Achieving your own pregnancy with IVF is possible in almost all cases. A particular problem is the absence of a uterus or ovaries, as well as high level follicle stimulating hormone (FSH) in a woman. Read on for details.
MAMA Clinic provides advisory and medical assistance upon the onset of pregnancy and prepares for IVF in case of elevated FSH, cysts and other complex cases.
At your first consultation with the doctor, you will be prescribed full examination, including hormones, because high FSH level and cyst for IVF are serious barriers.
It may take you quite a lot of time to complete the full range of tests, because... Many tests are taken strictly on certain days of the cycle.
Your patience and our professionalism will allow us to overcome the difficulties with IVF; increased FSH, hormonal cysts, ovarian dysfunction and others. The right treatment will allow your body to recover and prepare for motherhood.
In the absence of your own eggs against the background of cysts and a high concentration of FSH, we perform IVF using donor material and never give up. If you are tired of fighting with nature and want to become a happy mother; come to us, together we will definitely succeed!
Pregnancy with IVF is possible in almost all cases. However, there are a number of problems that create significant obstacles to achieving this goal. These include the absence of a uterus or ovaries, as well as high levels of follicle-stimulating hormone (FSH) in the woman.
FSH- a hormone produced in the pituitary gland. It stimulates the growth of follicles in the ovary and the production of estrogen - the female sex hormone. At the same time, the growth of the endometrium in the uterus increases. In the middle of the cycle, a high gradual increase in the level of FSH leads to ovulation, which causes a gradual decrease in the level of FSH and an increase in the concentration of another pituitary hormone - LH (luteinizing hormone), estradiol, progesterone. With the onset of menstruation, the LH level drops, which makes it possible for the cyclic process to begin again: increase in FSH level - ovulation - increase in LH concentration - menstruation - increase in FSH level...
Normally, with the onset of menopause, FSH levels become many times higher than during the childbearing period. This blocks the described cyclic process, prevents ovulation, and leads to inhibition of endometrial growth.
In addition to natural causes, high FSH also occurs with some endocrine disorders. The most famous of them is ovarian wasting syndrome or premature menopause. The disease develops in women under the age of 38-40 years. Menstruation is absent, often observed vegetative signs climacteric syndrome. At the same time, the level of FSH and LH in the blood is increased 5-10 times compared to the norm, and the level of estrogen is sharply reduced.
Somewhat similar to this form of infertility is refractory ovarian syndrome, in which, along with amenorrhea, the level of FSH and LH is increased to the upper limit of normal, and the level of estrogen is slightly reduced.
Overcoming the described syndromes is a painstaking task. There is no single treatment regimen, although the final stage in most cases is to temporarily “turn off” the function of the ovaries so that they can rest.
Since laboratory data are decisive for making a dire diagnosis, it is necessary to strictly follow the rules for donating blood for hormones. To determine the level of FSH, blood is donated in the early follicular phase (on days 3-5 of the cycle), if menstruation is still present. This is dictated by the fact that the FSH level increases with each day of the cycle until ovulation, and on the days of ovulation the numbers can be much higher than usual - as a manifestation of the peak of hormone production. Incorrect analysis tactics can lead to an incorrect diagnosis with all the ensuing consequences.
If there are no menstruation, then the analysis is done on any day, and the woman should not undergo any hormone therapy at this time.
A very high level of FSH dictates the need for IVF with a donor egg, since there is practically no hope for one’s own ovulation, and even more so, the maturation of a sufficient number of follicles. At slight increase FSH is possible to carry out a cycle with a minimum of stimulants and get one or two cells. This is certainly a chance, but the success of such a program is reduced. Still, one or two cells work. The most important thing is to get the information accurately and try it on yourself.
Our task is to do everything possible to ensure that your birth healthy children, and you, their parents, were happy. Our doctors are engaged scientific activity, which allows the MAMA Reproduction Clinic to offer its patients unique opportunities. All you need to do to benefit from our years of experience is call and make an appointment.
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The hormonal status in case of infertility in a man is examined only after obtaining a pathological spermogram from the patient (the number of sperm is reduced, there are sperm of an altered shape - with two heads, with two tails, without a tail, etc.). Hormonal studies allow us to determine the source of pathological changes:
Let's define the terms. Two hormones:
And one hormone produced in the testicles.
