What Are the Effects of Low FSH?

Six hormone tests (sex hormone test, reproductive hormone test) are routine tests of the female reproductive system.

Sex hormone six

Six hormone tests (sex hormone test, reproductive hormone test) are routine tests of the female reproductive system.

There is no complete and unified gynecological and obstetric endocrine hormone measurement value in China, and due to the source of various reagents, measurement methods, and calculation of data, the units used are different. Even if the same hormone specimen, the results obtained by each laboratory are not complete the same.

Chinese name: Sex hormone six
Belong to: Sex medicine

Purpose: Understanding endocrine
Method: Laboratory determination

To understand women's endocrine function and diagnosis by measuring sex hormone levels

The inspection methods differ depending on the items to be checked. The content of the inspection can be inspected in its entirety or individually.

1. Check for estrogen, progesterone, follicle stimulating hormone, and also check after venous serum separation, respectively. 2

It is best to check the endocrine for the first 3-5 days after menstrual cramps. This period belongs to the early stage of follicles and can reflect the functional status of the ovaries. But for

One,

Women have menstrual cycle disorders,

FSHLH Sex hormone six FSH and LH

During the normal menstrual cycle with a basic value of 5 to 10 IU / L, blood FSH and LH are maintained at low levels in the early stage of follicles (2 to 3 days of menstruation), and rise rapidly before ovulation. LH is 3 to 8 times the basic value, which can reach 160IU / L is very high, while FSH is only about twice the basic value, rarely 30IU / L. FSH and LH quickly return to the level of follicular phase after ovulation. Monitoring the levels of FSH and LH in the early stage of follicles can preliminarily determine the function of the gonad axis. FSH is more valuable than LH in determining ovarian potential.

1. Ovarian failure: Basal FSH 40IU / L, elevated LH, or 40IU / L, is amenorrhea of high gonadotropin (Gn), that is, ovarian failure; if it occurs before the age of 40, it is called premature ovarian failure (POF) ).

2. Poor ovarian reserve (DOR): Basic FSH / LH 2 to 3.6 indicate DOR (FSH can be in the normal range), which is an early manifestation of ovarian dysfunction, which often indicates that patients have a poor response to superovulation (COH) and should be The COH regimen and the dose of Gn were adjusted in time to improve the ovarian response and obtain the ideal pregnancy rate. Because the increase in FSH / LH only reflects DOR, not the decline in fertility, once the ovulation period is obtained, the ideal pregnancy rate can still be obtained.

3. Both basic FSH and LH are 5IU / L for low Gn amenorrhea, suggesting hypothalamic or pituitary dysfunction, and the difference between the two requires the use of gonadotropin-releasing hormone (GnRH) tests.

4. The basic FSH is 12 IU / L, and the next cycle is rechecked. Continuous 12 IU / L indicates DOR.

5. Polycystic ovary syndrome (PCOS): Basic LH / FSH 2 to 3, which can be used as the main indicator for the diagnosis of PCOS (basic LH level 10IU / L is an increase, or LH maintains normal levels, while basic FSH is relatively Low levels result in an increased ratio of LH to FSH).

6. Check the basic FSH> 20IU / L twice, which can be considered as the hidden period of premature ovarian failure, suggesting that amenorrhea may occur after 1 year.

P Sex hormone six P progesterone

Basic value is generally <1ng / ml. Under normal circumstances, blood P in follicular phase has always been at a low level, average 0.6 ~ 1.9nmol / L, generally <10nmol / L (3.15ng / ml). When LH peak appears before ovulation, P secretion After the ovulation, the ovarian corpus luteum produces a large amount of P, and the blood P concentration rises rapidly; when the corpus luteum matures (6-8 days after the LH peak), the blood P concentration reaches a peak, which can reach 47.7 to 102.4 nmol / L (15 to 32.2 ng / ml) or higher, and then continue to decline, reaching the lowest level in the premenstrual period. The change of P content in peripheral blood in the whole corpus luteum is parabolic.

1. Judging ovulation: in the middle corpus luteum (women on the 28th menstrual cycle is the 21st day of menstruation) P> 16nmol / L (5ng / ml) indicates ovulation, and 16nmol / L (5ng / ml) indicates no ovulation.

