Your physician will also examine estradiol levels that are tested along with your follicle stimulating hormone. Estradiol is one of the estrogens that your body produces, and is secreted by the ovaries. During ovulation, estradiol levels increase rapidly, and drop again after ovulation. Estradiol levels are also helpful in indicating ovarian reserve. Levels above 75 may indicate a poor ovarian reserve.
Once your FSH and estradiol levels have been determined, your health care provider will suggest certain treatment guidelines. A normal FSH and estradiol level probably indicate that you have a good ovarian reserve. This means that you do not have to undergo aggressive treatment right away. Instead, you have a little more time to play with when choosing and booking procedures. It is also likely that you will be able to use your own eggs.
Elevated FSH levels may suggest that you should begin treatment right away. Ovarian reserve can change rapidly, and even a short delay in treatment could mean the difference between conceiving and not conceiving.
High levels of FSH and estradiol may also indicate that you should consider using an egg donor. Your eggs may not be in the best condition for use in procedures.
The Clomiphene Challenge Test
Sometimes, your health care provider may choose to perform a clomiphene challenge test. This is an extension of the FSH test, however, it is more sensitive. It is often used in older women who are trying to become pregnant.
After your FSH and estradiol levels are tested, you are given the medication clomiphene. You will take 100 mg of clomiphene everyday, throughout days 5 to 9 of your cycle. Your FSH levels are then re-tested on day 10 of your cycle. An abnormal FSH level may indicate a poor ovarian reserve.
Accuracy of the Tests
FSH testing is thought to be an accurate predictor of ovarian reserve. A New Jersey study monitored women with abnormal FSH levels who became pregnant - less than 1% actually had a live birth, with two-thirds miscarrying. High levels of FSH were also found to be good indicators of genetic abnormalities in babies.
Things to Consider
It is important to remember that FSH tests are not the be-all and end-all to pregnancy. Just because you have a poor level of FSH does not mean you won't get pregnant. It is merely an indicator used to decide upon treatment options.
It is also necessary to consider age when undergoing fertility treatment. Age is an excellent predictor of both ovarian reserve and conception rates. Women over the age of 43 have a smaller chance of becoming pregnant than women under the age of 43, no matter what their FSH levels. This means that younger women with poor FSH levels may still want to try using their own eggs before seeking a donor.