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Test ID: FSH    
Follicle-Stimulating Hormone (FSH), Serum

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Useful For Suggests clinical disorders or settings where the test may be helpful

An adjunct in the evaluation of menstrual irregularities

 

Evaluating patients with suspected hypogonadism

 

Predicting ovulation

 

Evaluating infertility

 

Diagnosing pituitary disorders

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Luteinizing hormone (LH) is a glycoprotein hormone consisting of 2 noncovalently bound subunits (alpha and beta). Gonadotropin-releasing hormone from the hypothalamus controls the secretion of the gonadotropins, follicle-stimulating hormone (FSH), and LH from the anterior pituitary.

 

The menstrual cycle is divided by a midcycle surge of both FSH and LH into a follicular phase and a luteal phase.

 

FSH appears to control gametogenesis in both males and females.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Males

<12 months: < or =3.3 IU/L

> or =12 months-< or =5 years: < or =1.9 IU/L

>5 years-< or =10 years: < or =2.3 IU/L

>10 years-< or =15 years: 0.6-6.9 IU/L

>15 years-< or =18 years: 0.7-9.6 IU/L

>18 years: 1.2-15.8 IU/L

 

TANNER STAGES*

Stage l: <1.5 IU/L

Stage ll: <3.0 IU/L

Stage lll: 0.4-6.2 IU/L

Stage lV: 0.6-5.1 IU/L

Stage V: 0.8-7.2 IU/L

*Puberty onset occurs for boys at a median age of 11.5 (+/- 2) years. For boys there is no proven relationship between puberty onset and body weight or ethnic origin. Progression through Tanner stages is variable. Tanner stage V (adult) should be reached by age 18.

 

Females

<12 months: 1.2-12.5 IU/L

> or =12 months-< or =10 years: 0.5-6.0 IU/L

>10 years-< or =15 years: 0.9-8.9 IU/L

>15 years-< or =18 years: 0.7-9.6 IU/L

Premenopausal:

Follicular: 2.9-14.6 IU/L

Midcycle: 4.7-23.2 IU/L

Luteal: 1.4-8.9 IU/L

Postmenopausal: 16.0-157.0 IU/L

 

TANNER STAGES*

Stage l: 0.6-4.1 IU/L

Stage ll: 0.3-5.8 IU/L

Stage lll: 0.1-7.2 IU/L

Stage lV: 0.3-7.0 IU/L

Stage V: 0.4-8.6 IU/L

*Puberty onset (transition from Tanner stage I to Tanner stage II) occurs for girls at a median age of 10.5 (+/- 2) years. There is evidence that it may occur up to 1 year earlier in obese girls and in African American girls. Progression through Tanner stages is variable. Tanner stage V (adult) should be reached by age 18.

 

For SI unit Reference Values, see  International System of Units (SI) Conversion

Interpretation Provides information to assist in interpretation of the test results

In both males and females, primary hypogonadism results in an elevation of basal follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels.

 

FSH and LH are generally elevated in:

-Primary gonadal failure  

-Complete testicular feminization syndrome

-Precocious puberty (either idiopathic or secondary to a central nervous system lesion)

-Menopause (postmenopausal FSH levels are generally >40 IU/L)

-Primary ovarian hypofunction in females

-Primary hypogonadism in males

 

Normal or decreased FSH in:

-Polycystic ovary disease in females

 

FSH and LH are both decreased in failure of the pituitary or hypothalamus.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

No clinically significant cross-reactivity has been demonstrated with thyrotropin (previously known as thyroid-stimulating hormone), luteinizing hormone, human chorionic gonadotropin, prolactin, or growth hormone.

 

Some patients who have been exposed to animal antigens, either in the environment or as part of treatment or imaging procedures, may have circulating anti-animal antibodies present. These antibodies may interfere with the assay reagents to produce unreliable results.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Demers LM, Vance ML: Pituitary function. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 4th ed. Elsevier Saunders Company; 2006:1984-1989

2. Haymond S, Gronowski AM: Reproductive related disorders. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 4th ed. Elsevier Saunders Company; 2006:2101-2127

3. Kulasingam V, Jung BP, Blastuig IM, et al: Pediatric reference intervals for 28 chemistries and immunoassays on the Roche cobas 6000 analyzer--A CALIPER pilot study. Clin Biochem. 2010 Sep;43(13-14);1045-1050. doi: 10.1016/j.clinbiochem.2010.05.008

4. Konforte D, Shea JL, Kyriakopoulou L, et al: Complex biological pattern of fertility hormones in children and adolescents: a study of healthy children from the CALIPER cohort and establishment of pediatric reference intervals. Clin Chem. 2013 Aug;59(8):1215-1227. doi: 10.1373/clinchem.2013.204123