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Dr. Betina Chandolia

BDS, MDS - Oral Pathology and Microbiology

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Dr. Ashish Ranjan

MBBS, MD (Pharmacology)

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Follicle Stimulating Hormone

(FSH)

ADD TO CART

You need to provide

Blood

This test is for

Male, Female

Test Preparation

No special preparation required

Overview

What is FSH?

FSH is a hormone required for reproduction and the development of eggs in women and sperms in men. FSH is produced by the pituitary gland, and its production is controlled by a feedback system involving the hypothalamus, pituitary gland, and hormones produced by the ovaries or testicles. The hypothalamus releases gonadotropin-releasing hormone (GnRH), which stimulates the pituitary to release FSH and luteinizing hormone (LH), a closely-related hormone which is also involved in reproduction. This test measures the level of Follicle stimulating hormone (FSH) in your blood.

Without the release of FSH, a woman cannot continue her reproductive cycle, as her ovulation will be impaired. FSH levels can be tested in both sexes to assess fertility, or to see if a woman is going through menopause.

Why is FSH done?

FSH test is done for the following indications:

To evaluate infertility issues in females
To evaluate the function of reproductive organs (ovaries or testicles)
To assess irregular menstrual cycle in women
To diagnose disorders of the pituitary gland or diseases involving the ovaries in women
To evaluate early or delayed sexual maturation (puberty) in children
To evaluate low sperm count in men
To assess hypogonadism or gonadal failure in men
To assess testicular dysfunction in men

What does FSH Measure?

Follicle-stimulating hormone (FSH) is a hormone which is associated with reproduction and the development of eggs in women and sperm in men. This test measures FSH in the blood.

FSH is produced by the pituitary gland, and its production is controlled by a feedback system involving the hypothalamus in the brain, the pituitary gland, and the hormones produced by the ovaries or testicles. The Gonadotropin-releasing hormone (GnRH) from the hypothalamus stimulates the pituitary gland to release FSH and luteinizing hormone (LH; another closely-related hormone also involved in reproduction). FSH affects the growth and maturation of egg follicles in the ovaries during the follicular phase of the menstrual cycle. The menstrual cycle is divided into follicular and luteal phases, each phase lasting for 14 days. During the follicular phase, FSH initiates the production of estradiol by the follicle, and the two hormones work together in the further development of the egg follicle. Near the end of the follicular phase, the production of FSH and luteinizing hormone increases. The release of the egg from the ovary (ovulation) occurs shortly after this increased production of hormones. The hormone inhibin as well as estradiol and progesterone help control the amount of FSH released by the pituitary gland. FSH also facilitates the ability of the ovary to respond to LH. At menopause, ovarian function decreases and eventually ceases which results in increased levels of FSH and LH.

In males, the role of FSH is to stimulate the testicles to produce mature sperms and also promotes the production of androgen binding proteins. FSH levels are relatively constant in men after puberty than in women.

In infants and children, FSH levels rise shortly after birth and then fall to very low levels by 6 months in boys and 1-2 years in girls. Concentrations begin to rise again before the beginning of puberty and the development of secondary sexual characteristics.

Disorders affecting the hypothalamus, pituitary, and/or the ovaries or testicles can cause the production of too much or too little FSH, resulting in a variety of conditions such as infertility, abnormal menstrual cycles, or early (precocious) or delayed sexual maturation (puberty).

Interpreting FSH results

Interpretations

Reference range of FSH is age- and gender-specific. As for women, the reference range is menstrual cycle phase-specific.

