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You are Here: Message Boards > Pregnancy Chat > FSH 10.5 on day two???

chris73 asked on 8/30/2007 6:52:46 PM Report this post
We have been trying to conceive our third child for over one year (m/c last July at 8 weeks) Had my first FSH bloodwork, day 2 of cycle and it was 10.5. I was told that this is elevated and could indicate decreased fertility. Anyone have a similar experience and what happened? I have been told they will do a clomid trial. Anyone else had this or success?

fertilitygal said on 8/31/2007 2:03:07 PM Report this post

During the early part of your cycle, your hypothalamus signals your pituitary to produce Follicle Stimulating Hormone (FSH), which causes follicles, each of which contains one of your eggs, to develop in one of your ovaries. If your ovaries respond appropriately, follicles begin to develop and produce the hormone estradiol, which gets back to your petuitary gland and regulates the FSH level.

When viable follicles are not developing appropriately, your estradiol levels will remain low and your pituitary will continue to produce more and more FSH to try to kick your ovaries into gear, which will result in elevated day 3 FSH levels in your urine. This will happen as you age, but a woman's ovaries can age faster than she does meaning that your age and your reproductive age can differ.

By testing the amount of FSH in your urine on cycle day 2 or cycle day 3, your doctor can determine your reproductive age and the ability of your ovaries to respond to FSH in order to produce eggs capable of fertilization. Anything higher than 12 on day 3 is considered to indicate diminished ovarian reserve. If yours is elevated, your doctor will most likely give you the "clomid challenge test" (CCCT), an "Ovarian Volume Assessment" and/or a "Antral Follicle Count" test.

The CCCT that your doctor is planning consists of the following: On Day 2 or Day 3 of your menstrual cycle, your doctor takes a blood sample and measures your FSH as well as your estradiol levels. Then, on cycle Days 5 through 10, you take 100mg of clomid daily. On menstrual cycle day 10 or day 11, your doctor will take another blood sample and again measure your FSH and estradiol levels. If your levels of FSH are elevated either times (Day 2 or 3, or Day 10 or 11 of your cycle), it suggests that your ovarian reserve is poor.

It is importnant to realize that normal FSH levels do not ensure that you will get pregnant either, but those women who receive a poor result are more likely to:

- Miscarry
- Have embryos with chromosome abnormalities
- Respond unsuccessfully to gonadotropins (injectable fertility drugs)
- Have fewer eggs to retrieve during IVF
- Have lower pregnancy rates in IVF and IUI

Your doctor can also perform an "Ovarian Volume Assessment". For this test, your doctor will perform a transvaginal ultrasound to measure the length, width and depth of each ovary, which determines the volume of your ovaries. Because our ovaries get smaller with age, smaller ovaries mean an older "reproductive age". A 35-year old woman with ovarian volume of 5mL would have a reproductive age of 40 (which means that her ovarian quality is equal to a woman who is 40 years old). This goes both ways, though. A 35-year old woman with ovaries that measure 7mL, has a reproductive age of 30.

Another test is the "Antral Follicle Count". An Antral Follicle Count calculates the number of egg follicles at the start of your menstrual cycle. The fewer follicles, the more likely you are to have a decreased ovarian reserve. This is often used to determine how successful IVF might be, as the fewer the follicles, the less likely you'll respond to the fertility medications used to get your ovaries to produce multiple eggs during a cycle of IVF. If your follicle count is between 5 and 11, your fertility specialist will be able to determine if it is worthwhile for you to undergo costly IVF. Anywhere between 12 and 30 is a good number for successful IVF. If yours is greater than 30, it may indicate that you have PCOS (polycystic ovary syndrome) or that your ovaries could be over-stimulated by the fertility medication.

Let us know how your clomid challenge goes!

chris73 said on 8/31/2007 3:03:35 PM Report this post
Thank You! I will let you know.

fertilitygal said on 8/31/2007 3:54:27 PM Report this post
Certainly! I have been having bad pelvic pain for the last month or so, so I had my first ever transvaginal ultrasound on Monday and my doctor measured the size of my ovaries. I need to call her to see what my reproductive age is. I'll let you all know!

chris73 said on 9/23/2007 7:32:50 PM Report this post
fertility gal,
did you get the results from your US

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