High FSH Treatment for IVF & Infertility
Getting Pregnant with Your Own Eggs Is Possible, Even with High FSH
FSH, or follicle stimulating hormone, is a hormone released by the pituitary gland. Abnormally high FSH is a symptom of diminished ovarian reserve (DOR) or premature ovarian aging (POA), both of which are conditions that can make getting pregnant naturally very difficult.
But even with high FSH, many women can conceive if given proper fertility treatment for high FSH. Over the last 15 years, hundreds of women with diminished ovarian reserve have received high FSH treatment at CHR and ended up conceiving with their own eggs via an IVF protocol specifically developed for women with poor ovarian reserve.
How CHR Increases Pregnancy Chances with Treatment for High FSH Levels in Females
"Many of our colleagues believe that DOR is untreatable. We really do not believe that."Dr. Norbert Gleicher
The central tenet of CHR’s success in treatment for high FSH levels in females trying to conceive is the rigorous individualization of care. This individualization starts with the diagnostic work-up, where FSH levels and other blood test results are evaluated in an age-specific fashion, which allows our physicians to catch diminished ovarian reserve (DOR) early. Once a woman is diagnosed with DOR (indicated by high FSH and low AMH), a personalized treatment protocol is developed, often using androgen supplementation via DHEA, CoQ10 supplementation and highly individualized egg retrieval (HIER). CHR also proactively treat conditions that affect fertility prospects, such as inflammation and autoimmunity.
DHEA to Treat Women with High FSH
A central component of CHR’s successful approach to fertility treatment for women with high FSH is supplementation with dehydroepiandrosterone (DHEA) prior to IVF. Through extensive research, CHR has been able to demonstrate that DHEA supplementation for at least 6 weeks before start of an IVF cycle can dramatically increase IVF pregnancy chances in women undergoing this high FSH treatment. This is achieved through an androgen-rich ovarian environment that DHEA helps restore in women with DOR or POA.
We have also elucidated how this improvement in pregnancy rates is achieved by DHEA supplementation: DHEA “rejuvenates” the environment in the ovaries where eggs go through the final maturation process before ovulation.
HIER (Highly Individualized Egg Retrieval): Innovative High FSH Treatment
Highly individualized egg retrieval (HIER) is a high FSH treatment approach, developed at CHR based on the research conducted in-house. When our embryologists noticed that eggs retrieved from women with high FSH levels often appeared over-mature, CHR investigators conducted a study to determine whether retrieving eggs earlier than typical would improve egg quality for these women. As we have reported in peer-reviewed medical journals, the study revealed that retrieving eggs when the lead follicles are 16-18 mm rather than the conventional 20 mm improved the number and quality of eggs and embryos available in IVF cycles.
What Not to Do: “Natural” FSH Treatments
Some patients are drawn to “natural” FSH treatments. They should be warned that nutritional supplements and therapies that claim to treat high FSH lack scientific evidence and don’t work. Studies have also found that supposedly “natural” supplements are sometimes laced with hormones and other controlled substances. Furthermore, trying “natural” FSH treatments can delay high FSH treatment that is supported by concrete scientific evidence, reducing the eventual chances of pregnancy.
Treating the Cause, Not the Symptom With High FSH Treatment Options
CHR practically never refuses fertility treatment to women, as long as FSH levels aren't in the menopausal range. To women with very high FSH, our physicians explain relatively low pregnancy chances if they tried with their own eggs, in contrast to the superior pregnancy chances with donor eggs, even in older women. If patients, after giving fully informed consent, still wish to "give it a try" before moving on to egg donation, CHR will not withhold IVF treatment solely based on elevated FSH levels.
Most patients come to CHR for FSH treatment after having been turned away by other centers, or after having failed multiple IVF cycles elsewhere. We routinely hear that they were told "that their FSH needs to come down before they can try IVF." This is a somewhat silly argument, because high FSH is merely a symptom, and not the disease. For optimal results, one needs to treat the disease, which is the patient's diminished ovarian reserve.
This is precisely CHR's approach in treating women with diminished ovarian reserve when placing them on DHEA supplementation. In this sense, calling DHEA supplementation a "treatment for high FSH levels" is a misnomer; it’s a treatment for diminished ovarian reserve.
With this approach, CHR has been able to achieve impressive IVF pregnancy rates, despite our center's adversely selected patient population with a large number of women with severely diminished ovarian reserve and undergoing high FSH treatment. We suggest you look at our IVF pregnancy rates for the last year in this patient population, and you will be astonished!
Getting pregnant with your own eggs is still possible at CHR. We have over 30 years of experience in treatment for high FSH levels in females and diminished ovarian reserve, many of whom have had multiple failed IVF cycles elsewhere or have been rejected by another center due to a poor prognosis. By using individualized ovarian stimulation protocols that are tailored to each patient, we’re able to offer treatment options for older patients who wish to become pregnant using their own eggs.
Egg donation is also an option for these patients, but at CHR, the final decision is always up to the patient.
Learn Whether FSH Treatment at CHR is Right for You
To learn more about treatment for high FSH at CHR, call us at (212) 994-4400 or (212) 933-5700, or contact us online.
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned reproductive endocrinologist, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.
Last Updated: October 8, 2018