We prescribe these 3 hormones for research in case of infertility in men and evaluate the results obtained (you can get to know these hormones more closely in the linked articles).
FSH level is within normal limits. Violations endocrine regulation has not been identified, such male infertility is easily treatable with medication.
FSH levels are elevated. A poor prognostic sign, evidence suggests that any treatment will be ineffective.
FSH levels are low . This pathology is rare (about 1% of all patients with male infertility). In such patients, effective treatment is possible.
Testosterone levels are below normal. The pathology is quite rare. It must be remembered that if the patient donated blood for analysis in the evening, then normal level testosterone in his blood is 60-75% of the morning content. Testosterone deficiency (if it is testicular deficiency) cannot be treated. If testosterone levels are reduced due to a violation of the regulatory function of the pituitary gland (FSH levels are reduced), such deficiency can be corrected with medication.
Diagnostics low level testosterone has great value for a patient with male infertility, since in the future he may encounter problems mineral metabolism in the bones (osteoporosis) and impotence. In such cases it may be effective replacement therapy testosterone.
By simultaneously determining LH along with the listed hormones, a more reliable assessment is possible.
The main purpose of the circulation of hormones in the body during menstrual cycle is ovulation. The process of ovulation is controlled by the hypothalamus by regulating (via gonadotropin-releasing hormone) the release of hormones secreted by the anterior pituitary gland: LH and FSH. In the follicular (preovulatory) phase of the menstrual cycle, the ovarian follicle undergoes a number of transformations under the influence of FSH. When the follicle reaches a certain size and functional activity, under the influence of estrogens secreted by the follicle, an ovulatory LH peak is formed, which triggers the “maturation” of the egg (the first division of meiosis). After maturation, a gap is formed in the follicle through which the egg leaves the follicle. There is approximately 36 hours between the ovulatory LH peak and ovulation. During the postovulatory phase (corpus luteum phase), the egg usually moves along fallopian tube towards the uterus. If fertilization of the egg has occurred, then on day 3-4 the embryo enters the uterine cavity and the implantation process occurs. If fertilization does not occur, the egg dies in the fallopian tube within 24 hours.
Hormones are biologically highly active substances produced in the glands internal secretion. Life support reproductive function women is carried out through the hypothalamic-pituitary-ovarian system precisely with the help of these biologically active substances, that is, hormones.
Typically, to determine hormonal reasons In case of infertility, you will need to take tests for the levels of basic hormones in your blood:
FSH (follicle stimulating hormone):
“For rent” on days 3-5 of the menstrual cycle (hereinafter we mean an average 28-day cycle). This hormone stimulates the growth of follicles in the ovaries and the formation of estrogen. The endometrium grows in the uterus. Reaching a critical level of FSH in the middle of the cycle leads to ovulation. FSH is released into the blood in pulses at intervals of 1 - 4 hours, while the concentration of the hormone during the release is 1.5 - 2.5 times higher than the average level, the release lasts about 15 minutes. FSH is an indicator of a woman's follicular reserve; normally it is about 6 IU/ml.
Norms for women of reproductive age (units - mU/ml (= U/l)): Follicular phase: 1.37 - 9.90; Ovulatory phase: 6.17 - 17.20; Luteal phase: 1.09 - 9.2.
LH (luteinizing hormone):
Available for 3-8 or 21-23 days of the menstrual cycle. This hormone “ripens” the follicle in a woman, ensuring the secretion of estrogen, ovulation, and the formation of the corpus luteum. The release of luteinizing hormone is pulsating in nature and depends in women on the phase of the menstrual cycle. The peak concentration of LH occurs during ovulation; the concentration of LH in the blood is maximum in the period from 12 to 24 hours before ovulation and is maintained throughout the day, reaching a concentration 10 times higher compared to the non-ovulatory period. After ovulation, the hormone level drops and “stays” throughout the luteal phase at lower values than in the follicular phase.
The normal LH/FSH ratio after menstruation and before menopause is from 1.5 to 2.
