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Follicle-Stimulating Hormone: FSH levels, Ovulation & Pregnancy

Follicle-Stimulating Hormone: FSH levels, Ovulation & Pregnancy

Several hormones play a critical role in conception and pregnancy. However, the critical hormone that gets the ball rolling if you are trying to conceive is the Follicle Stimulating Hormone FSH.

FSH is a key hormone secreted by the Pituitary gland that is mainly responsible for the egg’s proper development within the ovary’s follicles before it is released during ovulation.

However, there is much more to this crucial hormone. The following article will look at FSH’s role in female physiology and pregnancy. We will also try to understand the levels of FSH in your body tell you and how and when you should get them tested.

Before we go any further, it is important to note that although FSH is produced in males and females, we will focus on female physiology as we advance.

What level of FSH indicates ovulation?
What level of FSH indicates ovulation?

What is Follicle Stimulating Hormone (FSH)?

FSH is one of the two hormones secreted by the pituitary gland called gonadotropins- the other one being the Luteinizing hormone (LH). Both these hormones work closely to ensure the smooth functioning of the reproductive process.

FSH plays several roles in the body, but its main function is to regulate the menstrual cycle and stimulate the growth and maturation of the ovum (egg) within ovarian follicles. Although we will not discuss how LH plays a role in regulating the reproductive process, you can read more about it here.

Why is FSH so important?

FSH is crucial in the reproductive process due to two important reasons-

  1. Without FSH, the early follicles in the ovary won’t be able to mature. It is vital as, without proper maturation, the egg won’t develop properly, and ovulation won’t occur.
  2. FSH also plays a key role in ramping up estrogen production in the ovaries. As estrogen is very important in preparing the endometrium of your uterus to receive the embryo, there must be no shortage in its supply. FSH ensures an ample amount of estrogen available for successful implantation.

FSH and pregnancy

FSH does not play a role in pregnancy. Once you are pregnant, your body halts all the processes related to the development and release of the ovum. Consequently, there is no need for the new ovum to develop, and hence, there is no need for FSH. However, the pituitary continues to produce a small amount of FSH even when you are pregnant.

The baseline level of FSH during pregnancy is below 0.1mIU/ml. In contrast, the level of FSH in the body during the follicular phase of the menstrual cycle can reach a concentration of 1.4-9.91mIU/ml.

Testing the levels of FSH

Although FSH is not routinely tested, certain situations warrant the testing. Some of the conditions in which your doctor might want your FSH level checked to include the following-

  • If you are struggling to conceive
  • If you have irregular menstrual cycles
  • If you are missing periods multiple times within a year
  • If you are premenopausal or approaching menopause
  • If facing symptoms such as weight loss, chronic fatigue, and reduced appetite

Your doctor might understand any problem you might have by looking at the level of FSH in your body. Testing the level of FSH might also help your doctor determine whether you are approaching menopause or not.

Why are FSH levels important?

Monitoring your FSH levels might give your doctor a great insight into the physiology of your reproductive system. Your doctor might be able to deduce crucial information regarding your reproductive health, including-

  • Whether your ovaries, your pituitary, and your hypothalamus are working properly or not
  • The quantity of the eggs you have in your ovaries (also known as ovarian reserve)
  • If you are receiving any fertility treatments, then testing for FSH might help your doctor to understand whether the treatments are working or not.

How is FSH tested?

In Australia, you can get your FSH tested in blood and urine.

Testing FSH in your blood

The best and perhaps the most accurate way of testing the FSH levels in your body is testing the blood. Fortunately, you can get at-home FSH testing kits available on the market. However, if you prefer your doctor’s office, you can get your blood drawn there.

While both methods can yield accurate methods, both are advantages and disadvantages. For instance, you might find it challenging to set up an appointment with your doctor due to your busy work schedule. On the other hand, the at-home FSH test is quite easy to perform and less expensive, but you are on your own when interpreting the results.

If you struggle to get pregnant or have irregular periods, we suggest getting the test done in your doctor’s office. If there is anything wrong, you can get expert medical advice, which might be invaluable in some situations. However, if your testing FSH levels are to see whether you are approaching menopause, you can go with the at-home test.

