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Follicle stimulating hormone, better known as FSH, is the hormone that in women enables a single follicle to mature and release its egg during the monthly process of ovulation. After ovulation, FSH levels fall only to start rising again at the onset of a new cycle. As women approach menopause, however, FSH levels stay high all the time, so a new ovulatory cycle is not initiated. High FSH levels are normal in menopause, but they can also interfere with reproduction in women who have not yet reached menopause. When women have high levels of both estrogen and FSH early in their periods, they are likely to be approaching diminished ovarian reserve, simply not having many more eggs on hand for future pregnancies.

When women have high levels of FSH but normal levels of estrogen early in their periods, the problem is likely to be an inability to respond to luteinizing hormone and progesterone to enable ovulation and conception. So what can doctors do? Sometimes the treatment is a process called "estrogen priming." FSH stimulates the release of the egg, and high FSH levels may be stimulating the release of the egg before it has matured. Taking synthetic estrogen during the first half of the menstrual cycle slows down the release of the egg and compensates for high FSH levels. Sometimes the treatment is meant to make ovulatory stimulants work better. Estrogen given in the second half of the menstrual cycle, after the expected time of ovulation, slows down the next cycle so that the next egg will be released only after it has matured. Women who benefit from estrogen during the first half of their periods, however, are not the same women who benefit from women during the second half of their periods. Timing estrogen treatment becomes a difficult medical judgment.

However, there are also alternative treatments. Some women report pregnancy after treatment with acupuncture. A single acupuncture treatment never results in pregnancy. Usually weekly treatments over a period of about a year are required, and it's a waste of time to attempt the method with any acupuncturist who does not have experience in using it for fertility. In the United States, acupuncture clinics specializing in women's fertility issues with acupuncture and herbs include:

Yu Chen at Meridian Medical Group in New York, NY. Sadhna Singh at Eastern Harmony in Houston, Texas. Pulling Down the Moon at three locations near Chicago, Illinois. Mary Margaret Dobson at Ocean Acupuncture in Redondo Beach, California. Lifang Liang in San Francisco, California. Ilumina Healing Sanctuary in Scottsdale, Arizona. Hoboken Acupuncture in Hoboken, New Jersey. Denise Wiesner at Natural Healing and Acupuncture in Los Angeles, California. Christine Kleinschmidt at Brentwood Center of Health in St. Louis, Missouri. Berkley Center in New York, New York. Axelrad Clinic in Houston, Texas. Acupuncture in Michigan in Detroit, Michigan. Acupuncture for Women in Dallas, Texas.

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