Follicle-Stimulating Hormone (FSH), Serum
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Gonadotropin-releasing hormone from the hypothalamus controls the secretion of the gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (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.
An adjunct in the evaluation of menstrual irregularities
Evaluating patients with suspected hypogonadism
Diagnosing pituitary disorders
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 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 antianimal antibodies present. These antibodies may interfere with the assay reagents to produce unreliable results.
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.
1-7 days: < or =3.0 IU/L
8-14 days: < or =1.4 IU/L
15 days-3 years: < or =2.5 IU/L
4-6 years: < or =6.7 IU/L
7-8 years: < or =4.1 IU/L
9-10 years: < or =4.5 IU/L
11 years: 0.4-8.9 IU/L
12 years: 0.5-10.5 IU/L
13 years: 0.7-10.8 IU/L
14 years: 0.5-10.5 IU/L
15 years: 0.4-18.5 IU/L
16 years: < or =9.7 IU/L
17 years: 2.2-12.3 IU/L
> or =18 years: 1.0-18.0 IU/L
Stage l: < or =3.7 IU/L
Stage ll: < or =12.2 IU/L
Stage lll: < or =17.4 IU/L
Stage lV: 0.3-8.2 IU/L
Stage V: 1.1-12.9 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.
1-7 days: < or =3.4 IU/L
8-14 days: < or =1.0 IU/L
15 days-6 years: < or =3.3 IU/L
7-8 years: < or =11.1 IU/L
9-10 years: 0.4-6.9 IU/L
11 years: 0.4-9.0 IU/L
12 years: 1.0-17.2 IU/L
13 years: 1.8-9.9 IU/L
14-16 years: 0.9-12.4 IU/L
17 years: 1.2-9.6 IU/L
> or =18 years:
Follicular: 3.9-8.8 IU/L
Midcycle: 4.5-22.5 IU/L
Luteal: 1.8-5.1 IU/L
Postmenopausal: 16.7-113.6 IU/L
Stage l: 0.4-6.7 IU/L
Stage ll: 0.5-8.7 IU/L
Stage lll: 1.2-11.4 IU/L
Stage lV: 0.7-12.8 IU/L
Stage V: 1.0-11.6 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.
Pediatric ranges derived for DXI method from analytic comparison to reference method in: Elmlinger MW, Kuhnel W, Ranke MB: Reference ranges for serum concentrations of lutropin (LH), follitropin (FSH), estradiol (E2), prolactin, progesterone, sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), cortisol and ferritin in neonates, children and young adults. Clin Chem Lab Med 2002;40(11):1151-1160
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. Seedat S, Nye E: The gonads. In Clinical Chemistry: Theory, Analysis, Correlation, Fourth Edition. Edited by LA Kaplan, AJ Pesce, SC Kazmierczak. St. Louis, MO. Mosby, 2003, p. 1179
2. Dumesic DA: Hyperandrogenic anovulation: a new view of polycystic ovary syndrome. Postgrad Ob Gyn 1995;15:1-5