High FSH low LH

[Greensmoothie1]

My FSH is right at the top of the “normal” range whereas my LH is on the lower end. The ratio is over 1, which is the ideal limit. My FSH is 6 numbers higher. My GP is investigating why I’m not ovulating every month.

Has anyone else experienced this?

Hi. My FSH is 9.6 and LH 4.5. I have been told that both are in normal range. However, I have also read some articles suggesting the ratio should be the same but my acupuncturist say FSH is normally double LH so I’m not sure.

How do you know you’re not ovulating and how long have you been TTC? X

@Hoping43 I have similar numbers! The ratio seems way to high considering they’re supposed to be similar numbers. I don’t have a period every month (cycle is 40+ days) so I’m not ovulating regularly. I’ve been ttc for 4 months now.

Have you had any feedback on your numbers? I have been TTC for 9 months now and just got a negative this morning. I have a referral to fertility clinic in Jan so will find out more about my numbers then. I have had blood tests done multiple times this year, once FSH were both around 6 and once FSH was 3.9. I think they do change every month x

@Hoping43 GP just said they were within normal levels, but I am having my bloods repeated soon. Very interesting that the levels keep changing!

Do you know why they’re repeating them? I’ve read loads of mixed things. I feel like 9.6 is pushing the boundaries of normal so I am worried about it, especially after 9 months without success x

Yes!! I have been trying for a year, had 3 cycles in that time and have the same issue. A consultant spotted it when I went for a scan, it had never flagged before due to both being in "normal" range. The consultant asked me if they'd ever spoken to me about PCOS as that can be a sign of it, supposedly you can have it without having the cysts! They took additional bloods to test my testosterone levels as that will confirm so I'm waiting on those.

@Hoping43 they’re repeating them because something else was borderline high. @Endogal very very interesting! I’m still waiting for my scan, but I’m going to quiz my GP further. The ratio is too high.

@Greensmoothie1 have you had a referral to the fertility clinic if you’ve been trying for a year?

@Hoping43 They’ve not referred me yet. GP told me that the year will be from when I had my blood test despite me asking for help about my periods/ovulation for nearly 2 years.

I would really push it. You should be referred after 12 months of unsuccessful trying. My GP referred me after 7 months and it’ll be cycle 10 by the time we have our initial nurse appt and cycle 11/12 by the time we see a consultant x

Thanks @Hoping43 I think I will push for it once I get my next bloods done. I’ve been asking for help about my period for a long time. No one in my family has struggled so I don’t know why my cycle is so unpredictable

Maybe look on the NICE guidelines and you’ll find the guidance for referrals. You could print it out and take it to your GP. I hope you get some answers as it really isn’t nice being disappointed month after month x

@Hoping43 thank you, I will have a look at the guidelines. It’s so depressing isn’t it?

I was in a similar boat to you, and often despite high FSH numbers told I had unexplained infertility as other results came back ok. Took almost 3years to conceive including a miscarriage which delayed referrals in addition to covid. Depending on age referral is now 2years.

I am due end of this month having found out the day we went in for our IVF protocols. Naturally conceived, I suspect a focus on a balanced but high protein/ Mediterranean diet and regular exercise helped as well as moving towards IVF helped 'de-stress'.

Please advocate you own health, chase appointments/referrals and blood tests, ask for a hycosy etc as it does take time. There is some scary reading out there when it comes to high FSH, NICE guidance in particular, but please do read it and be informed when you go into appointments so you can get the help you need.

This is so interesting. What was your FSH and were you told it was high? Mine is 9.6 and so far been told it’s normal. I already have two children and I turned 35 a few days ago. We’ve been TTC for 9 cycles. I’m beginning to think I may have to write off having a third child which I so desperately want ☹️

Unfortunately GPS are usually not very knowledgeable in this area. It’s no use saying your numbers are ‘normal’ if the ratio is off.

High FSH can be caused by stress. Can you reduce this? It will definitely help if you’re trying to conceive.

You should also be investigated for PCOS, which will involve tests and scans the GP can’t provide. Push for a referral.

@Hoping43 my FSH was 9 and LH was 3.5. I’m in my mid 20s and can’t predict when I’ll ovulate. @PBfingers @Totallydefeated I agree that although the levels are “normal” the ratio is way off! I’m going to take you advice and really push for this. I’m sick of being told to wait and see. It’s been nearly 2 years of asking for help.

@Greensmoothie1I think for PCOS it’s more concerning if the LH is higher than FSH. If FSH is higher than LH that’s probably more to do with ovarian reserve

I'm in my late 20s and definitely going to push as well! I have endometriosis so feel like the odds are just so stacked against me that more time with proper help will only be a good thing!

[quote Hoping43]@Greensmoothie1I think for PCOS it’s more concerning if the LH is higher than FSH. If FSH is higher than LH that’s probably more to do with ovarian reserve[/quote]
That’s really worrying. I’ve only just entered my mid 20s. I never thought I would have issues.

@PBfingers

@PBfingers This is so interesting. What was your FSH and were you told it was high? Mine is 9.6 and so far been told it’s normal. I already have two children and I turned 35 a few days ago. We’ve been TTC for 9 cycles. I’m beginning to think I may have to write off having a third child which I so desperately want ☹️

@Greensmoothie1 sorry, I didn’t mean to worry you as my information is purely from dr google and I have read everything and totally worked myself up.

Don’t forget though that your FSH is 9 and the cut off is 10 and it can change every month as mine has demonstrated. Also, the younger you are the better quality eggs you have and you will only ovulate one a month regardless of your overall ovarian reserve. There was a study done in 2017 showing no difference in conception rates between women with FSH over 10 and FSH under 10 over a 12 month period. I believe where it really matters is for IVF purposes. There are also other tests such as antral follicle count and AMH which can build up a better picture. I think you need to get to the bottom of your lack of ovulation as most people will have 12 chances over a 12 month period but obviously you’re getting less x

Thanks @Hoping43 I think we al read too much and then scare ourselves! I’m definitely going to ask my GP to do further tests to figure out why I’m not ovulating regularly.

Just refound my notes - So my highest level of FSH was 23 one month, however on the whole from day 3 bloods it ranged from 10 to 12.2. LH at 10.3. I was 32/33 around the time of the tests, with normal BMI.

Consultant was very keen that blood tests were done to include early period spotting not full onset. Done between 2 and 5 days. Plus progesterone at day 21 to confirm ovulation, which it did. They also pushed the healthy diet and weight piece heavily throughout all consultations... until she finally met face to face and could see I was not overweight!

Note that blood tests are only current for 6 months so they will retest you multiple times if needed so results are current.

Be careful what you read and action without seeking advice. Particularly around supplements and as others have said, don't get put off by what you read. As you will find IVF success rates are not great with elevated FSH so potentially not funded on NHS, however our NHS Trust/consultant were happy to do one round. It is such a individual postcode lottery and can be disheartening to read /hear but keep pushing .

Separately, we started using the clearblue digital ovulation monitor (the fancy, expensive one) in the 3 months prior to conceiving. It is expensive, but it helped reduce the pressure, stress and unknown for us.

I hope this brain dump helps a little and good luck with your appointments.