Norms for women of reproductive age (units - mU/ml (= U/l)): Follicular phase: 1.68 - 15.00; Ovulatory phase: 21.90 - 56.60; Luteal phase: 0.61 - 16.30;
Prolactin:
Available for 3-5 or 19-21 days of the menstrual cycle. Strictly on an empty stomach and only in the morning, but not earlier than 3 hours after waking up. On the eve of the test day, it is necessary to exclude: sex, physical activity, stress. Immediately before taking blood, you need to avoid smoking and sit quietly for about 30 minutes. Prolactin is a stress hormone and is sensitive to physical and emotional stress.
With an increased level of prolactin in the blood, the follicle may not develop, as a result of which the woman will not ovulate. During the menstrual cycle, prolactin levels are slightly higher in the luteal phase than in the follicular phase. You can read more about a significant increase in prolactin in the article
The level of prolactin fluctuates not only depending on the day of the menstrual cycle, but also depending on the time of day - during sleep its level increases, after waking up the concentration of prolactin sharply decreases, reaching a minimum in the late morning hours, in the afternoon the level of the hormone increases. In the absence of stress, daily fluctuations in levels are within normal values.
Norms for women over 1 year: 109 - 557
Units of measurement - honey/l. Alternative units - ng/ml (ng/ml x 21 => honey/l.)
Estradiol:
Blood tests for the content of this hormone are performed on days 4-7 of the menstrual cycle and on days 6-10 after ovulation. Estradiol is secreted by the maturing follicle, yellow body ovary, adrenal glands and even adipose tissue under the influence of FSH, LH and prolactin. Estradiol ensures the formation and regulation menstrual function, egg development. Before ovulation, a significant surge of estradiol precedes the LH surge and occurs approximately 24-36 hours before ovulation. After ovulation, the hormone level decreases, a second, smaller in amplitude, rise occurs with stagnation, ending with a decrease in hormone concentration at the end of the luteal phase.
Follicular phase 68 - 606; Ovulatory phase 131 - 1655; Luteal phase 91 - 861
Units of measurement - pmol/l. Alternative units - pg/ml ([pmol/l] = 3.671 * [pg/ml] or [pg/ml] = 0.2724 * [pmol/l])
In the follicular phase 14-160 pg/ml, in the preovulatory phase - 34-400 pg/ml, in the luteal phase - 27-246 pg/ml, during menopause -< 30 пг/мл.
Progesterone:
It is important to check this hormone 6-8 days after ovulation. Progesterone is a hormone produced by the corpus luteum and placenta (during pregnancy). It prepares the endometrium of the uterus for the implantation of a fertilized egg, and after its implantation it helps maintain pregnancy.
Standards for women over 18 years of age:
Follicular phase 0.3 - 2.2; Ovulatory phase 0.5 - 9.4; Luteal phase 7.0 - 56.6
Units of measurement - nmol/l. Alternative units are ng/ml. (ng/ml x 3.18 => nmol/l)
AMH (anti-Mullerian hormone, anti-Mullerian hormone):
In women, AMH is produced by granulosa cells of the follicles. The determination of anti-Mullerian hormone is most often used in the study of ovarian reserve, diagnosis of endometriosis and PCOS. It is believed that a decrease in AMH levels below 0.8 ng/ml is accompanied by a low likelihood of pregnancy (as a result of IVF).
Women of reproductive age: 2.1 - 7.3 (ranging from 1 to 10). Conducting the analysis: on the 2-3rd day of the menstrual cycle. Units of measurement - ng/ml.
Inhibin B:
Inhibin selectively suppresses (inhibits) the release of FSH from the anterior pituitary gland. In women, the hormone is synthesized in the follicles. As women age, there is a decrease in the concentrations of inhibin A and B. When the number of maturing follicles in the ovaries falls below a certain threshold, there is a decrease in the concentration of inhibin, which leads to an increase in FSH levels. Used to adjust the dose of drugs to stimulate superovulation (In women with reduced levels of inhibin B, it is necessary to increase the dose of exogenous hCG in the cycle of stimulation of superovulation) and a general assessment of ovarian reserve.
Women of reproductive age: 23.0-257.0 (mean = 76.0 pg/ml); Units of measurement - pg/ml. Conducting analysis: on days 3-5 of the menstrual cycle.