The reference range for follicle-stimulating hormone (FSH) is as follows (3rd generation immunochemiluminescence assay):

Females reference range:

· Age 0-7 years: <6.7 mIU/mL

· Age 8 years to adult:

· Follicular phase: 3.1-7.9 mIU/mL

· Ovulation peak: 2.3-18.5 mIU/mL

· Luteal phase: 1.4-5.5 mIU/mL

· Postmenopausal: 30.6-106.3 mIU/mL

Males

· Age 0-7 years: <6.7 mIU/mL

· Age 8 years-adult:1.3-19.3 mIU/mL

The reference range may vary from lab to lab*

Answers to Patient Concerns & Frequently Asked Questions (FAQs) about FSH

Frequently Asked Questions about Follicle Stimulating Hormone

Q. What do high levels of FSH indicate?

High levels of FSH can indicate loss of ovarian function or ovarian failure, menopause, polycystic ovarian syndrome, chromosomal abnormalities (e.g., Turner’s syndrome), and reduction in the production of good quality eggs and embryos for fertilization.

Q. What do low levels of FSH mean?

Low levels of FSH may indicate decreased ovulation in women, reduced sperm count in men, problems at the level of the hypothalamus or pituitary gland, which are the hormone control centers in the brain, and stress.

Q. What other hormone tests may be required along with abnormal FSH values?

FSH levels are usually just one part of the puzzle a doctor has to work out. To gain a clearer picture, further tests are likely to be needed. Following tests may be advised by your doctor: Estradiol Luteinizing hormone Progesterone Testosterone

Q. What are the causes of high levels of FSH in Children?

The start of puberty might be the cause for high levels of FSH in children.

Q. Can medicines have any effect on the levels of FSH?

There are certain medicines that can affect the levels of FSH. In order to prevent false readings, it is important for the individual to inform the doctor about all the medicines they are taking as they can alter the functioning of hormones. Medicines that could increase FSH levels include cimetidine, clomiphene, digitalis, and levodopa. Whereas, medicines that decrease FSH levels include hormone replacement therapies, oral contraceptives, and phenothiazines. Taking multivitamins that contain biotin or vitamin B7 may also affect the accuracy of the FSH test. Doctors usually recommend that a woman should not take these supplements for at least 12 hours before a test.

Q. Are there any special preparation required for FSH test?

As such no special preparations are required. However, in case of women, menstrual cycle timing is noted so as to compare the range accordingly.

Q. What are the causes of high levels of FSH in Men?

High levels of FSH in men may indicate Klinefelter’s syndrome, absence of testicles or impaired functioning of testicles, damage to testicles by a disease such as alcohol dependence, and testicular damage by treatments such as X-rays or chemotherapy.

Q. Which factors can affect the FSH level?

The levels of FSH can get affected by conditions like uncontrolled thyroid disease, sex-dependent hormone tumors, ovarian cysts, and unusual vaginal bleeding. Moreover, medicines like birth control pills, cimetidine, clomiphene, digitalis, levodopa, phenothiazines as well as medicines used in hormone replacement therapies can also affect the levels. Similarly, medicines used in hormone replacement therapies can also alter the FSH levels. Multivitamins containing biotin or vitamin B7 may also affect the accuracy of the FSH test. It is generally advised that a woman should avoid taking these supplements for at least 12 hours before a test.

Q. Can levels of FSH vary during different days of the menstrual cycle?

Yes, the FSH level can vary during the different phases of the menstrual cycle. Following are the normal range during different phases: Follicular phase: 3.1-7.9 mIU/ML Ovulation phase: 2.3-18.5 mIU/mL Luteal phase: 1.4-5.5 mIU/mL FSH levels can vary not only throughout the menstrual cycle but also from cycle to cycle. You can get a normal test value one month and an abnormal test value the next. Hence, to test basic fertility and to evaluate ovarian reserves, the FSH level is checked on day 3 of the menstrual cycle. The first day of the cycle is the day when the period begins. Reference range may vary from lab to lab* l range during different phases: Follicular phase: 3.1-7.9 mIU/ML Ovulation phase: 2.3-18.5 mIU/mL Luteal phase: 1.4-5.5 mIU/mL FSH levels can vary not only throughout the menstrual cycle but also from cycle to cycle. You can get a normal test value one month and an abnormal test value the next. Hence, to test basic fertility and to evaluate ovarian reserves, the FSH level is checked on day 3 of the menstrual cycle. The first day of the cycle is the day when the period begins. Reference range may vary from lab to lab*

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