FSH/ Thyroid and Options?
12 Replies
nixies - May 21

I am currently 36 yo, DH is 34. We have been TTC for 3 years. I should mention that we are living in Crete, Greece. After the first year with no success, I went for tests and was diagnosed with hypothyroid. At that time, April of 2004 my FSH was 8.8, E2 was 91 and LH was 6.6. Would my thyroid condition have affected the FSH and E2?

After this was sorted out, we took our time over the second year, getting a full fertility work up done. Everything checked out to be fine, and I appeared to be ovulating. In May 2005 my Dr. tried us on a protocol of Serperfar ( 2 pills daily for 10 days) and 1 shot of Pregnyl, followed by another, both lowest doses. This resulted in 2 eggs, one was reabsorbed and the other it was not clear if it released. I chose to take June off , and we tried again in July. The same routine, but they increased the amount of Pregnyl. This resulted in a cyst on my ovary that remained until September. Sept. showed FSH at 13.86 , E2 at 102.89 and LH at 12.88. My Dr. said this was due to the stimulation and not accurate. October showed my FSH back down to 8.54. I then went to see a specialist, who believes I have POF. In January 2006 ( 4 months after the cyst was gone) my FSH was 8.44 , E2 was 55.89 and LH was 8.72. We decided to do a round of IVF. I was put on a long protocol using Daronda and Gonal F and Pregnyl. The result was 7 eggs, one developed later and was not fully mature. Out of those 6, only 3 developed to grade C embryos, using ICSI. I tested with a low positive on Day 12, and and then was negative on Day 14. My Dr. here is optimistic for another try, if the numbers are low enough to go, but is recommending a short protocol in hopes of getting a larger number of eggs. My concern is that this might result in even lower quality. Does the protocol affect the quality of the eggs retrieved? Could the hardness of the outer lining of the ovaries and my eggs be a result of PCOS? Knowing that you don’t have the entire picture, would you recommend anything other then IVF?

Thank you for your time,


sonia989 - May 21

what u mentioned about FSH is interesting. My FSH in December '04 had been 2.1. I did one cycle of IVf in september '05. In late February '06 it was 10.8 I wondered if it had gone up because of the cycle we did, but they said no. High FSH is so discouraging. I turned 35 in April. My husband is paraplegic so ICSI is our only option.

I really hope things work out for you and i hope you have the means to keep trying.



B. Jacobs, M. D. - May 21

POlycystic ovaries are not caused by a hard surface of the ovaries. Polycystic ovaries are caused by an underlying metabolic disorder, ike insulin resistance. IVF is useful for tubal disease, and severe male factor problems, when we have to inject sperm into eggs. I do not know if you need IVF, or not.
Good luck.


nixies - May 24

Thank you Dr. and Sonia, for replying. I am frustrated by the FSH, and I am still not clear if FSH, E2 and LH are effected by hypothyroidism? Is that possible, or am I just borderline high?

What are some causes of a hard exterior of the ovum?

Also, does protocol affect the quality of eggs that are retrieved? Does one go for quality or quantity in a case of borderline high FSH?

Thanks again for your time


B. Jacobs, M. D. - May 25

I am not aware of any evidnce for human egggs having hard surfaces. There are multiple protocols to stimulate ovaries. I am not aware of the ones I use producing egg problems.
Good luck.


nixies - May 27

Human eggs... I always suspected that might be the problem. Seriously though, since I am dealing with the Greek medical system, the Dr's here tend to not use as many technical terms and try to pair things down. What my Dr. basically said, was that they needed to do ICSI , as my husbands sperm were unable to penetrate the egg. He said the surface was "hard" but perhaps this is lost in translation ( good movie, but crappy to deal with when doing IVF) My question is this, does the elevated FSH cause this problem, of making the egg more difficult for the sperm to fertilize on their own--- or is this caused by something else?


B. Jacobs, M. D. - May 27

First of all, the inability of sperm to enter the egg is not an egg problem. It is a sperm problem. High FSH implies you are running out of eggs, and your ovaries are not reponding to stimulation from your pituitary gland. FSH should be tested on cycle day 3, when the hormone should be at its lowest level in the cycle. Another test of ovarian reserve is to count the follicles in each ovary using ultrasound. You want greater than 4 follicles visible in each ovary.
Good luck.


nixies - May 28

Thank you for clarifying that for me. I think I am going to go for a second opinion in Athens, as the "hard egg" answer was not sitting well with me at all.

I just had day 3 blood workdone FSH 8.33, E2 41.63 and LH 9.72----They appear borderline to me, but the LH seems high. Being 36 I feel like I have to take advantage of the best numbers I can get...would you suggest waiting another cycle, or just going for it?

Thanks again,


B. Jacobs, M. D. - May 28

I cannot determine if you have poor ovarian reserve. You are walking a tight rope between your starting on the slow down hill slope of aging eggs and ovaries, on the one hand, and finding a clinic where you will be comfortable, on the other.
Good luck.


nixies - May 29

Thank you again for your input, it does help in making a decision.



sonia989 - June 3

Hi Nixies,
looklike we're in the same boat. By the way, I was told that because of my age (35) the zona pellucida around the outside of the egg is thicker, which makes it harder for the embryo to hatch. They used assisted hatching at the clinic where we did our IVF. Incidentally, one of them must have hatched because I got pregnant, although it seems to be turning out not to be a viable pregnancy.
Hope things work out for you.


nixies - June 3

Thanks Sonia,
I think that must be what my Dr. was trying to convey, but being foreign, he did not use enough technical terms with me, or describe it to my satisfaction.

I hope that all turns out well for you. I know it must be hard to get good news and then have it turn around on you. Hang in there.



sonia989 - June 3

Hi Jenn,
it's true communication problems add to the stress. Many, if not most, of the drs here don't speak english all that well. One of them seems to think 'that is why' and 'that is because' are interchangeable. You can imagine my concern when she tells me 'We give you very high doses of hormones; that is why you have low ovarian reserve' (!) :)



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