Alternative units of measurement - ng/l: 1-2 d.m.c. - 15.0-70.0; 3-5 d.m.ts. - 45.0-120.0. Follicular phase: 30.0-90.0; Ovulatory phase: 80.0-200.0; Luteal phase: up to 50.0.
17-OH-progesterone:
The analysis is usually taken on days 3 - 5 of the cycle.
17-OH-progesterone (17-hydroxyprogesterone) is a product of metabolic transformations of progesterone and 17-hydroxypregnenolone. The production of 17-OH-progesterone in the ovaries fluctuates during the menstrual cycle. The day before the peak of luteinizing hormone (LH), there is a significant rise in 17-OH-progesterone, followed by a peak that coincides with the LH peak in the middle of the cycle, after which there is a short-term decrease, followed by a rise that correlates with the levels of estradiol and progesterone. The content of 17-OH-progesterone increases during pregnancy.
Standards for women over 18 years of age:
follicular phase 1.24 - 8.24; luteal phase 0.99 - 11.51
Units of measurement - nmol/l. Alternative units: ng/ml (ng/ml x 3.03 => nmol/l)
Androgenic hormones: testosterone (total and free), DEA sulfate, cortisol.
These hormones can be taken at any time, but it is better to do this on days 7-9 of the menstrual cycle. Exceeding the normal concentration of testosterone in a woman can cause abnormal ovulation and early miscarriage, and the maximum concentration of testosterone is determined in the luteal phase and during ovulation.
RULES FOR TESTOSTERONE DELIVERY: The day before the test, you must exclude: sex, physical activity, stress. Immediately before taking blood, you need to sit quietly for about 20-30 minutes. Like prolactin, testosterone is a stress hormone and is sensitive to physical and emotional stress.
Testosterone (total)- Standards for women of reproductive age: 0.38 - 1.97
Units of measurement: nmol/l. Alternative units: ng/dl (unit conversion: ng/dl x 0.0347 => nmol/l), ng/ml (ng/ml x 3.4722 => nmol/l)
Testosterone (free)- Standards for women of reproductive age: less than 4.1
Units of measurement: pg/ml. Alternative units: pmol/l (conversion: pmol/l x 0.288 => pg/ml)
DEA-sulfate (DEA-S04, DEA-S, DHEA-sulfate, DHEA-S)- Standards for women over 18 years of age: 0.9 - 11.7
Units of measurement: µmol/l. Alternative units: 35 - 430 mcg/dl (Unit conversion: mcg/dl x 0.02714 => µmol/l)
Cortisol is the main catabolic hormone that breaks down proteins, promotes fat accumulation, and also increases blood glucose levels. Cortisol is produced in response to stress, fatigue, exercise, fasting, fear and others. emergency situations. Cortisol is also called the stress hormone and is designed to mobilize nutrients: body proteins (including muscle) are broken down into amino acids, and glycogen into glucose. (
Follicle-stimulating hormone is known to every woman who is planning a pregnancy. A test for this indicator is prescribed by a gynecologist, endocrinologist, or reproductive health specialist.
It is important to understand what level is considered normal and to know the reasons why FSH (follicle stimulating hormone) is elevated or decreased in women.
Follicle-stimulating hormone (follitropin)- a substance produced in the pituitary gland. In a woman’s body, it is one of the substances that ensure egg maturation and ovulation.
The synthesis of follicle-stimulating hormone occurs in the brain.
The pituitary gland secretes FSH and releases it under the control of the hypothalamus. With the blood, this substance spreads throughout the body, reaching its target - the ovaries.
Follicles mature in the ovaries under the influence of FSH. A mature follicle contains an egg that is ready for fertilization.
When the maturation process comes to an end, follitropin causes ovulation (the release of an egg from the follicle).
After ovulation becomes possible offensive pregnancy.
To find out the amount of follitropin, donate blood from a vein. Before blood sampling, you should not eat, smoke, or drink carbonated drinks for 2-3 hours (you can only drink clean water).
The day before this test you need cancel sports training, avoid nervous overstrain And stressful situations.
This analysis is required in the following cases:
The study should be carried out approximately 6 days after the start next menstruation when the level of the substance is highest.
If you failed to take the test on time, you will have to wait until next month to take the test.
