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FSH, TSH, and AMH- what is up with all these letters?

We hear the names of these three hormones quite often but what do they even do? Why are they important? Understanding how our bodies work and what goes on inside them can help us navigate our fertility better. There is a lot of difficult and complicated terminology involved so today we’re here to help you understand the significance of FSH, AMH, and TSH!

There are three hormones that can indicate ovarian reserve: AMH (Anti-mullerian hormone), FSH (follicle stimulating hormone), and E2 (estradiol).⁠

FSH, AMH, and TSH! As part of a basic fertility workup, your doctor will likely order blood work to check your FSH levels. Sometimes called the day 3 FSH test, this is a simple blood test meant to measure the amount of follicle-stimulating hormone (FSH) in your bloodstream.⁠

Studies show AMH is the best indicator of ovarian reserve. AMH levels (low, normal, high) directly correlate to the number of eggs remaining. FSH can also detect ovarian reserve, but it’s important to check E2 along with it because high E2 levels can suppress FSH. Meaning, if your FSH levels are suppressed by E2, this FSH measurement may not accurately represent your ovarian reserve. ⁠

Thyroid Stimulating Hormone: Average TSH levels in infertile women are reportedly higher than those in normal fertile women. And elevated serum TSH levels are associated with diminished ovarian reserve in infertile patients. ⁠

Endometriosis 

Endometriosis can be a debilitating disease Ie. painful periods, bleeding and pain during ovulation, uncomfortable intercourse, heavy bleeding and chronic pelvic pain.

Endometriosis can impact fertility in several different ways. Scar tissue and adhesions can block the fallopian tubes and uterus, making the uterus inhospitable to an embryo and damaging egg quality. 

What we call Endometriosis is probably several different diseases lumped together, not just “one” thing. We suspect it is caused by multiple factors but much more research is needed!! 

The most alarming part of this disease is that there is an average delay of four to 11 years from the onset of symptoms to diagnosis. 

Women who are unaware of their diagnosis (obvi) can’t get it treated!! 

During the time you go untreated, the symptoms can get worse and multiply, increasing pain and further negatively impacting your fertility. 

One reason for this delay is that endometriosis needs to be diagnosed through an invasive laparoscopy, a surgical procedure performed in the abdomen or pelvis. You have to CONVINCE your doctor that the pain is not just “normal” period cramps. 

The Trigger Shot 

Once the ovarian follicles have achieved an adequate size and stage of development, a trigger injection is given to induce final maturation of the eggs. The timing of this injection is very important to the outcomes of your in vitro fertilization (IVF) cycle and needs to be precise. An egg retrieval procedure is then scheduled for 36 hours following this injection.⁠

When the hCG trigger is administered too early or too late, or too low a dosage of hCG is administered the result can be an increase in the percentage of immature (M-I) or mature M-II (but aneuploid), eggs at retrieval. ⁠

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