29/03/2017
Follicle Stimulating Hormone (FSH) Test
Specimen Collection :
• This is done on serum of patient.
• Record the date of last menstrual cycle in women.
• It is important to measure both FSH and LH levels.
• Plasma and urine are also acceptable.
• Sample stable 8 days at room temperature and 2 weeks at 4 C.
Purpose of the test :
1. FSH ( along with LH ) helps to find whether gonadal deficiency is of primary origin or secondary due to insufficient stimulation of pituitary hormone.
2. FSH level helps to find the cause of hypothyroidism in women.
3. FSH level helps to find the cause of endocrine dysfunction in the men.
4. FSH and LH are helpful in children with precocious puberty due to endocrine causes.
5. In case of Anovulatory cycle ( infertility problems ), serial estimation to see the peak in mid cycle will be missing.
6. In primary ovarian or testicular failure FSH is helpful where you will find increased level.
7. FSH Help to find the cause of infertility.
8. FSH testing is commonly used to evaluate :
1. Woman’s egg supply (ovarian reserve).
2. Men’s low s***m count.
3. To evaluate menstrual problems, such as irregular or absent menstrual periods (amenorrhea).
9. FSH can help to determine whether the woman has gone through menopause.
10. Determine early puberty (also called precocious puberty ) or delayed puberty.
11. FSH diagnose certain pituitary gland disorders, such as a tumor.
12. FSH level done in menopause.
13. FSH level done in case of abnormal vaginal or menstrual bleeding.
14. In men where there are no testicles or under developed.
15. In children FSH level is done who develop s*xual feature at very younger age.
16. In children FSH level is done there is delayed puberty.
Precaution :
HCG and TSH may interfere with some immunoassay. So patient with HCG producing tumor and Hypothyroidism patient will have false high level.
Recent administration of radioisotopes interfere with radioimmunoassay estimation of FSH.
Pathophysiology :
1. FSH is glycoprotein pituitary hormone.
2. FSH is produced and stored in the pituitary gland.
3. FSH and LH hormones are secreted by the pituitary gland.
4. FSH is needed for the pubertal development and function of ovaries in women and te**es in men.
5. FSH is under the control of:
1. Hypothalamic-gonadotropin hormone ( G N R H ).
2. Ovarian estrogen and progesterone in female while testosterone in male when these are low.
3. FSH acts on granulosa cells of o***y and Sertoli cells of the te**es.
6. FSH level increases at the time of puberty.
7. In male FSH and LH are necessary for the maturation of s***matozoa.
8. FSH stimulates the formation of follicle in the early stage of menstruation.
9. At the midcycle, surge of LH leads to ovulation from the primed or active follicle.
10. It is one of the female harmone.In women, FSH helps control the menstrual cycle and ovulation by the ovaries.
11. The amount of FSH varies throughout a woman’s menstrual cycle and is highest just before the ovulation.
12. In men, FSH helps control the production of s***m. The amount of FSH in men normally remains constant.
13. The FSH level can help determine whether male or female s*x organs (testicles or ovaries) are functioning properly.
Normal value:
1. Women before puberty = 0 to 4 mIU/L
2. Menstruating women
1. Follicular or luteal phase = 5 to 20 IU/L.
2. Ovulatory phase = 30 to 50 IU/L.
3. Luteal phase = 1.09 to 9.2 IU/L.
3. Women post menopause = 19.5 to 100.6. IU/L.
4. Men before puberty = 0 to 5 mIU/L
5. Men during puberty = 1.42 to 15.4. IU/L
6. Men adult = 1.5 to 12.5.
7. Children:
1. Male = 0.3 to 4.6 IU/L.
2. Female = 0.68 to 6.7 IU/L.
High FSH values in a woman :
1. Loss of ovarian function before age 40 (ovarian failure).
2. Polycystic o***y syndrome (PCOS).
3. Menopause has occurred.
4. Pituitary adenoma.
5. Precocious puberty.
6. Ovarian dysgenesis ( Turner syndrome ).
