Raised LH - what does it mean?

[DotingDaisy]

Can it mean anything other than PCOS?

I was diagnosed with PCOS about 12 years ago, but I had a scan recently (for something else) and they said my ovaries didn't look polycystic at all. Is it possible for the condition to resolve?

I had bloods done on CD2 and my LH was 15.6 - reference range should be 2.4-12.6. (For reference, FSH was 12, range is 3.5-12.5)

Thanks if you are able to help. My GP has signed them off as normal?!

Pcos is an endocrine disorder. It does not resolve. One of the symptoms is polycystic ovaries. There are others.

Insulin resistance is the big issue with pcos and that doesn't go away (but can be treated).

Thanks physicskate. What I can't understand is why my ovaries would look normal on the last scan? Unless the PCOS was diagnosed incorrectly in the first place?

It's possible. There are a few ways of diagnosing pcos. You have to hit a certain number of indicators. One of those indicators is the appearance of your ovaries. Another is you lh:fsh ratio. If the ratio is higher than 2:1 (which yours is not that high) it's another indicator. Testosterone levels and physical symptoms are the other indicators, I believe.

There are 2 conditions: PCO and PCOS. The latter is the endocrine disorder, the former is cysts on your ovaries that can resolve. If you have PCOS that’s so bad it impacts your fertility there would be other symptoms than just a one off high LH result — facial hair, greasy skin, hair loss, irregular periods, a high follicle account (even if there aren’t any cysts).

I have had LH measured in the past (when I was diagnosed with PCOS) and it has always been high. At the same time my periods were completely irregular (as in, non existent). They are now every 28 days, bang on.

Maybe I only ever had PCO, which has resolved, then? But does that explain the high LH now? They didn't do testosterone testing this time.

Do you have any other symptoms? LH/FSH imbalance by itself isn’t generally proof of PCOS. You need 3 symptoms I think before you can be diagnosed.

I just had a quick look at the diagnosis criteria.

I had cysts on my ovaries. And no periods.

But I didn't have high levels of testosterone.

Apparently you have to have 2 out of 3, which I did.

But if I now don't have cysts on ovaries or irregular periods, then I can't have PCOS?!

PCOS is a syndrome. A syndrome if more of a comination of signs and symptoms rather than a disorder. It's a technicality that's all. It's just what it's called. Unfortunately no it won't resolve but with the correct treatment the symptoms can certainly improve for a lot of women. You have a combination of symptoms that fit the diagnosis.

You don't need excess androgen levels in order to have PCOS either. It is also possible that you were misdiagnosed 12 years ago. A lot of women have cysts on their ovaries but don't have PCOS (functional cysts). You can just have Ovarian cysts without any other diagnostic symptoms and sometimes they are very similar to PCOS. It's very confusing I know, so I would get a second opinion if I were you. Best of luck to you!

Hi @DotingDaisy

I'm not sure on the LH but if your FSH is >9.5 then you're eligible for early referral (reference: www.gponline.com/clinical-review-subfertility-women/obstetrics/assisted-conception/article/836742)

My GP marked FSH of 12 as normal too - but I emailed them this article - they referred me to fertility clinic and I started ivf a couple of months later (ivf due to MFI but they said due to FSH I shouldn't hang around) hope that helps a bit

www.gponline.com/clinical-review-subfertility-women/obstetrics/assisted-conception/article/836742

Try this instead

hoping2018 wow did it all really happen that quickly? Do you mind if I ask what area of the country you are in? I am in Bristol and assumed there would be a really big wait given it's a big city.

Thanks for the info re the high FSH. I had only really focussed on the LH so would have missed that otherwise

@DotingDaisy - my FSH is 12 also and I kind of had a faster referral (as in I'm being referred straight for IVF rather than dick about on clomid for six months first), but it's still taken six months since my first lot of tests and i haven't even had my first appointment with the fertility clinic yet. So a quick referral isn't necessarily the norm. I have been calling up to make sure I'm moving through their system but I haven't been pushing things a lot though, as we're not 100% sure we're going to go for IVF anyway, especially if the chances of success they give us are low.

Hi @DotingDaisy

I've PMd you my long story of how it all happened!

I think my area/clinic were good which is why things happened so quickly rather than it was my FSH alone! But the combination of my FSH and MFI meant we didn't do any other tests or treatment but went straight to ICSI. X

I would hope that with DPs MFI and my high FSH that we would go straight to ICSI too. Fingers crossed

79andnotout I found out yesterday that we won’t get NHS funded treatment, so we are looking to go privately. Are you going through NHS services?

@DotingDaisy - yes I think I will get one go on the nhs, according to the criteria they've given me, but that hasn't been confirmed yet. What have you been ruled out on?

Not being in a relationship for 2 years, and the fact DP has had previously funded treatment.

Ah yeah that's rubbish.