This document presents a study on the effects of follicle-stimulating hormone (FSH) in humans, covering its roles in male and female fertility, symptoms of high and low FSH levels, and associated infertility issues. FSH, secreted by the anterior pituitary, regulates various reproductive processes and can be affected by age, genetic factors, and health conditions. The study highlights the clinical significance of FSH levels and their management in relation to reproductive health.

1. University of Chakwal, Pakistan

2. Presented By: Maheen Zahra
Roll No: 20M-UOC-ZOL/52
Bs Zoology
Session 2020-2024
Subject: Endocrinology
Submitted To: Dr Syeda Nadia Ahmad
Topic: Effect Of Follicle Stimulating Hormone (FSH) in
Human

3. • Follicle-stimulating hormone (FSH) was first identified in 1930
(Spaziani et ai., 2023).
• The anterior pituitary gland secretes FSH, a heterodimeric
glycoprotein hormone with a molecular weight of 28–30 kDa, which is
composed of two components, α and β.
• Human chorionic gonadotropin (hCG), thyroid-stimulating hormone
(TSH), and luteinizing hormone (LH) are among the glycoproteic
hormones that share its structure.
Introduction

4. Organ Systems
Involved
https://images.app.goo.gl/6tZBFkeug9TjcXJbA
Fig;1.1 FSH axis
GnRH, which is
secreted by the
hypothalamus,
causes the anterior
pituitary to release
FSH and LH.

5. Females
• Estrogen production
• Follicular development
Males
• Induction and maintenance of spermatogenesis (Orlowski, M., &
Sarao, M. S. 2018)
Function

6. Extra-Gonadal Effects of FSH
(https://images.app.goo.gl/UnVYLDpLSkECWJSEA)
Fig 1.2;Extra-Gonadal Effects of FSH

7. • Hot flashes
• Weight gain
• Vaginal dryness
• Irregular menstruation
• Sleep disturbances
• Emotional changes
• Bone loss
• Limited sperm production
• Infertility
• Delays in sexual development
Symptoms of high levels Symptoms of low levels
Symptoms

8. • An estimated 15% of couples worldwide struggle with infertility, a
condition for which men are exclusively to blame for 20% to 30% of
instances and contribute to 50% of cases overall.
• Numerous studies have shown that men's serum FSH increases with age;
however, many FSH reference intervals that are used do not account for
men who are fertile for age-related partitioning(Waller et al., 2021).
Causes of high FSH level in male

9. • This study discovered that, as opposed to azoospermia, 29 patients
with isolated FSH insufficiency had oligoteratoasthenozoospermia.
• Additionally, aberrant sperm morphology was the most affected sperm
parameter, and those with abnormal sperm parameters had lower FSH
levels than those with normal sperm parameters(Orlowski, M., &
Sarao, M. S. 2018).
Low FSH level and male infertility

10. Causes of Low FSH level
Excess androgens
Destruction of
pituitary cells
Congenital/geneti
c problems
Drugs or
medications
Idiopathic low
FSH
Congenital
adrenal
hyperplasia

11. Management of low FSH
Stimulation of Endogenous FSH
Production
Implanted GnRH pumps are available
Exogenous FSH Replacement
(https://www.maleinfertilityguide.com/fsh-abnormalities)

12. High FSH levels due to testicular failure may be caused by
Chromosome
abnormalities
Testicular injuries
Advancing age
Undescended
testicles
Chemotherapy or
radiation
Testicular damage
by disease
Genetic
problems
Hormonal
disorders
Type 2 diabetes
(https://inovifertility.com/high-low-fsh-in-men)

13. • Describe the situation of a 33-year-old woman who has had primary
infertility for 4 years. Follicle-stimulating hormone (FSH) levels that
were high in isolation were at odds with the clinical picture and other
hormone markers that supported polycystic ovarian syndrome(Urrutia
et al.,2019).
High FSH level in female

14. High FSH level in female
Hypothalamic-pituitary
dysfunction
Infertility
Gonadal dysfunction
Estrogen deficiency Early menopause
Increased ovarian
follicle growth
Certain medications

15. • Irregular periods or no periods
• Hot flashes and/or night sweats
• Skin and hair changes
• Difficulty conceiving
• Low sex drive
• Fatigue
• Infertility
• Hot flashes
• Irregular periods or no periods
Symptoms of high and low FSH level

16. • Low FSH levels in women pose a health risk, just as high FSH levels
in women are concerning. Additionally, low FSH hormone levels
impair ovarian function and render puberty development incomplete.
• Infertility results from insufficient or incomplete development of the
ovarian follicles. Hypogonadotropic hypogonadism is the medical
term for low levels of FSH in the blood.(https://hertilityhealth.com/blog/what-do-
your-fsh-levels-mean/)
Low FSH level in female

17. • FSH Levels and Male Infertility
• Polycystic Ovarian Syndrome
• Hypogonadotropic
Hypogonadism
• Kallman Syndrome
• Primary Ovarian Insufficiency
• Premature ovarian failure
• Turner Syndrome
• Pituitary Adenomas
Clinical Significance

18. Medications
GnRH Agonists and Antagonists
Assisted Reproduction Techniques (ART)
(Orlowski, M., &Sarao, M. S. 2018).

19. • Orlowski, M., &Sarao, M. S. (2018). Physiology, follicle stimulating hormone.
Follicle Stimulating Horm, 6, 21.
• Urrutia, M., Grinspon, R. P., & Rey, R. A. (2019). Comparing the role of anti-
Müllerian hormone as a marker of FSH action in male and female fertility. Expert
review of endocrinology & metabolism, 14(3), 203-214.
• Spaziani, M., Carlomagno, F., Tenuta, M., Sesti, F., Angelini, F., Bonaventura, I.,
... &Pozza, C. (2023). Extra-Gonadal and Non-Canonical Effects of FSH in Males.
Pharmaceuticals, 16(6), 813.
• Waller, E. J., Conceicao, J., Matson, P., & Yovich, J. L. (2021). Proposed age-
stratified reference intervals of FSH derived from normozoospermic men. Asian
Pacific Journal of Reproduction, 10(4), 162-167.
REFERENCE