FSH is a critical hormone when you’re TTC, whatever gender you are. This hormone is made by the pituitary gland (the little pea-sized gland behind your nose that is responsible for a lot of our hormonal functioning), which affects the function of the ovaries and the testicles. Its name is a bit of a little confusing as we might assume follicles relates to hair, but the name comes from its effect on ovarian follicles (the small fluid-filled sacs that contain the egg cells). But what does it do, what is a normal FSH level to get pregnant, and why does it matter?

A Look at FSH and Its Role in Reproductive Health

FSH is important in many areas of reproductive health for women and men. In men, FSH stimulates and sustains sperm production. It does this with the help of luteinizing hormone (LH) and testosterone. In women, it helps regulate the menstrual cycle, specifically by stimulating ovarian follicles to prepare the eggs for release for ovulation.

How Does FSH Function in the Body?

Each part of the menstrual cycle has a knock-on effect that starts the rest of the cycle. In this case, gonadotropin-releasing hormone (GnRH) is responsible for the start of FSH release. FSH is most abundant in the follicular phase of the cycle (the part where you’re on your period and then the part before ovulation happens), with a bump just before ovulation, before the levels recede for the Luteal phase (the rest of the period). Of course, all bodies are different, so it’s rarely ever going to go like clockwork, but these are the patterns that are generally seen in women.

How FSH Affects the Female Reproductive System

The job of FSH is both to regulate the menstrual cycle and specifically to deal with ovulation. It’s a bit like an alarm clock that wakes up the ovaries and tells them to get to work making and releasing the egg. This is why levels dip after ovulation- it’s done its job and just needs to wait for the cycle to go around again.

The Importance of FSH During Fetal Development and Puberty

You’d be surprised how much of our development is dictated by FSH! Even as a fetus in the womb, in the second trimester FSH is working away on us to kick start the development of our reproductive organs. Once we’re out of the womb and approaching puberty then our hypothalamus will start making GnRH which kickstarts FSH and LH hormone production which pushes us towards our sexual development. In boys it starts testosterone production which then starts the changes such as the voice dropping and body hair growing, and higher FSH and LH levels in women signals the start of estrogen production which starts breast development and menstruation.

What Influences FSH Production?

With FSH being a part of the menstrual cycle, it is locked in a loop with the other hormones, but there are things we do outside of the body that can influence it. 

Factors That Drive FSH Production in the Body

In your body, the main thing that will kickstart FSH is GnRH. Other factors that can affect it can be dietary and lifestyle factors- including your energy consumption and your sleep levels. Another factor, believe it or not, can be testosterone and estradiol, as they have a negative relationship to FSH and LH.

What Are Healthy FSH Levels?

What do we consider normal and what is a normal FSH level to get pregnant? Whilst there is going to be some slight variation from person to person there are some ranges of FSH that are considered healthy for women who are menstruating and women who are TTC.

Normal FSH Levels in Women

In a healthy menstruating woman then FSH levels will be registered as 4.7 to 21.5 mIU/mL. What on earth do those numbers even mean, though? “mIU” stands for milli-international units- which means it is one-thousandth of a unit that scientists and doctors have agreed upon that they call an international unit. So, per milliliter of fluid (blood or urine), we would expect to find 4.7 to 21.5 milli-international units of FSH. You can see more here on this normal FSH levels by age chart.

What FSH Levels Are Considered Ideal for Conception?

In an ideal world for natural conception, the perfect level of FSH would be up to 10 mIU/mL on the third day of your cycle.

What Happens When FSH Levels Are Too High or Too Low?

As with most things to do with our bodies, we don’t want to have too much or too little of something, and that applies to our hormones too. If a hormone level is too high or too low then those imbalances tend to have knock-on effects to the rest of our body and our fertility.

How High FSH Levels Can Affect Fertility

If you have a high FSH level you’d think this could be fine as it would encourage ovulation or somehow make it stronger. Sadly, that’s not quite what it means in reality. High levels of FSH are signs of menopause and premature ovarian failure, genetic conditions like Turner syndrome, and the high levels mean it’s difficult for fertility regulations to work with your body, and IVF treatments may fail. It also could signal decline of egg quality. If you are concerned, always talk to a healthcare provider.

