By measuring a woman's baseline FSH on day 3 of the cycle (we do it on day 2, 3, or 4), we get an indication as to whether she has normal “ovarian reserve”. We are looking at how hard her body needs to “step on the gas” early in the menstrual cycle to get a follicle growing.
Estradiol, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) all need to be tested on day 3 of the menstrual cycle to get the most clinically meaningful results.
FSH, LH and oestradiol should be checked early in the menstrual cycle (day two – six, where day one is the first day of menstruation). Elevated FSH suggests reduced ovarian reserve and the possibility of impending premature ovarian failure.
Purpose of the test
The FSH test is used to evaluate fertility issues, the health of your reproductive organs (ovaries or testicles), or pituitary function. In children, it is utilized to evaluate early or delayed puberty.
Normal results are: 1.4 to 9.9 mIU/mL (follicular phase) 6.2 to 17.2 mIU/mL (ovulatory peak) 1.1 to 9.2 mIU/mL (luteal phase)
Also, as mentioned earlier, FSH is elevated during the early follicular phase and then begins to decline until ovulation. In contrast, LH is low during the early follicular phase and begins to rise by the mid-follicular phase due to the positive feedback from the rising estrogen levels.
Conditions Related to High FSH
If this is the case, you will have other signs of menopause as well, like missing your period and low levels of estrogen. These symptoms may be more severe than in women in natural menopause, and is considered atypical as it begins much earlier.
Follicle Stimulating Hormone (FSH)
It is measured by taking a blood test usually on day 2 or day 3 of your menstrual cycle (day 1 is the first day of your full menstrual flow). What do the test results mean? FSH levels measure egg quality and ovarian reserve, or how well the ovaries are working.
FSH causes ovarian follicles to enlarge and produce estrogen. Over time, fewer and fewer follicles remain to be stimulated and thus estrogen levels decline as a woman ages. This decline in estrogen leads to an increase in FSH as there is not enough estrogen being produced to "turn off" the brain's production of FSH.
How accurate is this test? These tests will accurately detect FSH about 9 out of 10 times. This test does not detect menopause or perimenopause. As you grow older, your FSH levels may rise and fall during your menstrual cycle.
The follicular phase of the menstrual cycle is the stage between the first day of menstruation and ovulation. During this phase, FSH stimulates several follicles inside the ovaries, which causes them to start maturing. FSH levels are highest during the first week of this phase.
For fertility or evaluating ovarian reserve, FSH is tested on day 3 of your cycle. If you cannot have lab testing done, most providers are fine testing between days 2-4. Testing on or around day 3 of your cycle can be helpful in evaluating PCOS diagnosis as well.
Also Known As: FSH and LH, LH and FSH, Luteinizing Hormone (LH) and Follicle-stimulating Hormone (FSH). Preparation: No fasting required. Stop biotin consumption at least 72 hours prior to the collection.
In women with regular menstrual cycles, FSH levels tend to range from 1.4-9.9 mIU/mL during the first half of the menstrual cycle before rising up to 17.2 mIU/mL during ovulation.
Around day 14 however, the peaking estradiol levels cause a rapid surge in FSH and LH levels. This directly results in ovulation – the release of the now mature ovum from its follicle. After ovulation, FSH levels drop in response to a rise in progesterone, and they remain low until the next menstrual cycle begins.
What does having high FSH levels mean? An elevated FSH indicates diminished ovarian reserve. Diminished ovarian reserve is associated with a reduced number of follicles or eggs, often of questionable quality.
Continuous evaluation by cycle phase indicated that recent daily stress was associated with lower total and free E2 and LH during the follicular phase and with lower progesterone and higher FSH during the luteal phase.
Women, when they undergo menopause, lose bone and gain body fat. FSH, which rises at menopause, could be responsible for the weight gain and bone loss that many women experience in their middle ages.
The test is normally done on day 2, 3 or 4 of your cycle (day 1 being the first day of your period) and tests for hormones including follicle stimulating hormone (FSH), LH and E2.
Various tests help in determining the condition of a woman's reproductive function. A few tests include antral follicle count and clomiphene citrate test but one common test is cycle day 3 testing. Cycle day 3 testing involves measuring hormone blood levels such as follicle-stimulating hormone (FSH) and estradiol.
Day 3 testing provides your physician with valuable information about the current status of your reproductive potential. The hormone levels show how easily your brain and ovaries work to mature an egg each month and provide insight into the egg quality.
The FSH test
The ideal time to sample blood for FSH levels is on day 3 of a cycle although day 2-5 will probably suffice. Any testing outside of these days is irrelevant. When used as a screening test for ovarian reserve, levels of estradiol should also be measured.
Hormone Tests
As the eggs decrease in quality, they are more resistant to FSH and it takes more and more FSH to keep the cycle progressing. Therefore, the higher the FSH value, the lower the quality of the eggs.
“(FSH levels) can fluctuate from month to month and the test is very limited because it has to be done on a certain day in the menstrual cycle. Also, the test has a number of false negatives: Even if an FSH level is normal, you could still have ovarian aging that wasn't detected that month.”