Posted by: Hilary | 2007/04/23

Elevated FSH and Injectables

Dear Doctor

Thank you very much for your very complete and explanatory answes to the various questions. i really enjoy reading them- its always "different" in that it is patient-specific instead of just generalisations.

However, I have had this burning question for a long time, but have not seen anyone ask it yet. I know that you will be able to give me a more than satisfactyory answer"

I would like to know why do fertility experts still recommend injectables such as Gonal F and the like injectables even though a patients FSH is already high?
Would'nt this increase FSH further and thus lead to poorer egg quality?

I was always confused about this and am confident that you will ultimately put my case to rest>

Thanks once again for an excellent forum.

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Our expert says:
Expert ImageFertility expert

Dear Hilary

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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