Our expert says:
In the first instance the reasons for the naturally elevated FSH level is a compensatory mechanism by the pituitary gland to override the ovarian resistance or poor ovarian response. Such elevation of FSH is often seen in peri-menopausal women and is the bodies attempt to continue maintaining ovulation despite the poor reserves within the ovary.
In cases pertaining to fertility the objective of a high dose FSH is to assist the pituitary gland in overcoming the ovarian resistance and hence to force follicle production and hopefully ovulation. In my practice I often use an antagonist to first suppress FSH production, which will then allow ovarian receptors to recruit and be more sensitive when we attempt high dose injectables.
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