fertility abbreviations

Gele · Post by **Gele** » Sun Jun 22, 2003 7:36 pm

hi can anyone please "enlighten" me as to what the abbrevs all mean? I'm up on a few...but am getting a bit lost. Also, does anyone know what the "ideal/normal" ranges are for FSH & LH?...... I'm having to go for 21 day blood tests, and was going on day 2, but my Cons says it should be day 4....any help anyone? Thanks Gele x

Traci · Post by **Traci** » Mon Jun 23, 2003 7:52 am

DH Darling Husband AF Aunt Flow OMG "Oh my God" EC Egg Collection ET Egg Transfere I have got this information from the internet but its very interesting hope it helps. Day 3 follicle stimulating hormone: FSH Follicle stimulating hormone (FSH) is one of the most important hormones involved in the natural menstrual cycle as well as in pharmacological (drug-induced) stimulation of the ovaries. It is the main hormone involved in producing mature eggs. FSH is the same hormone that is contained in the injectable gonadotropins which are used to produce multiple eggs for infertility treatment. When a women goes into menopause she is essentially running out of eggs in her ovaries. The brain senses that there is a low estrogen environment and more FSH is released from the pituitary gland in an attempt to stimulate the ovaries enough to produce a good follicle and estrogen. You can think of it like stepping on the gas pedal in the car to get going. The FSH is the gas, and the pituitary gland releases FSH to get a follicle "going" at the beginning of every menstrual cycle. If there are less follicles left (and perhaps lower quality follicles) the "gas" has to be increased to get a follicle to start developing. In a menopausal woman, the gas pedal is on the floor for the rest of her life - even though there are no follicles (or eggs) left that are capable of developing, the woman's body never gives up trying and FSH levels are permanently elevated. Women in menopause usually have FSH levels that are above 40 mIU/ml. As women approach menopause their baseline FSH levels (day 3 of their cycle) will tend to gradually increase over the years. When they run out of follicles capable of responding, their FSH will be quite high (over 30-40 mIU/ml) and they will stop having menstrual periods. By measuring a baseline FSH on day 3 of the cycle (we do it on either day 2, 3, or 4), we can often get an indication that the women is closer to menopause and has relatively less "ovarian reserve". Another way of saying this is that if the baseline FSH is elevated the ovarian reserve (how many eggs are left) and probably also the egg quality is reduced. In other words, it usually reflects a compromise of both quantity and quality. There are some practical problems associated with this test: 1. The cut off values used to say that egg quality is good, ok, or poor is very laboratory dependent. What this means is that a given level of, for example, 12 in one laboratory may reflect good ovarian reserve and egg quality - whereas the same level in another laboratory using a different assay may reflect poor ovarian reserve, poor egg quality, and low live birth rates with IVF. See below for more on interpretation of results. 2. While an abnormal result (high baseline FSH) tends to be very predictive of poor egg quality, a normal result does not necessarily mean that the egg quality is good. There are a significant number of women with normal baseline FSH values that do have poor egg quality that is not being reflected in their FSH value. This is particularly true for women in their 40s. An infertile 44 year old woman with a normal FSH (for example 6) still has a very low probability of conceiving and delivering with in vitro fertilization - or with any other fertility treatment. The fact that she is 44 greatly diminishes her chances - even if her FSH is normal. This is why IVF programs have age cutoffs. The oldest women accepted by IVF programs varies somewhat - most programs have a cutoff somewhere between age 42-45. Infertile women older than this will rarely be successful using their own eggs. However, women in their 40s are excellent candidates for in vitro fertilization with donor eggs. Interpretation of day 3 FSH levels In our center we are currently using a DPC assay run on an Immulite machine. We consider normal for this assay to be under 8. As levels go above 8.0 we often see a reduction in response as illustrated in the table below. If your levels were run with a different assay, you can not compare the results to those shown here with any confidence at all! For example, with some assays, a level of 14 is normal... Day 3 FSH level Interpretation (DPC Immulite only) Less than 6 Excellent. Very reassuring level. 6-8 Normal. Expect a good response to stimulation. 8 -10 Fair. Response is between completely normal and somewhat reduced (response varies widely). Overall, a somewhat reduced live birth rate. 10 - 12 Lower ovarian reserve. Usually show a reduced response to stimulation and some reduction in egg and embryo quality with IVF. Reduced live birth rates. 12 - 17 Generally show a more marked reduction in response to stimulation and usually a further reduction in egg and embryo quality with IVF. Low live birth rates. Over 17 "No go" level in our center. Very poor (or no) response to stimulation. No live births. "No go" levels must be individualized for the particular lab assay and IVF center. Some caveats about day 3 FSH testing In general, your ovarian reserve and your egg quality is a s bad as your worst FSH. If you have an FSH of 15 in one cycle and have it repeated in another cycle and get a 7 - the situation is not improving. Some women do "bounce around" with FSH levels in the normal to abnormal range - but they will generally respond and have chances for pregnancy more like those women who are consistently at their higher FSH level. Waiting for a menstrual cycle with a lower FSH level and then stimulating quickly for IVF is probably of no benefit at all. Young (e.g. under 35) women with elevated FSH levels stimulate better and have a higher pregnancy potential than "older" women.