High FSH Myths and Facts

happy patient at doctor's appointment

When you’re trying to become pregnant, there are many hormonal factors you’ll encounter that can impact the process. One of the hormones instrumental for baby-making is called FSH (Follicle Stimulating Hormone). There’s been a lot of recent attention on how high FSH levels can affect your fertility, and with all the information out there, it can be confusing to know what’s true and what’s not. Here are some common myths and facts about high FSH that you should know.

FSH is vital to fertility.

FACT Without FSH, your follicles will not be stimulated to produce eggs and you won’t ovulate.

So high FSH must be better than low FSH.

MYTH The lower your ovarian reserve (the number of eggs you have left in your ovaries) is, the harder your body has to work to mature an egg for ovulation. In other words, the fewer eggs you have left, the higher the amount of FSH you’ll need to develop one of them for ovulation.

If I have high FSH, then I’m definitely in menopause.

MYTH Though menopause is the most common cause of high FSH levels, if you’re 40 or younger, then high FSH levels are considered abnormal. Your fertility doctor can help you determine what the cause might be, but your high FSH levels could be the result of a number of conditions including:

  • Premature menopause.
  • Premature ovarian failure.
  • In rare cases, congenital adrenal hyperplasia or a pituitary tumor

I have high FSH, which means I’m never going to get pregnant.

MYTH If you have high FSH, your ability to get pregnant will actually depend on exactly how high your FSH levels are, as well as your age. Your fertility doctor can help you understand what your levels mean for your individual fertility treatment options, but below are some general guidelines.

If you’re 35 or younger with increased FSH levels, you’ll tend to have higher success rates with IVF than older women with the same FSH levels, as the quality of your younger eggs is generally better.

It’s important to understand that regardless of age, high FSH levels usually makes it much more difficult to get pregnant, even with fertility medications and IVF.

My high FSH levels can mean I’m not an ideal candidate for fertility treatments.

FACT Unfortunately, this statement is true. If you have very high FSH levels, then you won’t be considered a good candidate for treatment with fertility medications. This is because your ovarian reserve is so low that no matter how much your ovaries are stimulated, they are not going to be able to produce eggs. But there is some hope and good news, here; while IVF with your own eggs may not be an option, many women have great success with donor eggs.

My FSH level is normal, so that factor is definitely not the problem.

MYTH If your FSH levels are normal or low but your estrogen levels are high, the estrogen may be artificially lowering your FSH levels. Ask your doctor to have your estrogen levels tested at the same time your FSH levels are tested, to see if this is the case.

My high FSH levels can be lowered

This one’s harder to call, as it’s not so clear-cut. FSH levels can technically be lowered with medications including estrogen and the birth control pill, but lowering the FSH level does not actually change the ovarian reserve, or the chances of becoming pregnant.

Some practitioners of Traditional Chinese Medicine (TCM) claim that they’re able to lower FSH levels using herbs, acupuncture and dietary changes, though clinical studies do not necessarily support these claims. Always talk to your fertility doctor before trying herbs or supplements, engaging in any experimental treatments, or undergoing any major lifestyle changes.

Dr. Alan Copperman is a board-certified reproductive endocrinologist and infertility specialist with a long history of success in treating infertility and applying fertility preservation technologies. He serves as Medical Director of Progyny, a leading fertility benefits management company, and co-founded and serves as Medical Director of RMA of New York, one of the largest and most prestigious IVF centers in the country.  Dr. Copperman is also the Vice Chairman and Director of Infertility for the Icahn School of Medicine at Mount Sinai, and Chief Medical Officer of Sema4, a health information company. Dr. Copperman has been named to New York magazine’s list of Best Doctors 17 years in a row. He has been recognized by his peers and patient advocacy organizations for his commitment to patient-focused and data-driven care. He has published more than 100 original manuscripts and book chapters on reproductive medicine and has co-authored over 300 scientific abstracts on infertility, in vitro fertilization, egg freezing, ovum donation, and reproductive genetics.