Age-specific reference values for serum FSH and estradiol levels throughout the reproductive period

Gynecol Endocrinol. 2014 Jun;30(6):451-5. doi: 10.3109/09513590.2014.893572. Epub 2014 May 7.


High serum day 3 FSH levels are associated with poor ovarian reserve and reduced fertility, but the interpretation of FSH values according to age is still not univocal. The purpose of this study was to determine age-dependent reference values in women with regular menstrual cycles and FSH as a guide for specialists. The study was performed at the Department of Mother-Infant of a University-based tertiary care centre. One-hundred ninety-two healthy normal menstruating women were recruited for the study. All patients attended the department on menstrual cycle day 3 for a blood sample for FSH and estradiol determination. A linear relationship between FSH or estradiol serum levels and age was observed. The FSH level increased by 0.11 IU for every year of age (1 IU for every 9 years of age). The values of FSH and estradiol corresponding to the 5th, 25th, 50th, 75th, 95th centiles for any specific age have been calculated. Serum FSH levels need to be interpreted according to age-dependent reference values. Serum FSH levels on 95th centile for any age may represent a warning sign for reduced ovarian reserve.

Keywords: Estradiol; FSH; nomogram; reference values.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aging*
  • Biomarkers / blood
  • Cross-Sectional Studies
  • Estradiol / blood*
  • Estradiol / metabolism
  • Female
  • Follicle Stimulating Hormone, Human / blood*
  • Follicle Stimulating Hormone, Human / metabolism
  • Follicular Phase / blood*
  • Humans
  • Italy
  • Linear Models
  • Luminescent Measurements
  • Ovary / growth & development*
  • Ovary / metabolism
  • Pituitary Gland, Anterior / growth & development*
  • Pituitary Gland, Anterior / metabolism
  • Premenopause
  • Reference Values
  • Tertiary Care Centers
  • Up-Regulation*
  • Young Adult


  • Biomarkers
  • Follicle Stimulating Hormone, Human
  • Estradiol