient based on the health of her kidney, liver, and spleen functions, which control our reproductive health and underlie our metabolic processes. We generally recommend incorporating foods that encourage estrogen production or production of yin and jing, and decrease spicy, hot foods which burn up the estrogen/yin/jing of the body. Organic foods and cooling foods, like chlorophyll and wheat grass juice, are also recommended. A diet rich in dark green leafy vegetables and low sugar helps as well.
How Western Medicine Treats Elevated FSH Levels
There is no real treatment for elevated FSH levels in Western medicine. Most doctors will test the FSH level and then retest the level again a few months later to see if it changes. If there is no drop in the FSH level, or if it increases, then donor eggs are typically recommended for those undergoing IVF treatment.