Treatment for High FSH
Even with high FSH, many women can conceive, if given proper treatment. Over the last 10 years, hundreds of women with diminished ovarian reservediminished ovarian reserve have received high FSH treatment at CHR and ended up conceiving after all, using an IVF protocol specifically developed for women with abnormally poor ovarian reserve.
A central component is supplementation with dehydroepiandrosterone (DHEA)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 pregnancy chances with IVF in women with high FSH. Recently, a small-scale clinical trial from Israel also confirmed that DHEA supplementation is an effective treatment for diminished ovarian reserve, indicated by high FSH levels. 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.
Treating the Cause, Not the Symptom
"Many of our colleagues believe that DOR is untreatable. We really do not believe that."
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 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 high FSH. We suggest you look at our IVF pregnancy rates for the last year in this patient population, and you will be astonished!
IVF with High FSH Levels
Success of an In Vitro Fertilization (IVF) cycle depends largely on the patient's ability to produce a good number of high-quality eggs. In attempts to predict the probability of an IVF cycle being successful, experts have developed a number of tools to assess patients' ovarian reserve. They include blood tests like FSH and others (like AMH, anti-Müllerian hormone). Assessing the so-called antral follicle counts (AFCs), the number of small follicles at the start of a menstrual cycle, through vaginal ultrasound is another popular method of measuring ovarian reserve. High FSH levels, as well as abnormally low AMH and/or AFCs also denote a relatively poor fertility prognosis and low probability of success with IVF.
Last Updated: November 15, 2014