Conditions That Can Lead to Low FSH Levels

Low levels of FSH are a problem as if it’s too low, there may be problems with ovulation. There are some conditions that can cause low FSH, such as problems with the pituitary gland or hypothalamus, Sheehan syndrome, Chronic Systemic Diseases like cirrhosis and AIDS, Type 2 diabetes, and rapid weight loss. If you are concerned that your chronic condition could affect your fertility, then talk with your healthcare provider.

How Can You Test and Track Your FSH Levels?

Healthcare providers can do an FSH blood test or urine test that you can have your healthcare provider perform, but it’s sometimes easier to do them at home, and we now live in an age where we can use at-home testing kits!

Different Ways to Measure FSH Levels, Including At-Home Kits

The easiest way to monitor your FSH levels at home can be a hormone monitor. For example the Mira Hormone Monitor and Wands can give you a variety of ways to track FSH and other hormones so you can best understand what is happening inside your body. Using the free Mira App you can keep all of your results together in one easy-to-understand and read place so you’re never lost on where you are in your journey.

How to Understand and Interpret Your FSH Test Results

Understanding what your results mean is important, especially taking them into context of your whole fertility journey. For extra help the Mira Hormone Health Clinic for Fertility has expert practitioners who can walk you through all your readings and point you in the right direction. These experts are here for the physical and emotional sides of fertility so you know you’re never alone.

How to Manage FSH Levels to Improve Fertility

Whilst working with a healthcare provider to manage your FSH, there are also some practical and easy steps you can take in the comfort of your own home to manage your FSH.

Practical Tips for Balancing FSH Levels

Immediately if you are concerned about the balance of your FSH levels then you can naturally balance it by eating well, sleeping well, and getting exercise (more on this later). There is also the world of supplements to consider when it comes to regulating FSH levels, and there is some evidence to suggest that maca and ginseng could be beneficial in helping regulate FSH levels. Mira Prenatal Supplements can be a part of this, the multi-formulated vitamins containing all twenty of the essential vitamins your body needs for your fertility journey in one capsule.

If you aren’t fond of or can’t take capsule medication, then there are still options for you, such as the Mira Fertility Tea. This delicious blend of organic and caffeine-free tea has been carefully selected by experts to help balance your hormones.

Lifestyle Adjustments and Treatments to Regulate FSH

There are many different ways to get treatment for high FSH levels in women including HRT.

As always, diet and lifestyle are the big players when it comes to affecting your internal system. By now, you’re probably fed up with everyone talking about this when it comes to fertility but they talk about it because it is important. It is all the usual advice: eat a better quality diet, try to avoid being overweight, and be careful with high glycemic index carbohydrates. However, these steps will only help if there is a dietary or lifestyle reason that your FSH is low. This is especially true if your FSH is low because of an energy deficiency, as you may need to look at your sleep as opposed to your diet. Sleep and FSH can be linked, so make sure that you are getting enough sleep to keep FSH levels up, but absolutely do not neglect sleep if your FSH levels are too high, as a lack of sleep is detrimental to your whole body. 

It is also possible that your partner has high or low FSH which will need it’s own treatments. Men can be given FSH injections for low FSH or they could be given testosterone for high FSH as testosterone and FSH have a negative feedback loop. FSH will be dosed to help them get to 1.5–12.4 mIU/mL, and testosterone can be around 1 ml (equivalent to 100-200 mg of pure testosterone). That sounds low, and can make you wonder is 1 ml of testosterone a week enough, but that dosage is considered moderate and physicians will adjust it based on your partners response.

Pros and Cons of Tracking FSH Levels for Fertility

Benefits of Using FSH Tracking for Fertility Planning

If you are TTC and having some troubles, then it can put your mind at ease to track FSH, help you find the causes of infertility, check for medical conditions that affect your ovaries, and even help you find when you are most likely to get pregnant. It is easiest to do this kind of tracking at home with a monitor, such as the Mira Hormone Monitor, which can be used for all stages of your fertility planning and is made with lab-grade technology so you get the best results without going to the lab!

Limitations and Challenges of Tracking FSH

There are some challenges with tracking FSH, such as the fact that the levels vary both on a person-to-person level but even on a month-to-month level, and tracking has to take place on a specific day in your cycle. The other limitation is that whilst you might be producing FSH there may not be eggs being released for other reasons that you can’t see with an FSH test. Your FSH readings need to be taken in the context of the whole of your fertility journey for you to get an accurate understanding of what is happening inside your body.