Depending on the phase of the menstrual cycle, the amount of follicle-stimulating hormone in healthy woman ranges from 1.7 to 25.0 mIU/ml, reaching a maximum during ovulation.
After ovulation, this value decreases until the onset of a new cycle.
In girls before puberty the FSH value is low - from 1.5 to 4.0 mIU/ml. With the onset of puberty, the amount of follitropin gradually increases, and a year after the onset of menstruation it is set at the level of an adult woman.
FSH levels increase with age- during menopause, its value increases to 140-150 mIU/ml.
The norm of the FGS hormone in women by age in the table (for fertile women and during menopause):
Luteinizing hormone is another substance, which regulates the work of women's reproductive system. In the first 15 days of the menstrual cycle, the proportion of FSH is higher, in the second half - LH.
For pregnancy to occur, the correct ratio of the hormones LH and FSH is important.
To determine fertility (the ability to become pregnant), it is necessary to obtain the results of a blood test for the content of both substances, and then determine their ratio.
For an adult lady the normal LH/FSH ratio is 1.3-2.5 to 1.
Ratio less than 0.5 speaks of impaired egg maturation, and an increase of more than 2.5 is caused by polycystic ovary syndrome.
A deviation upward or downward is a reason for an in-depth examination.
What is it and what are the hormones FSH and LH responsible for in women, what are their norms, how to take a blood test to determine the level, the video will tell you:
Low FSH in women does not always indicate abnormalities in good health. Most likely, the doctor will order a repeat test.
Taking a woman can cause a decrease in the amount of FSH medicines . These include:
The value of follitropin always decreases during pregnancy. In pregnant women, FSH levels remain low until delivery and postpartum period. In addition, the amount of this substance decreases with low-calorie diets.
In much rarer cases the decrease in FSH is caused by pathological processes . Such ailments include disorders of the hypothalamus and pituitary gland, excess prolactin, cysts and ovarian tumors.
However, there is no need to worry ahead of time - these diseases are rare.
To exclude dangerous diseases the doctor will prescribe additional research(determination of hormone levels in the blood, ultrasound examination pelvic organs and others).
If the value turns out to be low, you can retake the test next month. To rectify the situation, you should pay attention to nutrition. Fasting and anorexia inhibit follitropin synthesis.
You need to give up exhausting diets and include foods that increase FSH production in your diet.
These include:
Besides, Avoid stressful situations, excessive physical activity . General massage, baths with essential oils(jasmine, neroli, sage, lavender).
Daily is important night sleep at least eight hours. At healthy eating and following a sleep and rest schedule, there is a high probability that the next test will be normal.
Taking certain medications can cause an increase in the amount of the hormone.. These include:
High FSH levels in women are normal during menopause.
Pathologically increased level FSH in women is observed after severe infections and intoxications, with endometriosis, ovarian cysts, as well as with tumors of the ovaries and pituitary gland.
In addition, the amount of follicle-stimulating hormone increases for chronic alcoholism.
How to lower FSH in women? Before re-examination need to make changes to the diet. Should be excluded from the diet vegetable oil, fatty fish (mackerel, saury, herring, sprat, halibut).
Necessary completely stop drinking alcohol.
Excess body weight causes deviations in a woman's endocrine system and, naturally, the result of the FSH analysis is higher than normal.
If your body mass index is 24 or more, you need to take measures to lose weight: increase physical activity, reduce the caloric content of the diet.
If a follitropin test has not been prescribed by a doctor, consultation with a specialist may be necessary. You need to make an appointment if the study revealed an increase in FSH.
If the amount of this substance is reduced, you can wait and do another analysis. The reason for contacting a specialist is a decrease in follitropin in repeated tests.
An endocrinologist deals with hormonal disorders, but if you have complaints from the reproductive system (pain in the lower abdomen, unusual vaginal discharge), you can first contact a gynecologist.
Some clinics have a fertility specialist, which will help if a woman is planning a pregnancy.
A decrease or increase in follicle-stimulating hormone levels can be caused by: natural causes(stress, alcohol consumption, diet disorders), and serious illnesses.
FSH is a key link in the hormonal system, ensuring women's reproductive health.
If there are deviations in the content of this substance, you need to consult a doctor in time in order to preserve fertility in the future, become pregnant and bear a healthy child.