Testing FSH in your urine

It is also possible to get an indication of FSH in your body through urine using an at-home test kit. While the test cannot give you an exact value of your FSH levels, it can tell you whether your levels are above the standard levels for menopause.

Understanding the FSH test results

It is important to understand that the ‘normal’ FSH levels can vary greatly among women. Several factors play a key role in determining the ‘normal’ FSH values in your body, including your age and the phase of your menstrual cycle. Here is a brief overview of the normal FSH levels in the various phases of your menstrual cycle.

  • Follicular phase (when the ovarian follicles are developing): 1.4 to 9.9 IU/mL
  • Ovulation phase peak FSH level: 6.2 to 17.2 IU/mL
  • Luteal phase (post ovulatory phase): 1.1 to 9.2 IU/mL
  • During pregnancy: <0.1 mIU/mL
  • Perimenopause FSH levels: 1.4 mIU/mL to 30+ mIU/mL
  • Menopause FSH levels: 19 to 100 IU/mL

Your FSH levels can be too high or too low, depending on the results.

What if the FSH levels are too high?

One of the most direct implications of a higher-than-normal value of FSH in any phase of your menstrual cycle might indicate that more FSH is required to help the follicles mature and grow. Thus, elevated FSH might suggest that your eggs are low in quality or you have a low ovarian reserve. Although if you are approaching menopause between the ages of 40 and 50, the high level is normal.

However, if you are younger, having a high FSH might mean a problem in your ovaries’ normal functioning, and you might have difficulty conceiving. One of the medical conditions that might lead to an elevated FSH level is Primary Ovarian Insufficiency (POI). Although it is a rare health condition affecting less than 4% of women in Australia, it often causes issues with the menstrual cycle and difficulty in conception.

What if the FSH levels are too low?

Having a lower-than-normal FSH level might indicate problems with your pituitary gland. Hypopituitarism is a condition that causes your pituitary gland to malfunction resulting in reduced gonadotropin release. If you have Hypopituitarism, reduced FSH is not the only symptom. The condition also results in a battery of symptoms, including weight fluctuations, deficiency of hemoglobin (Anemia), and excessive thirst (diabetes insipidus).

Polycystic Ovarian Syndrome (PCOS) and Kallmann syndrome might also cause a decline in the levels of FSH.

Are there any risks of getting tested?

There is almost no risk of getting tested for FSH.

The only risk of using an at-home test is that you might get inaccurate results due to the improper usage of the kit. Hence, you must follow the directions on the ah-home test kits precisely.

If you get tested in your doctor’s office, the risk is only a minor prick that is no different than any other blood test.

How is FSH deficiency treated?

In most cases, FSH treatment involves the administration of the hormone via an injection. FSH is usually co-administered with human chorionic gonadotropin (hCG) to stimulate the follicles’ growth and ovulation.

The FSH treatment is part of some in-vitro fertilization (IVF) regimens.

Follicle-stimulating hormone (FSH) FAQs

When should I get tested for FSH?

Your doctor might recommend getting the FSH test done on the 3rd day of your period to determine your’ baseline’ FSH levels. The reason for doing this is that the level of FSH in your blood is the lowest at this point in your menstrual cycle which is an ideal situation to capture the baseline picture.

Can stress play a role in FSH levels?

Stress is bad for your body and interferes with every system, including the endocrine system. According to a study, stress is associated with higher-than-normal levels of FSH. Chronic stress can hurt your fertility and ability to carry a pregnancy to term.

You can read more about how stress can affect your fertility by clicking here.

How can I naturally increase my FSH levels?

Apart from FSH treatment, you can also work on improving your lifestyle to boost the production of this hormone in your body naturally. Certain foods have also been shown to regulate your body’s FSH levels.

According to one study, consuming a large amount of soy protein may cause a reduction of FSH levels below normal.

Apart from food, you can also try incorporating the following tips in your routine to have a healthier endocrine system.

  • Maintain a diet that is natural, diverse, and balanced
  • Make exercise a part of your daily life
  • Get sufficient sleep
  • Try to reduce your stress levels