Welcome to my blog, discover acupuncture with Dr Maggie Ju

Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many year research and clinical experiences. This blog is for information only.

Wednesday, 20 July 2022

High FSH to get pregnant? Acupuncture can help.

What is Follicle stimulating hormone (FSH)?

There are three organs that are directly involved in producing hormones for reproduction: the hypothalamus, pituitary gland (in the brain) and ovary (in the pelvis). Five hormones are produced by these organs including GnRH, FSH, LH, oestrogen and progesterone. GnRH is produced by the hypothalamus; FSH and LH are produced by the pituitary gland; oestrogen and progesterone are produced by the ovary. The FSH production is determined mainly by the levels of oestrogen and progesterone. At the start of menstrual cycle when oestrogen level is low, FSH is produced. FSH acts at the ovary to stimulate follicles growth in the ovary. FSH level can be checked in the blood test. This is a part of the fertility check.

Follicle stimulating hormone (FSH) is one of the most important hormones involved in female reproductive function. It is involved in producing mature eggs in the ovaries. It is used to stimulate ovaries during IVF treatment. FSH is produced in the pituitary gland a part of the brain. When the ovaries are running out of eggs say, in menopause, ovaries produce less oestrogen. The brain senses the low estrogen environment - and sends signals to the pituitary to make more FSH hormone. More FSH is released from the pituitary in an attempt to stimulate the ovaries to produce a good follicle and estrogen hormone. FSH can be a parameter to measure ovarian function. It is normally tested on day 3 of women’s menstrual cycles which is the lowest FSH in the cycle which can be as a baseline.


If FSH level is elevated, what does that mean?

If day 3 FSH is elevated, it means that the ovaries don’t work normally, the brain has to work hard to produce more FSH to get ovaries functioning normally. High FSH level tends to indicate low egg quantity and quality. In circumstances, if the ovary does not respond to FSH, the follicles don’t grow well and then the pituitary gland will produce more FSH for the ovary. As a result, FSH level becomes higher than normal. This indicates the ovary does not function normally. Your egg quality and quantity will be poor and the chance to get pregnant is low and the chance to succeed for IVF treatment is also low because of poor response to ovary stimulation and poor egg quality. Sometimes high FSH is masked by high estradiol (E2) level. E2 will artificially suppress FSH to normal range which gives you a false impression that your FSH is normal.


Acupuncture can help, if FSH is elevated.
Acupuncture is the best option for now. The purpose of the treatment is lowering FSH level; restoring ovary function and helping eggs grow is the key of the treatment. Acupuncture improves ovarian blood supply, as a result ovarian function is improved, and eggs grow. Egg quality is also improved. Once ovaries respond to FSH and egg quality increases, pituitary gland will not produce excessive FSH. This will decrease FSH level, increase egg quality and improve the chance to get pregnant naturally or through IVF.

Here is some example of research that acupuncture decreases FSH in patients with high FSH.
In a study, twenty-one patients with high FSH were received 12 weeks acupuncture treatment. Mean FSH levels fell from 19.33±9.47 mIU/mL at baseline to 10.58±6.34 mIU/mL at week 12 and 11.25±6.68 mIU/mL at week 24. Change in mean FSH from baseline was -8.75±11.13 mIU/mL at week 12 (p=0.002) and -8.08±9.56 mIU/mL at week 24 (p=0.001). Mean E2 and LH levels, FSH/LH ratios and irritability scores were improved at weeks 12 and/or 24. Approximately 30% patients reported subjective increases in menstrual volume after treatment.

Acupuncture helps IVF success in women with declined ovarian reserve
Recently there was a study about acupuncture on IVF/ICSI involved in 63 women with declined ovarian reserve. They were divided into two groups: acupuncture group and control group. In acupuncture group acupuncture was given twice a week until second menstrual cycle of oocyte retrieval. The patients in the control group were treated with IVF-ET but no acupuncture. The ovarian reserve function, including basic follicle-stimulating hormone (FSH), estradiol (E2), antral follicle count (AFC), number of retrieved oocytes, number of fertilization and number of high quality embryo, were compared and analyzed before and after acupuncture in the acupuncture group. The differences of outcomes of IVF-ET, including the cycle cancellation rate, implantation rate, the clinical pregnancy rate, were compared between the two groups. Their result has shown that Compared before acupuncture, the E2, AFC, number of retrieved oocytes, number of high quality embrgo and number of fertilization were all increased after acupuncture in acupuncture group. Compared with the control group, levels of the E2, the number of retrieved oocytes, number of fertilization and number of high quality embryo were all increased in acupuncture group. Also, the implantation rate, the clinical pregnancy rate were improved and cycle cancellation rate was reduced.

Acupuncture can help lower FSH. This is proved by some research papers. A review analysed six studies on acupuncture for elevated FSH level. All studies evaluated FSH levels at the end of treatment. The results showed a significant decrease in the FSH level in the acupuncture group compared with the control groups.

References
Wang Y et al Acupunct Med (2016) May 13. pii: acupmed-2015-011014. doi: 10.1136/acupmed-2015-011014.
Zhou L et al Zhongguo Zhen Jiu (2016) 36:25-8

Jo J et al (2015) Evid Based Complement Alternat Med 2015:842180. doi: 10.1155/2015/842180. Epub 2015 May 18.

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