2. Diagnosis of luteal dysfunction (LPD): P 32nmol / L (10ng / ml) in the middle corpus luteum, or P on 3rd, 5th, 7th and 9th days after ovulation, the total P 95.4nmol / L (30ng / ml) is LPD; or P 47.7nmol / L (15ng / ml) before the 10th week of pregnancy is the diagnostic criteria for LPD.

3. Differentiating ectopic pregnancy: The blood P level of ectopic pregnancy is low, and most patients have blood P 47.7nmol / L (15ng / ml). Only 1.5% of patients were 79.5nmol / L (25ng / ml). In normal intrauterine pregnancy, P90% 79.5nmol / L and 10% 47.6nmol / L. Blood P level can be used as a reference in the differential diagnosis of intrauterine and ectopic pregnancy.

4. Judging the prognosis of IVF-ET: The P level before ovulation can estimate the prognosis of IVF-ET. On the day of intramuscular HCG injection, P 3.18 nmol / L (1.0 ng / ml) should be regarded as increased, and the implantation rate and clinical pregnancy rate were decreased. P 4.77 nmol / L (1.5 ng / ml) suggested premature luteinization. In the IVF-ET long schedule ovulation promotion, even if there is no increase in LH concentration on the day of intramuscular HCG injection, if P (ng / ml) × 1000 / E2 (pg / ml)> 1, it indicates that the follicles are prematurely luteinized, and the The clinical pregnancy rate of these patients was significantly reduced. Premature luteinization is also a manifestation of DOR.

PRL Sex hormones six PRL prolactin

PRL is synthesized and secreted by eosinophilic PRL cells. PRL secretion is unstable. Emotion, exercise, sexual intercourse, hunger and eating can affect its secretion status, and there is a small fluctuation with the menstrual cycle, which has a rhythm related to sleep; PRL secretion increases in the short-term after falling asleep, compared with the morning in the afternoon. Rise. Therefore, according to the characteristics of this rhythm secretion, blood should be drawn on an empty stomach at 9-10 am.

Those with a significant increase in PRL can be determined with a single examination; those with a mildly elevated PRL should undergo a second examination. It is not easy to diagnose hyperprolactinemia (HPRL) and abuse bromocriptine treatment. PRL 25ng / ml or higher than the unit's normal test value is HPRL. PRL 50ng / ml, about 20% have prolactinoma. PRL 100ng / ml, about 50% have prolactinoma, and can be used for pituitary CT or magnetic resonance. PRL 200ng / ml, microadenomas often exist, and pituitary CT or magnetic resonance imaging must be performed. Reduced PRL: Sheehan syndrome, use of anti-PRL drugs such as bromocriptine, levodopa, VitB6, etc.

E2 Sex hormone six E2 estradiol

The basic value is 25 45pg / ml in the normal menstrual cycle. The early E2 of the follicle is about 183.5pmol / L (50pg / ml). The first peak before ovulation can reach 917.5 1835pmol / L (250 500pg). Ovulation After a rapid decline, the luteal phase formed a second peak, about 458.8 pmol / L (124.80 pg). After a period of maintenance, the luteal atrophy dropped to the level of early follicular phase, that is, the third day of menstruation should be 91.75 183.5 pmol / L (25-50 pg / ml).

1. Basic E2> 165.2 293.6pmol / L (45 80pg / ml), regardless of age and FSH, suggest that fertility is decreased.

2. When the basic E2 is 367pmol / L (100pg / ml), the ovarian response is worse. Even if FSH is 15IU / L, there is no possibility of pregnancy.

3. Indicators for monitoring follicular maturation and ovarian hyperstimulation syndrome (OHSS) Follicle stimulating: When the follicle is 18mm and blood E2 reaches 1100pmol / L (300pg / ml), HMG is stopped on the same day Or, HCG10000IU was injected 24 to 36 hours after the last HMG injection. E2 3670pmol / L (1000pg / ml), OHSS generally does not occur. E2 9175pmol / L (2500pg / ml), as a high risk factor for OHSS, stop or reduce the amount of HMG in time, and disable HCG to support the corpus luteum function, which can avoid or reduce the occurrence of OHSS. At E2 14800pmol / L (4000pg / ml), nearly 100% of OHSS occurs and can rapidly develop into severe OHSS.