YOU ARE WHAT YOU EAT
Women who are more than 30 years and still wish to post pone child bearing should carefully monitor their ovarian reserve. Ovarian reserve refers to the number of eggs that are present and available for fertilization (viable). Human are not very efficient at reproduction when compared to other species. Only 25% of the eggs produced by the women during her reproductive age are viable to give rise to a pregnancy.
In order to test ovarian reserve, we can measure FSH levels (Follicle Stimulating Hormone). FSH levels inversely co-relate with the number of eggs. This analysis is done on day 3 of the menstrual cycle. The quality and quantity of the eggs can be predicted. A high level of FSH suggest poor ovarian reserve and should be a wake up alarm. It shows that the biological clock is ticking away rapidly and the fertility parameters are dipping.
At this juncture it is best that the couple plan for conception right away and if not occurring naturally should directly, opt for ART procedures instead of delaying further. It is also important that this is analysis done in a reliable laboratory to have precise values. Other parameters which can also be used are Inhibin B levels on Day 3, AMH levels (Antimulleraian Hormone which can be done on any day of the menstrual cycle), Estradiol levels, antral follicle count (transvaginal ultrasound scan on day 3), LH and TSH. But none of the analysis are truly reliable. Sometimes if women have high estradiol levels more than 75pg/ml and normal FSH levels still can be an indication for low ovarian reserve.
What is good level of FSH? Well that depends on each individual generally values between 3 to 10 m IU/mL values of FSH are considered to be normal. Anything over 12 mIU/ mL should worrisome or impaired ovulation. Increasing FSH levels suggest to start off treatment right away. FSH levels > 25 mIU/mL confirm ovarian failure. Sometimes FSH levels can be found to be raised by ovulation induction drugs.
Let’s understand the basic biology. If ovary has plentiful eggs then FSH levels in blood is low because the body doesn’t need to produce much FSH to induce normal ovulation. On the otherhand if the eggs are low, the body has to work harder to bring about ovulation so the amount of FSH levels are elevated in an effort to push the ovaries for ovulation.
Treatment for high FSH levels:
Traditional treatments would include.
- Yoga to improve pelvic blood flow
- Accupuncture to improve ovarian blood supply.
- DHEA (Dehydroepiandrosterone, 75mg daily)
Others advanced therapies include.
- Stemcell therapy
- PRP infusions etc.
However no clinical trials have been done to prove the efficacy of any of these interventions.
Keeping in mind that prevention is always better than cure we should act when our body sends signals before it is late.
So the fertility specialist with good experience will be the right person to guide and assist you in accomplishing your dream of parenthood.
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