FSH Levels by Age - Follicle Stimulating

Hormone Levels with Chart

What is a normal FSH level to get pregnant? When it comes to FSH levels and fertility, it’s
important to recognize that there is no one normal FSH level for all women. What is normal is
that the normal range depends on a woman’s age. As women get older, FSH levels rise, until
they reach a level of 40 mIU/mL or higher during menopause. The chart further down this page
can help you understand what FSH level is normal for you, based on your age.

Do Not Wait for FSH to Improve

CHR explains why treatment should not be postponed when FSH is high.

What is FSH?
FSH is a hormone released by the pituitary gland, which is located on the underside of the brain.
A blood test to measure FSH levels is a common part of any infertility workup. An FSH blood
test detects the level of this hormone in the blood to check whether a woman’s levels are normal.
This information is then used as an indicator for ovarian function.

Lower FSH levels are generally associated with better ovarian function, while higher FSH levels
are associated with diminished ovarian reserve. Most women have low FSH levels in their 20s,
and FSH increases as a woman ages.

Interpreting Your FSH Levels: What FSH Level is Normal

for You?
About a decade ago, CHR's research established references for AMH and FSH levels by age.
Any FSH level means something different depending on a woman’s age. For example, a normal
FSH level for a woman at 42 suggests premature ovarian aging (POA) if found in a 30-year old.
To really assess a woman's ovarian reserve and her IVF pregnancy chances, we need to look at
age-specific AMH and FSH levels. The AMH and FSH levels chart below demonstrates age-
specific AMH and FSH levels among CHR's patients.

What is a Normal FSH Level? FSH Level Chart by Age

FSH levels naturally rise as women get older. The FSH levels chart below shows the normal
range (along with AMH levels) by female age. As the table demonstrates, normal FSH levels go
from below 7.0 mIU/mL for someone younger than 33 to over 8.5 mIU/mL for a woman over 41.
This chart is an important tool that we use to create tailored fertility treatment plans for our
patients.
Age Specific Baseline FSH and AMH Levels by Age

Normal FSH Levels

Age (Day 3 of the Menstrual Cycle) AMH
< 33 Years < 7.0 mlU/mL = 2.1 ng/mL
33-37 Years < 7.9 mIU/mL = 1.7 ng/mL
38-40 Years < 8.4 mIU/mL = 1.1 ng/mL
= 41+ Years < 8.5 mIU/mL = 0.5 ng/mL

"CHR developed and uses an age-based AMH and FSH scale, which is more accurate at
predicting pregnancy chances."

Dr. Norbert Gleicher

Many fertility centers, unfortunately, still use universal cut-off values for a normal FSH range.
This can mean that younger women with POA and resulting higher FSH levels for their age (but
within normal range based on a universal “normal” value) are given inappropriate fertility
treatment or misdiagnosed as “unexplained infertility.

When a patient has high FSH, some of these centers also refuse to provide treatment, irrespective
of patient age and other factors. Or these centers may push women to egg donation (prematurely,
in our opinion). This approach may ensure higher pregnancy rates at such centers (because they
reject women with lower chances of pregnancy), but it leaves women with elevated FSH (and/or
low AMH) abandoned, without access to treatment that can be quite successful if done correctly.

CHR does not use such arbitrary cut-off values. We look at follicle stimulating hormone range in
the context of a woman’s age and other factors. This way, our physicians are able to
individualize fertility treatments for each woman’s level of ovarian function. This is why we
have so many patient with stories of successful pregnancy with their own eggs!

The graph you see on this page provides a visual representation of age-specific FSH levels, along
with AMH level, as they change over a woman’s reproductive lifetime.

AMH May Be More Useful than FSH

What makes the “universal FSH cut-off” approach even more problematic is the fact that the
most up-to-date medical literature suggests that FSH is not as specific as it was once thought. A
number of papers published by CHR's physicians suggest that AMH is actually more specific
than FSH in assessing ovarian reserve and pregnancy chances with IVF. Better AMH specificity
makes sense because AMH reflects the smaller follicles, which represent a majority of a
woman's ovarian reserve. (The figure above demonstrates that normal AMH ranges are narrower
than normal FSH ranges, suggesting that AMH is more precise in reflecting ovarian reserve.)
Given the superiority of AMH, IVF treatment decisions based on the FSH level alone, appears
outdated.

While tests to check AMH and FSH levels are important in assessing ovarian reserve, both have
limitations. Neither result can, indeed, categorically determine whether a woman can or cannot
conceive, unless she has very high FSH levels. In addition, women can get pregnant with IVF
even when AMH is completely undetectable, as over 50 pregnancies established so far at CHR in
women with undetectable AMH levels clearly demonstrate. Therefore, placing too much
emphasis on high FSH and low AMH can be misleading. It can also be harmful, as some
physicians make patients wait for low FSH levels to magically appear in the next blood test
before starting an IVF cycle--a practice that wastes precious time and makes no physiological
sense.

Read more about High FSH

What is High FSH?

FSH (follicle stimulating hormone) is a hormone released by the pituitary gland...

Read more
Interpreting Your Levels

A few years ago, CHR's research established age-specific levels of FSH and AMH...

Read more

What is FSH (Follicle Stimulating Hormone)?

FSH: Definition and Why Follicle Stimulating Hormone is Important for Female Fertility...

Read more

Norbert Gleicher, MD, FACOG, FACS

Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief
Scientist. A world-renowned reproductive endocrinologist, Dr. Gleicher has published hundreds
of peer-reviewed papers and lectured globally while keeping an active clinical career focused on
ovarian aging, immunological issues and other difficult cases of infertility.

Follow Dr. Norbert Gleicher on Google+ or LinkedIn