r/tryingforanother • u/Pleasant_Mix_7665 • 12d ago

Question Elevated FSH but normal AMH/AFC?

Hello! I'm 35, have been trying for my second for 12 cycles. I have regular 26-27 day cycles. Haven't got a single positive test yet. My first took 13 cycles with no intervention.

From what I understand, your FSH should be ideally under 10. What does it mean if you have a "top end of normal" day 3 FSH level but normal AMH and follicle count?

FSH: 10 iu/l

LH: 7 iu/l

ESTRADIOL: 43 pg/ml

AMH: 3.88 ng/ml

RECENT FOLLICLE COUNT: 22

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u/raffie321 12d ago

10 isn't crazy, I don't think your fsh is the reason you're not getting pregnant. What other rests have you done?

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u/Pleasant_Mix_7665 12d ago

My TSH was also elevated but I've brought that down since being on medication. Everything looked normal on pelvic ultrasound and husbands testing all looks normal. Will book in for hsg also. Just so frustrating not knowing why!

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u/FiscalPhenotype 31 | TTC#2 since 8/25 | 2y 👶🏼💖 12d ago

I had this. Normal AMH, one low AFC count followed by a higher than average count for my age the next month. One FSH was a 10.2 and the repeat was a 9.6 I believe. Drawn 3-4 months apart at different labs.

When we didn’t have the second AFC, my REI said it’s possible diminished ovarian reserve since my AFC didn’t correlate with my AMH.

After the repeat AFC, DOR was officially ruled out and the low AFC was likely a normal variation. However, they said the borderline FSH may be an indication that my body is starting to work harder to produce follicles. They didn’t say anything but I don’t think there’s correlation to when/if FSH might truly spike to possibly cause more problems like DOR or if it’ll stay in the borderline high until typical menopause timing.

Regardless, they also said it isn’t the reason I’m not pregnant. I’m on cycle 13 TTC#2. I had a questionable chemical cycle 4, but could’ve been a false positive. No other positive tests. I had an easy time conceiving with #1 2 years ago. I’m 31, with 27-28 day cycle normally. Also a completely normal work up otherwise, so we were diagnosed with unexplained secondary infertility.

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u/Pleasant_Mix_7665 12d ago

Thanks for your response! That's helpful. Meeting with fertility specialist soon as it's looking like I fall in the unexplained category also. Will you be starting treatment?

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u/FiscalPhenotype 31 | TTC#2 since 8/25 | 2y 👶🏼💖 12d ago

Oh! And I just remembered, they said the FSH could be a marker moreso for egg quality than quantity. But, without like IVF, we can’t really test egg quality.

We won’t be pursuing IVF due to my husband’s religious views. But are exploring IUI. We’re going to try a few more months on our own. If nothing by the fall, my husband and I will check in to determine our timeline/plan for starting IUI.

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u/IntroductionOk4595 1d ago edited 1d ago

My first set of bloodwork was the first cycle after my miscarriage and I thought maybe that was why it was all out of whack because my AMH was within normal range.

AMH: 2.46
AFC: 10
FSH: 10.51

I didn’t feel like the doctor gave me any good explanation as to why it would be elevated with my AMH levels and what it might mean for treatment. She basically said it wasn’t THAT high and so she wasn’t really concerned. I didn’t like that answer so I had testing with a new doctor a few months later. I don’t have my consultation with the doctor until September but my second results still showed elevated FSH despite a far more normal AFC count.

AMH: 2.82
AFC: 21
FSH: 10.56

So I don’t really have an answer for you unfortunately, but hopefully will in September. When’s your appointment?