Studies About High FSH and It's (Sometimes) Non-DOR/POF Meaning

Found on the High FSH Support board:

I was 'diagnosed' on June 5 by the first RE I went to. My husband and I were so disturbed by the High FSH (16) diagnosis that we started going through the medical literature. (I'm a trained librarian and my husband's mother is a nurse. He learned in self-defense ) Anyway, we ended up going to a completely different doctor for a second opinion - which gave us better news - with a ton of research in our hands:

Other reasons for High FSH:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=9871915&query_hl=2&itool=pubmed_docsum

Twinning:
http://www.infertilityspecialist.com/ovulation_toner.html -- this also mentions Thyroid and the writer blasts the tendency to push DE even though he runs the DE program at his clinic.

http://jcem.endojournals.org/cgi/content/full/83/2/481#T1

Cimetidine:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7946012&dopt=Abstract

Clomiphene:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=12254980&query_hl=2&itool=pubmed_DocSum

Thyroid and FSH: (Find Alec's posts for the best on Thyroid issues.)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=805044&dopt=Abstract

http://www.pathology.vcu.edu/education/endocrine/endocrine/pituitary/diseases.html --- Clomiphene blocks estrogen receptors, this causes GnRH release and elevation of LH. A lack of response may point to hypothalamic dysfunction.

http://www.aarda.org/infocus_article.php?ID=20 -- FSH elevation indicative of autoimmune disease!

LH as a neglected measure:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16412772&query_hl=2&itool=pubmed_DocSum

August 2006 study showing low reliability of Ovarian Reserve to IVF success rates:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16891297&query_hl=5&itool=pubmed_docsum

I have to say, I think that the doc's are rather presumptuous to say that they can't treat you. There is a possibility that other factors are at play from reading through the lit. Most doctor's are trying to keep their numbers up http://www.motherjones.com/news/feature/2006/07/breeder_reaction.html It is not easy to diagnose unusual problems.

I have spent the last 12 years keeping up with immunological research because I have severe allergies - not the type most people deal with. I'm part of the 3% who really can die from minimal exposure to an allergen. Research in reproduction is woefully behind several other fields. They are a 'baby' field in more ways than one! You need to find a doctor who knows that. I also have gotten spoiled by some excellent physicians who knew they didn't have all the answers.

For me, I fit 3 of the possible reasons for a high FSH reason that do NOT mean DOR or POR:
-- Familial twinning (mom and her mom are fraternal, plus she has a cousin who had 2 sets of fraternals; father's family one of the rare hereditary monozygotic twinning families.)
-- Taking Cimetidine. (New doc said he only knew about it because he was 'old'.)
-- TSH levels are borderline (4 - new guidelines say a TSH reading must be 1 or 2 to get pregnant.) There is also research (see above) that indicates elevated FSH + borderline TSH are early markers for Hashimoto's disease.) [Now normal (2.1 in June), but I have to wonder if allergy season raised it in me (May in MI)... I'm the 'research' case of allergy.

The new RE is well-known for research and having people who have worked for him go off to open new clinics - or run other clinics. He may not do a lot of IVFs compared to some other clinics, but I am having a real sense that he looks more closely at the case than those who are just looking to keep numbers up.

The High FSH diagnosis, as I do more research, seems more and more a crutch used to keep numbers up. Remember, fertility drugs were not widely used until the late 80s! That was over 10 years with working with just 1 or 2 eggs! Also, I haven't been able to track the study down again, lost it in BSOD, but, it said there is no difference in the number of natural pregnancies by age group when controlling for High FSH. (If anyone finds it, please post so I can add it to my list.)

There is also growing evidence that Ovarian Volume and antral follicle count is a better measure of Ovarian Reserve than any endocrinological test:

"Recent data indicate that the number of antral follicles present on cycle day 3 provides a better single prognostic indicator for poor response during IVF than the patient's age or any other endocrine marker.[58,60] Ovarian volume, which partly reflects the number of ovarian follicles, has also been shown to decrease with age,[61] and several studies have suggested a role for this parameter as a marker of ovarian reserve.[62,63,64] from : http://www.medscape.com/viewarticle/522445_4"

I just started this journey, and, I'm amazed at how little they really know about this most basic human function!

MLO

Source: http://www.network54.com/Forum/209394/message/1159455294/

Category: Clomid, FSH, research