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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Fertility Treatment For Female With High FSH And LH Levels

Hi Dr.,I would like to hear your opinion regarding my secondary amenorrhea. I am 40-years-old F, G0P0.My last period was on November 13, 2015, and today is February 12, 2016.I remember not having regular cycles for all of my life, ranging 26-32 most of the times. Past 3-4 years I did have skipped 1-3 cycles (in continuum) yearly during periods of intensive stress, and past 6 months were particularly stressful.I do not have other medical issues and do no take any drugs. No surgeries, history of pelvic inflammatory disease, or signs/symptoms suggestive of PCOS. I also did not have any pre-menopause symptoms, like hot flushes and sweats, though I have noticed decreased libido, hair loss and fatigue. I gained 8kg in past year after I stopped my daily jogging due to lack of free time. But my BMI is 22,8.My family history is significant for lung cancer in my father, and RA in my mother, who also lost her period when she was 40, though she attributed that to MTX she was taking at that time. I did some lab work: BW, including iron studies, B12, LFT and kidney function, prolactin level and TSH are all good; however, my FSH is 75 IU/L and LH is 135IU/mL. TV Ultrasound is normal, a few follicles bilaterally and ovarian size of ~4,8/4,5cc.I am currently in monogamous relationship and we want to have children. I understand that chances for this are poor since I am 40 and given this results.I would appreciate your opinion regarding my increased levels of FSH/LH and suggestions to maintain my fertility.With thanks,Dana
Tue, 12 May 2020
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General Surgeon 's  Response
Hello,

As per my clinical experience, the raised FSH and LH may be secondary to either:
- Excess stimulation by pitutary via certain tumors or else
- Loss of negative feedback inhibition of ovary through estrogen and progesterone due to anovulatory cycles.

It is the study of:
Endometrial biopsy
Ovarian sampling
endocrine evaluation of hypothalamus, pituitary and HPO axis which is vital to co relate the data and guide accordingly.

Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Bhagyesh V. Patel, General Surgeon
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Suggest Fertility Treatment For Female With High FSH And LH Levels

Hello, As per my clinical experience, the raised FSH and LH may be secondary to either: - Excess stimulation by pitutary via certain tumors or else - Loss of negative feedback inhibition of ovary through estrogen and progesterone due to anovulatory cycles. It is the study of: Endometrial biopsy Ovarian sampling endocrine evaluation of hypothalamus, pituitary and HPO axis which is vital to co relate the data and guide accordingly. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon