FSH levels is one of the indicators of a women’s ovarian function and their ability to conceive. Sometimes it is used as one screening criteria for women’ suitability for receiving assisted reproductive treatment (ART). Elevated FSH is one of the most common causes which make it difficult for women to conceive. In general, these women respond poorly to the drugs used to stimulate their ovaries for ART. In case they do respond, the egg quality is usually not good enough and/or the number of eggs are few. In fact, many fertility clinic assume that elevated FSH is unreversable condition, therefore they would refuse to treat women with high FSH level, or would advise them to consider using donor eggs (2).
The FSH level is taken by blood test, often in day two or day three of the menstrual cycle. Table 1 gives the typical ranges for FSH levels, although individual fertility clinics and laboratories may use different ranges.
|Normal values||4.5-21.5 IU/L|
|FSH values >10 IU/L predict poor response to ovarian stimulation|
|FSH values >18 IU/L predictor of poor pregnancy outcome|
|Menopausa||25.8 -134.8 IU/L|
Traditional Chinese Medicine point of view
A decline in women’s ovarian function and egg quality is described in Chinese medical as a natural decline in Kidney essence, including Kidney Jin and Kidney Jang. The goal of treatment is not directly to reduce FSH level, but to improve the function and responsiveness of the ovary, regulate the pituitary hormon output, which in turn help increase the patient’s reproductive capability. Successful treatment would results in the improvement of many symptoms, including menstruation, number and quality of follicles, overall well-being, and in most of the cases with the reduction of FSH.
According to Traditional Chinese medicine, elevated FSH can be categorized into the following patterns (4):
- Kidney Jin deficiency
- Kidney Jang deficiency
- Dampness and Phlegm
- Blood deficiency (caused by Liver and/ or Spleen deficiency)
- Blood stagnation
- Liver Qi stagnation
- Liver Excessive Heat
- Combined of these patterns
Acupuncture treatment effectively treat women with elevated FSH thanks to these effects:
- Increase the blood flow to the uterus and the ovaries to nourish the follicles.
- Normalizes the function of the Hypothalamus-Pituitary-Ovarian axis to regulate the normal hormonal production, therefore improves ovarian function and responsiveness.
- Help relaxes the body, reduce stress.
- Moreover, acupuncture treatment was reported to have almost no side effects. It even helps to reduce sides effects of other treatments when combines with them.
After treatments patient often feel better with:
- More regulated menstruation, less blood cloth, less abdomen discomfort, less hot flash.
- Be relaxed, calmed, less anxious.
- Better sleep and digestion.
- More energy and better overall well being.
A pilot study from the Institute of Acupuncture , China Academy of Chinese Medical Science and University hospital of Tianjin has show positive effect of acupuncture on 31 women with elevated FSH:. Compared with baseline, patients’ serums FSH and LH were decreased, E2 was increased, and SAS score and Kupperman score were decreased. No serious adverse events were found in all patients. The results indicated that acupuncture help decrease serums FSH and LH level, raise serum E2 level, relieve anxiety, reduce mental stress, and improve the menopausal symptoms.(1)
Another case study report also emphasized that even TCM cannot help turn back the biological clock, it can help improve the ovarian function and responsiveness to FSH, therefore help increase the patients’ fertility. The reduced FSH after TCM treatment also help patients access to ART that would otherwise be denied (4).
6 case study from Dr. Xiao-Ping Zhai, a famous TCM doctor for treating infertility in London, the UK, also mentioned that TCM treatment, including acupuncture, can lead to a considerable improvement in ovarian function and help to regenerate a woman’s reproductive system (2).
Although FSH may not give a complete picture for the ovarium capability of the women, it is undeniable that a suitable FSH level is a desired factor before starting fertility treatment. Acupuncture treatment can help improve the function and reponsiveness of the ovary in many cases and as a result, FSH level should decrease. Ofcourse it cannot guarantee the success in all cases, but it is always worth having acupuncture to prepare and optimize your health before get into any kind of assisisted reproductive treatment. Improved ovarian function will further result in better chance of getting pregnancy. The combination of acupuncture and assisted reproductive treatment therefore is potentially bring better results for patients.
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- Effects of Acupuncture on Premature ovarian Failure: A pilot study, Evidence-Based Complementary and Alternative Medicine, Volume 2014, ID 718675https://pubmed.ncbi.nlm.nih.gov/24711856/
- Treatment of elevated FSH with Traditional Chinese Medicine, Dr. Xiao-Ping Zhai el al, www.zhaiclinic.com
- The American Association for Clinical Chemistry, Link https://www.ucsfhealth.org/medical-tests/003710 and the University of California, San Francisco https://www.aacc.org/cln/articles/2012/november/fertility-testing
- The treatment of Elevated FSH levels with Chinese Medicine, Journal of Chinese Medicine, Number 91, October 2009.
- Dr Beke Artúr, Semmelweis Egyetem, Petefészek elégtelenség, https://semmelweis.hu/laboratorium/files/2014/04/09._Petef%C3%A9szekel%C3%A9gtelens%C3%A9g_dr._Beke_Art%C3%BAr.pdf
- POF (korai petefészek-kimerülés) vizsgálata, Versysclinic, https://versysclinics.com/a-kor-es-a-meddoseg-kapcsolata/pof-korai-petefeszek-kimerules-vizsgalata
- Dr. Deli Tamás, A korai petefészek-kimerülés (POF) I. – diagnózis, etiológia, http://www.drdelitamas.hu/pof.html