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Understanding Elevated FSH Levels in Women and Its Impact on Fertility

Fertility is a complex and delicate aspect of reproductive health, and many factors can influence a woman's ability to conceive. One crucial factor is the level of follicle-stimulating hormone (FSH) in the body. Elevated FSH levels can be a concerning issue for women trying to conceive, as it may indicate underlying reproductive challenges.

What is FSH?

Follicle-stimulating hormone (FSH) is a vital hormone produced by the pituitary gland, a pea-sized gland at the base of the brain. FSH plays a key role in the menstrual cycle and reproductive system by stimulating the growth and development of ovarian follicles in the ovaries. These follicles house and nurture eggs, eventually leading to ovulation.

Normal FSH Levels:

In a healthy menstrual cycle, FSH levels fluctuate, reaching their peak just before ovulation. However, elevated FSH levels, particularly during the early phase of the menstrual cycle, can signal potential fertility issues.

Causes of Elevated FSH Levels:

Diminished Ovarian Reserve (DOR): Elevated FSH levels are often associated with diminished ovarian reserve, which refers to a reduced quantity and quality of eggs in a woman's ovaries. This condition is more common in women as they age, particularly after the age of 35.

Premature Ovarian Failure (POF): Premature ovarian failure occurs when a woman's ovaries stop functioning before the age of 40. Elevated FSH levels are a hallmark of this condition, leading to irregular menstrual cycles, infertility, and hormonal imbalances.

Polycystic Ovary Syndrome (PCOS): While PCOS is typically characterized by higher levels of luteinizing hormone (LH) and androgens, some women with PCOS may also experience elevated FSH levels. PCOS is a common hormonal disorder that can affect fertility by disrupting ovulation.

Functional Causes: Other factors, such as stress, excessive exercise, and extreme weight loss, can lead to temporary elevations in FSH levels. These functional causes are usually reversible with lifestyle adjustments.

Implications for Fertility:

Elevated FSH levels can adversely impact fertility by indicating a reduced ovarian reserve or dysfunction in the reproductive system. As FSH is crucial for the development of ovarian follicles, higher levels may suggest that the ovaries require more stimulation to produce viable eggs. This can result in difficulty conceiving and an increased risk of miscarriage.

Acupuncture can help, if FSH is elevated.

Acupuncture is a traditional Chinese medicine technique that involves inserting thin needles into specific points on the body. It has been used for centuries to treat a wide range of health conditions, including infertility. Acupuncture can improve ovarian blood supply, which in turn can improve ovarian function and egg quality. When the ovary functions properly, it responds to FSH, and the pituitary gland does not produce excessive FSH. This can decrease FSH levels, increase egg quality, and improve the chance of getting pregnant.

Several studies have investigated the effects of acupuncture on FSH levels in women with elevated FSH. In one study, 21 patients with high FSH levels received 12 weeks of acupuncture treatment. The mean FSH levels decreased from 19.33±9.47 mIU/mL at baseline to 10.58±6.34 mIU/mL at week 12 and 11.25±6.68 mIU/mL at week 24. The change in mean FSH from baseline was -8.75±11.13 mIU/mL at week 12 (p=0.002) and -8.08±9.56 mIU/mL at week 24 (p=0.001). Other hormonal levels and irritability scores were also improved, and approximately 30% of patients reported an increase in menstrual volume after treatment.

Another study investigated the effects of acupuncture on in vitro fertilization (IVF) success in women with declined ovarian reserve. The study involved 63 women who were divided into two groups: an acupuncture group and a control group. The acupuncture group received acupuncture twice a week until the second menstrual cycle of oocyte retrieval, while the control group received IVF-ET but no acupuncture. The study found that acupuncture improved ovarian reserve function, as evidenced by an increase in basic FSH, estradiol (E2), and antral follicle count (AFC), as well as the number of retrieved oocytes, fertilizations, and high-quality embryos. The acupuncture group also had a higher implantation rate and clinical pregnancy rate and a lower cycle cancellation rate than the control group.

Overall, several studies have shown that acupuncture can significantly lower FSH levels in women with elevated FSH. Acupuncture can improve ovarian function and blood supply, which can lead to an increase in egg quality and quantity, and may improve the chances of conceiving naturally or through assisted reproductive technologies like IVF.

References

Wang Y et al Acupunct Med (2016) May 13. pii: acupmed-2015-011014. doi: 10.1136/acupmed-2015-011014.
Zhou L et al Zhongguo Zhen Jiu (2016) 36:25-8

Junyoung Jo, et al Evid Based Complement Alternat Med. 2015; 2015: 842180.

Yang Fu et al Evid Based Complement Alternat Med. 2022; 2022: 9053930.

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