Understanding LH/FSH Ratio for Fertility: A Doctor's Explanation

Question
QUESTION: Doctor, I am 30 yr old, and trying to conceive.  I did my fsh and lh test on Nov 2008 during mid cycle peak (which i am sure was my ovulation time) and the result was LH 81.9 and FSH 28.5.  Whether that means I have some problem, or is it normal range during the mid cycle peak??  After that on Jan 2009 i again did the test on Day 1 (the starting day of my periods) and the result was LH 4.72 and FSH 10.48 .   Is these ranges are normal.  Please suggest. Regards

ANSWER: Hello,

FSH and LH levels are generally drawn on cycle day # 2 and 3 (the second and third day after the period starts).  It is used to interpret ovarian function, not ovulation.  It reveals whether or not the ovaries are working properly.

Sincerely,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

---------- FOLLOW-UP ----------

QUESTION: Thanks a lot...Doctor, but just as i have done this test on Day 13 and Day 1, I just want to gain some knowledge about it, as too what range the LH and FSH can be the standard range during that days.  Because i studied somewhere that at one point of your cycle LH will be more and in some other place FSH will be more and i am getting confused with the things i studied and in internet i am not getting any relevent information.  So please help me to understand whether i am having any problem with the proporation between fsh and lh or it normal during that days.

Answer
Hello Again,

This forum is not appropriate for a course or lecture on the bodies hormonal patterns, so I'll just give you a quick synopsis.  At the beginning of the cycle, both FSH and LH are at the lowest levels.  That is why we draw on cycle day # 2 or 3.  It gives us an idea of your "baseline" ovarian function.  As the cycle proceeds, the FSH and LH increase toward ovulation.  The fSH stimulated the ovarian follicle to grow.  Near the follicles peak size, LH rises abruptly to stimulate ovulation ("LH surge").  They then plateu and remain so until the end of the cycle whereby they drop.

FSH and LH should be about equal.  In patients that have a disorder call polycystic ovarian syndrome, the LH/FSH ratio is elevated i.e. there is 2-3 times higher LH than FSH.

I hope this helps,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.