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Does high levels of FSH indicate infertility?

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Dr. Manisha Jain

OBGYN

Practicing since :2007

Answered : 5136 Questions

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Posted on Wed, 20 Aug 2014 in Infertility Problem
Question: i had an ovarian cyst. i took norethisterone 5 for 2 weeks and it disappeared. The dr did an ultrasound and did not find it again. On the same day he told me to have a hormonal test. It was the 3rd day of my period. FSH is 31.4 amd LH 14. Also Anti-TPO Ab 217. I am shocked about FSH. I am 39 single and do want to have kids.
Does the FSH level of 31 mean i am infertile? have my ovaries stopped working?
Can i still get pregant naturally or with IVF? Can i do egg freezing? Can anything be done to lower FSH? Will DHEA work? Can the elevation be due to the cyst or the norethisterone i took? Could it be due to the fact that i had on going stress for months not eating or sleeping well with too much caffeine? Can it be just a one time thing and then FSH go back to normal and stay there?
Please help!!!!!!!!!!!!!!!!!!!!!!
doctor
Answered by Dr. Manisha Jain 6 hours later
Brief Answer:
Investigations advised

Detailed Answer:
Hello mam, thanks for trusting health care magic.
This high FSH is suggestive of menopausal transition.
In my opinion get a pelvic ultrasound for antral follicle count on day 2 of cycle and AMH levels tested which will tell us about your fertility potential.
In case they are very low then dheas can be tried for 3 months and we can see for result.
But most probably you will need IVF and that too with donor eggs (most probably)
Resorting to donor egg will help you to bear children and taking the semen of your would be husband will let the child have his genetic material at least.
All this is not related to norethisterone or cyst but definitely related to poor nutrition and stress.
Avoid excessive caffeine and smoking in case you do and take good healthy diet with good sleep.

In case you have any other question I will be happy to help.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain 4 hours later
hi dr and thanks for your answer. I dont have any symptoms if meopause though. no hot flashes and my period is regular. Only in XXXXXXX i had my period twice and i thought that was the cyst. But after that i kept on being regular.

However ever since may i have this burning feeling inside my lower abdomen. I have it most days and it is not going. It is like my ovaries and uterus are burning. I thought again it was the cyst but now the cyst is gone and i still have this nagging burning pain. What is this? Could it be some inflammation making my hormones crazy?

Also another test called Anti-Tpo Ab was very high around 200!

Can the rise in FSH be just a one time thing and with proper nutrition and sleep go down and stay down?

Have you ever heard of a woman falling pregnant with such high FSH using her own eggs or is this flatly impossible?

Does it mean that the ovaries have stopped working?

Will egg freezing work for me? And does it work in genera? To make things worse i am still single so falling pregnant right now is not possible unless i save eggs.

Please help me. Becoming a mother is all i want in life but kept putting it off as i wanted to find the right person which i havent yet. And now it seems my body wont wait anymore...Please dr answer the above questions and help me do the best i can to have my own baby. Thanks

doctor
Answered by Dr. Manisha Jain 4 hours later
Brief Answer:
egg conservation is management of choice

Detailed Answer:
Hello mam, this burning sensation in lower abdomen is due the after effects of cyst.
Basically cysts move with respiratory efforts and other movements and it rubs against adjacent structures that eventually causes slight inflammation and this type of pain.
But this inflammation won't have any effect on hormones per se.
This mild rise of hormones is typically suggestive of transition to menopausal state and thus you need to actively participate in conservation of eggs or pregnancy.
As a matter of fact I have seen women conceiving with these levels of hormones but they suffer from abortion and preterm births at a rate higher than general population.
Best management plan will be first get AMH and antral follicle count on TVS and see for fertility potential.
In case there are ample number of eggs ( good possibility because of regular cycles), then they can be induced to mature to a certain level by hormone supplements and then retrieve them and conserved for future use.
Whenever you will be in a condition of getting pregnant these eggs can be thawed and fertilized with your husband's semen and have good success rates.
Rest and mental peace can help in providing suitable mileau for a healthy pregnancy to grow but will not have any fruitful effect on FSH levels.
Anti tpo antibodies have no effect on FSH levels and if your thyroid hormone levels are in range then there is nothing to worry about tpo antibodies.

In case you have other questions in future you can contact me directly on http://bit.ly/drmanishajain.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain 30 minutes later
thank you so much. That was a very detailed answer.
Just a few more things-1) even though the cyst is gone i still have the burning pain in the lower abdomen. What can this be? and could it be affecting FSH?
2) does egg freezing really work? do eggs manage to remain in good condition under freezing and does fertilization work with an egg that was frozen?
3) have you ever seen FSH come down to normal levels and stay down? can this be just one bad month?
I am really grateful to you for answering so clearly and in detail. Few doctors i have found on the net were as clear and detailed as you. Thank you dr. Please answer the above questions as well..i cant tell you how worried i am but need to know truths and options.
doctor
Answered by Dr. Manisha Jain 4 hours later
Brief Answer:
Egg freezing works well

Detailed Answer:
Thanks for the appreciation.
This pain is most probably due to the leftover inflammation by the cyst wall.
But it has nothing to do with FSH Levels which is controlled by brain and is pre programmed in every female.
It won't come down to normal in any of the following cycles and can only fluctuate around 5-10 units with dheas which will not improve your chances of conception in future to make you pregnant without assistance from outside.
The levels of FSH will only rise in coming future so you need to work actively in this direction so as to bear child with your genetic material otherwise in case you start it very late then due to exhausted reservoir of eggs you my right need to go for donor eggs.
Frozen eggs are almost as active as are natural ones and the only important point for its maintained efficiency is appropriate maturity at the time of retrieval.
Assessment of maturity requires experience and thus selection of infertility specialist is of paramount importance.
Wish you all the best.
Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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