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Journal of Chinese Medicine • Number 91 • October 2009 The treatment of Elevated FSH Levels with Chinese Medicine 5 The Treatment of Elevated FSH Levels with Chinese Medicine Abstract By: Daniel Follicle stimulating hormone (FSH) levels are routinely tested during biomedical investigations into female fertility. Elliott An appropriately low FSH level is frequently required by fertility clinics as an entry requirement for women wishing to receive assisted reproductive technology (ART) treatment such as in vitro fertilisation (IVF). This article Keywords: presents the diagnosis and treatment of elevated FSH levels according to traditional Chinese medicine (TCM), and Acupuncture, puts forward the view that high FSH levels do not necessarily mean that a woman is approaching menopause, but TCM, Chinese rather simply indicate the current status of ovarian functioning at the time of the test. The author asserts that with herbal the appropriate treatment using acupuncture and Chinese herbal medicine, the proper functioning of the ovaries medicine, and anterior pituitary gland - in cases where they have been pathologically affected - can be restored. This process fertility, does not, however, necessarily imply that treatment has reversed the aging process or affected the quality of eggs infertility, produced. The theory presented is illustrated with three case histories from the author’s own clinical practice. IVF, follicle stimulating Introduction to menopause, as well as reflecting the quality of eggs hormone, FSH. F or practitioners of traditional Chinese medicine she is producing. This accepted view has recently, (TCM) treating those women experiencing however, come under more scrutiny.3, 4, 5 fertility problems who are also under the care of Western fertility clinics, follicle stimulating hormone (FSH) levels have become an important aspect of both Many patients have started to view low FSH levels as diagnosis and prognosis. FSH levels are usually taken an entrance requirement to ‘get into’ their preferred to be an indicator of a patient’s ovarian function, egg quality and their suitability for receiving assisted clinic. reproductive technology (ART); as such they are increasingly being used as a marker for a woman’s FSH testing ability to conceive.1, 2 Because many fertility clinics The basal FSH level is taken by blood test between use FSH as part of their patient screening criteria, days two and five of the menstrual cycle, and must and decide not to treat patients where the levels are always be taken together with an oestradiol reading too high, many patients have started to view low in order to obtain a meaningful result. Due to the FSH levels as an entrance requirement to ‘get into’ feedback mechanism explained above, elevated their preferred clinic. As a result of this, a growing oestradiol levels may reflect lower FSH, and vice number of patients are presenting for Chinese versa. Table 1 gives the typical ranges for FSH levels, medical treatment with the specific aim of reducing although individual fertility clinics and laboratories this hormone level. may use different ranges, which may be stricter than FSH is produced by the anterior pituitary gland those given below.6 and functions to stimulate the ovaries. During the follicular phase of the menstrual cycle, FSH secreted Normal 3.5-12.5 by the pituitary gland stimulates the production of ovarian follicles and oestradiol. This continues until Elevated or peri-menopausal 12.6 - 25.7 the oestradiol level peaks, causing the pituitary gland Post menopausal 25.8 - 148.8 to increase its production of luteinising hormone (LH), which then acts as the trigger for ovulation to Table 1: Follicular phase FSH levels (IU/L) measured on occur. If the ovary responds poorly to the FSH, and day two of the menstrual cycle.7 the level of oestradiol does not rise sufficiently, the pituitary gland recognises this and secretes more FSH and Western fertility treatment FSH to further stimulate the ovary. In this feedback Because much Western fertility treatment, and system the FSH level rises as the ovary becomes less in particular in vitro fertilisation (IVF), works by responsive. FSH levels have therefore traditionally stimulating the ovaries with additional FSH to been considered a measure of how close a woman is produce multiple follicles,8 the patient’s own FSH level 6 The treatment of Elevated FSH Levels with Chinese Medicine Journal of Chinese Medicine • Number 91 • October 2009 is used as a marker for the likely success or failure of TCM patterns treatment, and indeed whether treatment should be A woman’s journey
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