QuestionI recently went to my MD to get my hormones tested as I have irregular
periods and am trying to get pregnant. I had an ectopic pregnancy about 6
months ago (which was apparently a fluke). Anyway my TSH, LH and FSH was
tested they apparently all came back within normal range but my TSH was
3.6, my LH was 6.5 and my FSH was 3.2.
Should i get further testing for thyroid function with my TSH being on the
high side?
I also heard that my LH should be about them same as my FSH, it there a
concern with my FSH being significantly lower?
Finally should I be worried that my FSH is so low apparently less then 3.0 is
prepubertal?...I am a little concerned that I am so close to that being 26.
These hormone levels where taken towards the end of a 42 day cycle
Thank you for any insight
AnswerHello April,
I don't think that any of these levels are concerning. The discrepancy between the LH and FSH indicates that there is an ovarian dysfunction present. This dysfunction is called Polycystic ovarian disease (PCOD) and explains why you don't have regular menstrual cycles. However, the levels are normal.
The only other advice, however, is that the FSH and LH levels should be tested on the second or third day of your period. Since they were not, they are not as interpretable. The reason is because the levels change depending on where you are in your cycle. By doing them at the beginning of the cycle when they should be at their baseline, we have a better idea of how your ovaries are functioning.
It sound like you will need to use some form of fertility medication to help you to ovulate on a regular basis, and I suspect that is all you will need for that. The only other concern that I have is your history of an ectopic pregnancy. That indicates that there is some tubal damage, and that is why the pregnancy got stuck in the tube. If that is the case, you are at higher risk for another ectopic pregnancy (which is an emergency situation by the way). The tubal damage may also contribute to not getting pregnant. In this situation I recommend IVF as the treatment of choice to bypass the tubes.
Finally, your thyroid is not a problem so don't worry.
I hope this answers your questions.
Sincerely,
Edward J. Ramirez, M.D.
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
