High FSH in women is most commonly an indicator of diminished ovarian reserve/ovarian insufficiency or premature ovarian aging. These terms are commonly used to describe women who are under the age of 40 and experience a decreased amount of potential eggs, but diminished ovarian reserve is also the result of advancing age. Because the clinical implications of an elevated FSH level can be serious, it is important to gain more of a complete clinical picture to assess the severity of the depletion. An ultrasound of the ovaries and other laboratory work are used to confirm the finding.
It is important to be aware that high FSH levels DO NOT mean that the woman does not have a chance of reproduction. Instead this should serve as notice and alert her to her advanced reproductive aging. This information should serve as an educational tool to make decisions about her options. Often times it can result in women trying to get pregnant sooner rather than later and if that poses a challenge, seeking help with trying to conceive and possibly moving toward IVF.
Among the different protocols of IVF, Mild Stimulation IVF, Mild Stimulation IVF, or Natural IVF may be the more suitable treatments for these patients. This is because sometimes the ovaries may not respond to extreme-high doses of medications. As a result, mild stimulation IVF may work. It does not mean getting less eggs for patients, but rather because of patient’s condition, maximizing the ovarian potential by using a milder approach.