Follicle Stimulating Hormone(FSH) : Everything you need to know

Follicle Stimulating Hormone, or FSH Terms in Surrogacy - Follicle Stimulating Hormone - FSH hormone - Follicle Stimulating Hormone in Surrogacy - Gestational Surrogacy

Follicle Stimulating Hormone (FSH for short) is one of the important hormones monitored during Gestational surrogacy. Keeping it secret from the anterior pituitary gland, and together with Luteinizing hormone, plays the main role in normal female reproduction. The main function of FSH is to enhance the growth of the follicles in the ovaries during egg development. Also known as the ‘master gland,’ the pituitary gland gets messages from the developing egg and the ovaries and releases the FSH hormone to encourage the growth of follicle containing eggs (dominant follicle), which later undergoes ovulation.

In the first few days of the menstrual cycle, the follicle-stimulating hormone stimulates the growth of immature, dormant eggs referred to as oocytes. During this early phase, the biggest and most developed follicle that contains the most mature egg begins to secrete Estradiol, which goes on to trigger ovulation, for the most developed egg to be released and fertilized, if possible. This is also the time that the immature eggs are set free.

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The Increase of FSH and the decrease in Egg Count (Menopause)

A woman is born with a finite number of eggs, ranging from one to two million, and by the time she attains puberty, she would have approximately 400000 eggs left.

On average, a woman should have 400 ovulatory cycles during her reproductive years, during which the remaining 400,000 eggs are going to be released. These dormant, immature eggs decline in overall quality as a woman becomes older and may cause babies conceived at this time serious health problems.

The pituitary gland can detect when the ovaries get older, secreting a higher amount of the follicle-stimulating hormone to ensure that the monthly ovulation takes place. At a point, there will be no eggs, and menopause sets in. A point when the high levels of FSH in the serum will be of no help. Before menopause, doctors can help check this decline in egg quantity and quality by evaluating the levels of FSH in the blood. The higher the level of FSH, the less likely to get pregnant.

How Follicle Stimulating Hormone works (FSH) in the Surrogacy Process

After menstruation, you are going to start Controlled Ovarian Supra-Ovulation with daily fertility injections. You will also keep taking other drugs at the time to prevent ovulation before the surgical egg retrieval.

During medical visits, the doctor will check your ovarian response via ultrasound and carry out blood tests to examine your hormone levels. In case you are responding poorly to the ovarian stimulation drug, you need to adjust the dosage until your response improves significantly.

Typically, enough eggs should have matured after 8 to 13 days of medication. It is at that point that you will be asked to take intramuscular injections to trigger the final changes in the eggs and get them ready for retrieval, roughly 36 hours later.

Effect on Eggs

Generally, the number of a woman’s eggs that will mature under the influence of FSH depends on her age. For instance, a woman in her mid-twenties can produce 20 to 30 eggs after getting ovarian stimulation medication (FSH) for approximately two weeks.

FSH and other hormones administered under medical supervision are safe to use during traditional & gestational surrogacy, and until it’s time to retrieve the eggs, the patient is monitored using hormone level tests and ultrasound examination. Note that egg retrieval involves the harvesting of all the mature eggs in the two ovaries.

The Side Effects of FSH

One of the first side-effects that we should note here is the fact that follicle-stimulating hormone medication tends to have a very short half-life in the patient’s body. What this means is that fertility treatment with this hormone will need to be administered frequently, as the FSH included in the medication will disappear from the bloodstream rather quickly.

In addition to the short half-life, there are possible side effects we see in women who had the FSH as part of their fertility treatment.

In most cases, side-effects that occur due to the use of FSH (Follicle Stimulating Hormone) medicine will be mild.

These side-effects may include:

  • Nausea
  • Stomach pain
  • Runny nose
  • Stuffy nose
  • Sore throat
  • Numbness
  • A tingling sensation
  • Headache
  • Breast swelling
  • Breast tenderness
  • Skin rash
  • Acne

The area where the injection is administered may become painful for a short period of time. There may also be irritation and redness, as well as bruising because of FSH.

There are more serious side-effects too. OHSS or Ovarian Hyperstimulation Syndrome is a particularly serious adverse event. This complication refers to the accumulation of fluid in the chest area, as well as in the stomach region.

Symptoms that may signal OHSS include:

  • Swelling that affects the legs and hands
  • Sudden and unexpected weight gain
  • A reduction in urination
  • Severe lower abdominal pain
  • Severe nausea, bloating and vomiting
  • Diarrhea
  • Shortness of breath

When Is FSH Not The Best Fertility Treatment Option?

Many women consider FSH as a relatively safe fertility treatment and generally hormones will tolerate it well. There are cases where a fertility specialist might find that a patient is not good for this treatment, however.

When using gestational surrogacy this might sometimes be the case. With this type of surrogacy, an egg from the surrogate will not be used during the fertilization process. Instead, we collect an egg and a sperm cell from the parents of the baby. The egg and sperm cells will combine to fertilize the egg. Then with the IVF therapy, it will create an embryo – which will transfer to the surrogate.

A woman who has already become pregnant should not use FSH (Follicle Stimulating Hormone). Experts only administrate this treatment before a successful pregnancy test. Some women may also not be appropriate candidates for the use of FSH. Women with asthma or polycystic ovary disease might be at an increased risk of complications. We advise not to utilize FSH if the woman has a history of blood clots and stroke in her past.


Several hormones play a role in reproduction. In cases where a woman will act as a Surrogate mother, FSH is a common hormonal treatment expert will provide. The hormone helps eggs in the ovaries mature, providing an increase in the chances of the fertility treatment being successful. Patients who receive treatment with this hormone should have a thorough understanding of FSH and its effect during gestational or traditional surrogacy. They should know what it is and how it works in the process of reproduction.

Do you want to know more about Gestational Surrogacy and How Follicle Stimulating Hormone (FSH) Works in Surrogacy? Contact us if you are willing to become a Surrogate and to know our requirements.

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Physician’s Surrogacy is the nation’s only physician-managed surrogacy agency. Join our community to get updates on surrogacy, expert insights, free resources and more.