Elevated FSH or Low AMH

Dr. Braverman discusses many diagnostic testing for elevated FSH or low AMH and some of the treatments that are available to achieve pregnancies.

Many patients come to our practice with a history of recurring pregnancy loss or multiple failed IVF cycles and these patients are found to have either remarkably or even mildly elevated FSH levels. Sometimes there is no clearly identifiable cause as many of them are under age forty and that is an unusual age to have them start to have a rise in their FSH levels. My job is to find out why their FSH is going up if it is not clearly related to the patient's age. There are several reasons for elevated FSH that can be treated and improve the chances of conception in this group of patients.

One of these diagnoses is autoimmune oophoritis which is simply an immune condition where the mother actually attacks her own ovaries and actually the follicles inside the ovaries. This can be tested for and we look for the presence of high levels of ovarian antibodies and the good news is by treating these high levels, if the diagnosis is made in close proximity to the actual onset of the disease, we can actually create a window where we may actually get a better response to the stimulatory medications that are used in either the in vetro fertilization cycle or the insemination cycle.

The second situation with unexplained elevation FSH is those patients that are found to have endometriosis. As we mentioned elsewhere on the website, when the ovaries are bathed in abdominal fluid with high levels of inflammatory cytokines such as tumor necrosis factor, this also begins a very slow degradation process in the patient's follicles and slowly decreases her ovarian reserve. What we found in these situations if we put the patients on high doses of antioxidants and we begin to lower the attack on these ovaries by these inflammatory cytokines we can actually improve not only the quantity of eggs that we see with in vetro fertilization cycles but actually the quality of these eggs.

Sometimes our patients have to go to surgery to debulk the amount of endometriosis if the medical therapy is not working. So it's important if you have an elevated FSH level and even if it is due to advance maternal age that you are aggressive and you treat each of the problems that are found. In our patients with no other identifiable cause except advance maternal age or a family history of premature ovarian failure, we have therapies that can increase the number of receptors on these older follicles so we get a better response from the stimulatory medications.

So if you have an elevated FSH you may be in this group of patients that still have an opportunity to have a child and you may not necessarily need donor eggs; although a large portion of patients still must be realistic that it's a difficult battle, but one that we are willing to fight and many times we're successful.

More Reproductive Immunology Videos

Welcome - Dr Braverman

Dr. Braverman

Do You Only Treat Immune Related Miscarriages?

Dr. Braverman discusses all of the areas of diagnosis that their practice specializes in - including both immune and non-immune causes of miscarriage.

When Do You Discharge Us From Your Care?

Dr. Braveman discusses why his practice continues to manage his patients through the first 12 weeks of their pregnancy.

Why Can’t I Have My Second Child?

Dr. Braverman discusses why patients who have had one child have a difficult time successfully completing another pregnancy.

Are You a Full Service Infertility Practice?

Dr. Braverman discusses all the services provided at Braverman Reproductive Immunology including IVF and IUI procedures.

Dr. Braverman on TLC's A Baby Story

Dr. Braverman on TLC's A Baby Story

Autoimmune Disease and Recurrent Pregnancy Loss

Dr. Braverman discusses the association between autoimmune disease and recurrent pregnancy loss as well as the mechanisms that are most likely ...

Endometriosis and Recurrent Pregnancy Loss

Dr. Braverman discusses the complexity of treating patients with endometriosis and why so many of these patients present themselves to his practice ...

Male Factors in Recurrent Pregnancy Loss

Dr. Braverman discusses the role of the male in the causes of recurrent pregnancy loss and why it is so important to include the male partner in this ...


Dr. Braverman discusses the importance of a complete workup after a Still birth and that most of the times an answer and treatments can be found.

Positive ANA and Miscarriage

Dr. Braverman discusses the mechanisms by where patients with positive ANA may miscarry even when they do not have active autoimmune disease or ...

Supplements and Natural Remedies for Recurrent Pregnancy Loss

Dr. Braverman discusses the use of supplements for the treatment of recurrent pregnancy loss and why their use should be tailored to the diagnosed ...

Thyroid Disease and Recurrent Pregnancy Loss

Dr. Braverman discusses the contribution of thyroid disease in patients with recurrent pregnancy loss.

Outsmarting Endo

Dr. Braverman discusses outsmarting endometriosis.

Understanding and applying transplant medicine to recurrent pregnancy loss

DaVinci Robotic Endometriosis