INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE
ISSN: 2692-5206, Impact Factor: 12,23
American Academic publishers, volume 05, issue 07,2025
Journal:
https://www.academicpublishers.org/journals/index.php/ijai
page 170
HIGH FSH AND THE EFFECTIVENESS OF ART PROGRAMS: MODERN
APPROACHES TO PATIENT MANAGEMENT
Jalilova Dilnoza Juraevna
Tashkent Pediatric Medical Institute
Clinical Residency
Scientific Supervisor:
S.Z. Yuldasheva
Annotation:
An increase in the level of follicle-stimulating hormone (FSH) in women of
reproductive age is one of the key markers of decreased ovarian reserve and a harbinger of
reproductive failure. The article discusses the pathophysiological mechanisms of increased FSH,
its diagnostic value and clinical significance in the context of infertility. The article presents the
results of the analysis of data from 152 patients with varying degrees of increased FSH, and
studies possible causes (age-related changes, iatrogenic interventions, autoimmune processes,
genetic predisposition) and potential approaches to treatment. Modern strategies for patient
management are covered, including the use of hormone replacement therapy, an individualized
ovarian stimulation protocol, the use of donor oocytes, as well as innovative methods using
growth factors and stem cells. Emphasis is placed on the need for a differentiated approach and
careful assessment of the ovarian reserve in clinical practice.
Keywords:
Follicle stimulating hormone, FSH, infertility, ovarian reserve, AMH, hormonal
therapy, donor eggs, IVF, premature ovarian failure, decreased fertility
Introduction
A woman's reproductive function directly depends on the state of the ovarian reserve, the
key biomarker of which is the level of follicle-stimulating hormone (FSH). Elevated FSH,
especially in the early follicular phase of the menstrual cycle, is a prognostic sign of decreased
ovarian function. The FSH level closely correlates with the number of antral follicles and anti-
Müllerian hormone (AMH), which makes it one of the most studied and clinically significant
parameters in the diagnosis of infertility. An increase in FSH is usually associated with a
compensatory increase in pituitary stimulation during depletion of the follicular pool. However,
interpretation of the FSH level requires a comprehensive approach that takes into account the
patient's age, cycle phase, the presence of concomitant pathology and previously performed
treatment methods.
Methods
The study included 152 patients diagnosed with infertility of various origins and confirmed
elevated FSH levels (>10 MME/ml). The women's age ranged from 28 to 43 years. The patients
were divided into 3 groups: Group I — with moderate FSH elevation (10–15 MME/ml), Group
INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE
ISSN: 2692-5206, Impact Factor: 12,23
American Academic publishers, volume 05, issue 07,2025
Journal:
https://www.academicpublishers.org/journals/index.php/ijai
page 171
II — with marked elevation (15–25 MME/ml), Group III — with critical levels (>25 MME/ml).
All women underwent a comprehensive examination: determination of FSH, LH, E2, AMH,
ultrasound monitoring of the ovaries, karyotyping, study of autoantibodies to ovarian tissue,
and assessment of somatic status. In some cases, enzyme immunoassay methods were used to
exclude concomitant endocrine disorders. The effectiveness of various treatment approaches
was assessed, including hormonal therapy, IVF with the woman's own or donor oocytes,
ovulation induction, and experimental methods.
Results
Analysis of clinical data revealed a direct relationship between the FSH level and the
severity of menstrual cycle disorders. Patients with FSH> 25 MME/ml more often had
amenorrhea or infrequent menstruation, as well as low E2 and AMH levels, indicating profound
ovarian dysfunction. Autoantibodies to ovarian tissues were detected in 78% of women in
Group III, confirming the involvement of the autoimmune mechanism in pathogenesis.
Mutations in the FMR1 gene (premutation) were diagnosed in 16% of patients, which correlates
with the clinical picture of premature ovarian failure. The effectiveness of classical IVF
protocols with their own eggs in this category of patients was extremely low (the overall
pregnancy rate was 5.6%). The highest result (up to 47%) was shown by the protocol using
donor oocytes. The use of hormone replacement therapy allowed to normalize the menstrual
cycle and subjective well-being in most patients, but did not affect the restoration of fertility.
Injections of stem cells and growth factors in the experimental group demonstrated positive
dynamics of the AMH level in 3 of 12 patients during 6 months of observation, but require
further research.
Discussion
An elevated FSH level in women with infertility is an important marker indicating a
decrease in ovarian reserve and the need to revise reproductive tactics. Its interpretation should
be comprehensive and take into account age, hormonal background, the presence of
concomitant pathology and previous reproductive failures. This indicator should not be the only
criterion for refusing IVF attempts, especially with a moderate increase (up to 15-18 MME/ml),
where individualized stimulation is possible. However, with a pronounced and critical FSH
level (>25 MME/ml), it is rational to use programs with donor eggs or participate in clinical
trials of new methods for restoring ovarian function. The autoimmune component and genetic
predisposition emphasize the need for extensive screening and a multidisciplinary approach to
diagnosis and treatment.
Conclusion
Elevated FSH levels are a prognostically unfavorable factor in women with infertility,
especially in combination with low AMH and menstrual irregularities. Individualization of the
approach, timely diagnosis of causes, expansion of indications for the use of assisted
reproductive technologies and the development of new experimental methods are key areas in
the management of such patients. Further research in the field of molecular biology,
INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE
ISSN: 2692-5206, Impact Factor: 12,23
American Academic publishers, volume 05, issue 07,2025
Journal:
https://www.academicpublishers.org/journals/index.php/ijai
page 172
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fertility prognosis.
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