July 10, 2014

FSH Levels and Fertility

fshNot too long ago we discussed how cell phones kept in the pants pockets might be a potential cause of male infertility. Today we will look at the relationship between FSH (follicle-stimulating hormone) and female causes of fertility.

What is Infertility?

Infertility is when a couple is unable to conceive or sustain a pregnancy after 12 months of unprotected sexual intercourse. Fertility requires the proper function and interaction of several hormones and other factors that involve the ovaries (in women), testicles (in males), thyroid gland, pituitary gland, and the hypothalamus.

What Does FSH Do?

FSH is made in the anterior pituitary, a small pea-size gland in the brain. In women follicle-stimulating hormone triggers the development of eggs in women and sperm in men. In women, FSH levels fluctuate throughout the menstrual cycle reaching a peak at the time of ovulation.

As women go through menopause and no longer produce eggs FSH increases – a physiologic attempt to develop more eggs.

Follicle-stimulating levels are measured in the blood. FSH levels are usually obtained along with other hormones as part of a fertility work up, but they are also used to help determine the cause of menstrual irregularities and confirmation of menopause.

FSH and Infertility

Follicle-stimulating hormone levels can help determine the cause of infertility. High FSH levels suggest that the ovaries are the source of the problem. Low levels suggest the problem is with the hypothalamus or pituitary gland.

There are a number of ovarian disorders and diseases that affect ovarian function that can lead to a high FSH level and include:

  • Failure to ovaries to develop
  • Turner syndrome (genetic abnormality)
  • Damage to ovaries from radiation or chemotherapy
  • Polycystic ovary syndrome (PCOS)
  • Adrenal and thyroid gland disease
  • Ovarian tumor
  • Alcohol abuse

There are medications that also can cause a high FSH and include:

  • Bromocriptine
  • Cimetidine
  • Clomiphene
  • Danazol
  • Erythropoetin
  • Ketoconazole
  • Leuprolide
  • Levodopa
  • Metformin
  • Phenytoin
  • Pravastatin
  • Tamoxifen

And, there are medications that can cause a low FSH and include:

  • Carbamazepine
  • Corticosteroids
  • Danazol
  • Leuprolide
  • Megestrol
  • Phenothiazines
  • Pimozide
  • Pravastatin
  • Tamoxifen
  • Valproic acid

As you can see there are few drugs that can cause both low and high FSH levels. So if you are having difficulty getting pregnant be sure to look at any medication you are taking.

 

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Dr. Joe Jacko


Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio at Grandview Primary Care. Read more about Dr. Joe Jacko

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