Sudden spike in FSH?

[Anonymous]

I was about to start a new IVF cycle this week, but my doctor canceled it because my FSH spiked to 21. Only one month ago my FSH was 6.8 and two months ago it was 6. I have been TTC for three years and the highest FSH I have had until this week was 7.2. Has anyone else had this sort of spike? I am wondering if I am suddenly moving into menopause (hope not!). After the the 21 result came back, I asked if I could do another test in case there was an error, but the second test came back at 19, still very high. I am 43. Thanks for sharing your experience/thougths on this!

[Anonymous]

Stress can cause Fsh to spike.

[Anonymous]

FSH fluctuates month-to-month naturally. Some clinics like to test FSH each cycle and others don't - mine didn't test. Have you done IVF cycles previously and had good results? If so, then a single spike in FSH shouldn't be a big deal. And, if you do have a high reading again and want to cycle, then you could ask if you could go ahead and start the cycle. If you are not responding to the drugs, then you can cancel or convert to IUI - assuming you are willing to spend the money on drugs and some monitoring to see what happens. Given your age (I am 42), I would push the envelope to move forward with a cycle.

[Anonymous]

Also, not sure what protocol you are using. When FSH is higher, some protocols work better than others. Estrogen Priming tends to be the best choice when FSH is higher.

[Anonymous]

"Have you done IVF cycles previously and had good results? If so, then a single spike in FSH shouldn't be a big deal."

Agree. Who is your RE and what was his explanation for the cancellation? At your age, if you can get 7-10 eggs per cycle you're doing good and its worth a shot.

[Anonymous]

This happened to me, though my FSH did not go as high and I am younger. We went ahead with the cycle that month and got a relatively poor response. Now I am on to my 4th cycle this year and I am taking double the meds I took in March to get the same response. I think part of it for me is pushing my body to far in one year. Anyway, I am just saying that previously good responses do not guarantee that you will continue to respond well. You may need a new protocal.

[Anonymous]

Anonymous wrote:This happened to me, though my FSH did not go as high and I am younger. We went ahead with the cycle that month and got a relatively poor response. Now I am on to my 4th cycle this year and I am taking double the meds I took in March to get the same response. I think part of it for me is pushing my body to far in one year. Anyway, I am just saying that previously good responses do not guarantee that you will continue to respond well. You may need a new protocal.

There is never a guarantee of your response. The REs at Cornell believe variability in response is related more to your body than to protocol or stim dosing - as in, some months are just going to drive better responses than others. And, while high FSH is indicative of a reduced response to stims, not everyone has a lower response when their FSH is higher. Some women respond very well on low stim dosings (225ius) with FSH over 20 and others get nothing to budge with 600ius and the same FSH level.

[Anonymous]

Thanks all, for your helpful responses. I just switched from Shady Grove to Columbia Fertility. At Shady Grove they tested my FSH once, only (it was 7.2) but at Columbia they have already tested it three times in the lead up to this cycle (my first with Columbia). I did three IVF cycles at Shady Grove -- one was lupron (only 1 egg fertilized and it didn't stick), the other was with ganirelix and the BCP ( three eggs fertilized, but did not implant), and for the last cycle I used the estrogen patch (poor response so the cycle was turned into an IUI). In the last few weeks (the period within which my FSH spiked), I have also developed hives, and I wonder if that might have something to do with the spike. The person who said stress might have made the FSH go up caught my attention because apparently my grandmother used to get hives when she was stressed. So, maybe the hives and increased FSH are a result of stress (I have been very stressed at work). The allergy doctor thinks the hives should go away in six weeks (so another two weeks). Honestly, a part of me just wants to quit my job and focus on this baby making, but I think it would be tough for us to afford the cycles if I did that.

Any additional thoughts welcome. Thanks again!

[Anonymous]

Honestly, OP, given your response to past cycles my thought is that you've probably have high FSH for awhile but never caught it on the particular cycles you've tested on. Mine is just about as high and my responses to similar IVF cycles has been similar.

[Anonymous]

FSH levels are an indicator for response to stims. Some people with low FSH tend to be poor responders and others with high FSH are good responders. It may be that OP is not a good responder in general -regardless of FSH level.

[Anonymous]

Well, I don't think anyone can disagree that high FSH is at least highly correlated with poor response to stims, notwithstanding exceptions on both ends.

But given OP's history as a poor responder, I don't see why this sudden spike in FSH would cause the RE to cancel the cycle, unless it caused an issue with insurance coverage (in which case OP should have been given the choice of going forward on a self-pay basis or canceling).

[Anonymous]

Unfortunately from what you've said your response to stims is poor and the FSH reading kind of falls in line with that fact. I would seek a high FSH friendly doctor who works with this issue regularily.

[Anonymous]

Some REs won't start an IVF cycle if FSH is over 12 - regardless of insurance coverage or any willingness to pay out of pocket. Given OPs response when FSH was lower (and possibly never elevated at the time), I can see where a RE may opt to cancel given the likelihood that response would be lower with higher FSH.

If OP is at CFA, then I hope you are seeing Dr. Sacks. He is very high FSH friendly.

[Anonymous]

I went to the doctor for a check up and told her that I wasnot feeling too comfortable that I was wet down there blah blan y she said ;you are ovulating and I got a ultrasond and other test to check because I have irregular period and sometimes pain there, the doctor told me that every thing look good blah blah (ovary and uterus) few months later I start losing weight, irregular period (missing, bleeding more) and also I am under stress (loss my job, personal problems), my fsh is very high - diagnosis early menopause.

To be honest I feel very good, my memory is much better, I sleep my 8 hour, my skin looks good, but I have dark circles eyes.

What is happening to me is this menopause?