By measuring a woman's baseline FSH on day 3 of the cycle (we do it on day 2, 3, or 4), we get an indication as to whether she has normal “ovarian reserve”. We are looking at how hard her body needs to “step on the gas” early in the menstrual cycle to get a follicle growing.
FSH is best tested on day 3 of a woman's menstrual cycle, but could be done between days 2 and 4. At-home FSH tests use a woman's urine (at the doctor's office, we analyze FSH levels in her blood) and provide the range of FSH, either normal or elevated. If the test is elevated, fertility is most likely decreased.
FSH, LH and oestradiol should be checked early in the menstrual cycle (day two – six, where day one is the first day of menstruation). Elevated FSH suggests reduced ovarian reserve and the possibility of impending premature ovarian failure.
Doctors call day 3 the “baseline” because that's when E2, FSH, and LH are most stable, before they begin to rise. Aiming to test on day 3 (for most people) puts you right at the beginning of the follicular phase and is the best time to get a clear read of these baseline levels.
Normal results are: 1.4 to 9.9 mIU/mL (follicular phase) 6.2 to 17.2 mIU/mL (ovulatory peak) 1.1 to 9.2 mIU/mL (luteal phase)
An FSH level of > 30 IU/L is consistent with the perimenopause, although FSH levels of 70-90 IU/L are not uncommon for postmenopausal women. Many gynecologists base their decision about whether someone is peri or postmenopausal on the woman's menstrual history and the presence of common menopausal symptoms.
For basic fertility testing and to evaluate ovarian reserves, you need to have the blood test on day 3 of your menstrual cycle (day 1 is the day your period begins). However, most doctors are OK with the test being done on any day between days 2 to 4.
Follicle Stimulating Hormone (FSH)
It is measured by taking a blood test usually on day 2 or day 3 of your menstrual cycle (day 1 is the first day of your full menstrual flow). What do the test results mean? FSH levels measure egg quality and ovarian reserve, or how well the ovaries are working.
Why measure around Day 2? At this time, E2 is at its lowest so FSH should be at its highest. If the E2 level on Day 2 is > 200pmol/l, then follicle growth will have already started, and the measurement of the FSH is not reliable because the raised E2. will have already started to suppress the FSH level.
The follicular phase of the menstrual cycle is the stage between the first day of menstruation and ovulation. During this phase, FSH stimulates several follicles inside the ovaries, which causes them to start maturing. FSH levels are highest during the first week of this phase.
You will probably have your estradiol levels checked via a blood test on day 3 of your menstrual cycle, along with your FSH levels.
Sometimes, elevated follicle-stimulating hormone (FSH) levels are measured to confirm menopause. When a woman's FSH blood level is consistently elevated to 30 mIU/mL or higher, and she has not had a menstrual period for a year, it is generally accepted that she has reached menopause.
Time to Test: Day 3 - Normal Range: <7 mIU/ml
o A normal LH level is similar to FSH. o An LH that is higher than FSH is one indication of PCOS.
How accurate is this test? These tests will accurately detect FSH about 9 out of 10 times. This test does not detect menopause or perimenopause. As you grow older, your FSH levels may rise and fall during your menstrual cycle.
Day 3 testing provides your physician with valuable information about the current status of your reproductive potential. The hormone levels show how easily your brain and ovaries work to mature an egg each month and provide insight into the egg quality.
Various tests help in determining the condition of a woman's reproductive function. A few tests include antral follicle count and clomiphene citrate test but one common test is cycle day 3 testing. Cycle day 3 testing involves measuring hormone blood levels such as follicle-stimulating hormone (FSH) and estradiol.
In women with regular menstrual cycles, FSH levels tend to range from 1.4-9.9 mIU/mL during the first half of the menstrual cycle before rising up to 17.2 mIU/mL during ovulation.
In women, FSH helps control the menstrual cycle and stimulates the growth of eggs in the ovaries. FSH levels in women change throughout the menstrual cycle, with the highest levels happening just before an egg is released by the ovary.
Conditions Related to High FSH
It could be premature menopause — also known as premature ovarian failure or ovarian insufficiency. If this is the case, you will have other signs of menopause as well, like missing your period and low levels of estrogen.
Follicle stimulating hormone levels can be elevated for many reasons. Though high FSH can have genetic components, not all causes of DOR, indicated by high FSH, have been elucidated. Symptoms of high FSH in females often mimic those of menopause, including irregular periods, hot flashes, and headaches.
Women, when they undergo menopause, lose bone and gain body fat. FSH, which rises at menopause, could be responsible for the weight gain and bone loss that many women experience in their middle ages.
Many common perimenopause symptoms are similar to menopause signs. For example, hot flashes may occur — when your body feels very hot for brief periods of time, and night sweats. Some people experience mood changes, anxiety, problems sleeping, vaginal dryness, and less interest in sex.