I am 41. I had one abortion at age 22. I just had blood tests that showed normal thyroid and normal estrogen levels, but my FSH level was 15. The fertility specialist told me that I could not use my own eggs, but would need donor eggs. Does this mean I have no eggs, or few eggs? What are my chances of having a normal full-term pregnancy? Can the FSH 15 be reversed? Does it change monthly? Is there any way I might conceive with my own eggs?

C.M.

At age 41, even with a normal FSH level, your chance for success with aggressive treatment is about 4-6 percent at best, with about a 30-40 percent miscarriage rate. Unfortunately, high FSH levels -- over 10 -- correlate with poor pregnancy rates even if you ovulate normally. This reflects egg quality, not just quantity; pregnancy rates for women with high FSH who undergo in vitro fertilization are still poor even if normal embryos are transferred. FSH levels over 14 or 15 indicate you probably have no chance of success with your own eggs; you would need donor eggs and in vitro fertilization (IVF).

For younger women, in their 20s or early 30s, high FSH may be due to an undetected infection or immune abnormalities; in some cases, the level returns to normal on its own. The high FSH levels that occur in women age 38 and older are unlikely to be reversible. I am aware of none of my patients with a similar situation who have conceived using their own eggs.