February 21, 2018

Navigating this fertility website

Here are some explanations of the categories used on this blog:

FERTILITY STRATEGIES: Posts on how to logically approach the problem, choose the right decisions and take the right actions.

INSIDE VIEW: An inside glimpse of this reproductive endocrinologist’s daily work life

LIFE AND HAPPINESS: Bits and pieces from my personal life, my philosophies and beliefs, including political views

QUESTIONS AND ANSWERS: A mixed bag of reader questions

FERTILITY NEWS: News stories about fertility-related issues

REAL STORIES: Real cases from patients who have generously agreed to share their stories

UNCATEGORIZED: Anything that doesn’t neatly fall into any of the above categories

  • Megan Hernandez

    I am looking for some information on high FSH/high estradiol levels. I am 31 and had blood work done in November 2008 on day 1 of my cycle because my skin keeps breaking out, so my dermatologist was trying to figure out if my hormones were the culprit. Turned out my androgen levels were fine, but my FSH was 17.7. So, I went straight to my OBGYN who tested me on day 3 of the next cycle in December 2008. More bad news. FSH was 11.9 and estradiol was 89. He referred me to an RE and said I probably wouldn’t be able to get pregnant on my own (without drugs). Why is this happening to me at 31 years old? I don’t smoke, drink occasionally, and I work out and eat well. What could have possibly happened to me that, at 31, my hormone levels are indicating that my ovarian reserve is either low or of poor quality (or both)? I was on the pill (on and off, but mostly on) for about 12 years. I had a miscarriage (chemical pregnancy) back in October 2008 (I went off the pill in July 2008). I have a history of endometrial polyps, and had a polypectomy back in October 2006. The polyps have not come back, but despite that, I still have dull aches/cramps in my lower abdomen on a regular basis. However, transvaginal ultrasounds show no more polyps growing. I recently had a CT scan which showed a small cyst (less than 2 cm in size) on my right ovary, but the radiologist didn’t seem to think it looked too alarming. Could any of these things be related to my high FSH/estradiol levels? Is this POF/premature menopause? If so, wouldn’t my estradiol be low, not high? I’ve read that the one thing in my favor is my age. Is that true, or do high FSH/estradiol levels mean bad news, despite being only 31?

  • IVF-MD

    I posted a detailed reply. Thank you for your question.

  • Kari Crosman

    I used to read your blog this past summer, but after my first round of Clomid I successfully conceived and took a break from reading about infertility issues. Yet I had to come back after hearing about the octuplets to get your information on how this could have happened.

    I know you said you’re not a psychiatrist, but you referenced Axis II psychopathology. I’m going to have to research this a bit after leaving this comment, because you’re the first person I’ve heard mention that there may be a psychological issue at play. Something about this woman’s appearance and demeanor really jumps out at me, and I’m surprised most of my friends and co-workers aren’t making the connection. The mother looks a lot like Angelina Jolie, right down to the collagen-injected lips. And her demeanor and attitude about having more and more children matches Angelina’s as well.

    It makes me wonder if she’s suffering from what I call the “Barbie Doll Syndrome” – women who strive to look like someone else and be like them, like the woman who had repeated plastic surgeries in the 1980’s to look like a Barbie Doll. It’s just a little too bizarre. There’s definitely more going on here than a woman’s desire to have children. I have that same desire, but was sooooo thankful that the Clomid dose resulted in just a single baby for me. I would be devastated if it had resulted in high-order multiples, not thrilled. And, if in her position, I would be terrified about the long-term health issues my children would be facing right now.

  • Keldy

    Hello my name is Keldy and I am currently a Junior at Queens College. My question to you was what made you go into Medicine, becasue I was reading an article about you on Student Doctor Network, SDN, and being a doctor was not your first option. So what made you change, because I am going through the same process, which is that I am a year away from graduating, and I want to pursue a career in Medicine. So if possible, any tips you can give me in regards to pursing this. Thank You. Please email me if possible at kelorti4917@gmail.com

  • susan

    I am 45 years old (the room grows quiet ūüôā and have been trying to get pregnant naturally for about 2 1/2 years. I conceived easily and gave birth to my first and only child at age 37. Recently I had my blood work done and the #s were as such: E2 =16, FSH 5.90 and LH 5.
    with that said, I was told the E2 was too low and that they look for 20-80 ….. I still felt like it was promising due to my FSH being good as well as LH. however, the nurse practitioner thought otherwise and was not encouraging. I asked what is usually the next step, she said CLOMID. I ovulate regularly (at least as per charting indicates) and have a luteal phase on average of 14 days. I fear to take EXTERNAL drugs when overall , for my age, my body is working well. Do you advocate women of my age taking clomid or does one take estrogen? or anything for that matter. I can’t say I will take clomid or anything else that is natural, but sure would like a good opinion on the matter since the NP was not really helpful in the least….and can I naturally raise my E2 level?

  • jessica

    I am a 38 year old local gal, here in Los Angeles who is aka a DES daughter. Sure enough, after “trying” for four years, I just got news that my FSH levels are at 83. It appears I am on the road to menopause. I’m not even sure I really have a question because everything is so confusing but I was wondering what you knew about DES. I can’t seem to find a doctor who knows about my situation in regards to my exposure. For example, after a very painful HSG my doctor asked me if I wanted to go on Clomid. How would producing more eggs work for me if my tubes are blocked?

    So there you have it. DES. I’m not a fan of it.

    Thank you.

  • Dana

    I am 41 years old, half hispanic/half african american – In late 2009 I had a myomectomy – they removed 25 fibroids all different sizes. Two months after the fibroid removal I went through 4 IUI cycles – no luck and I have just had my first IVF failure. During my IVF transfer the doctor had the eggs loaded in the catheter he had trouble is guess getting through my cervix so he took it out and had the eggs reloaded in another catheter. I quess my question is – What questions should I be asking my doctor of this next IVF cycle? Should I get another opinion from another doctor? Having that many fibroids removed is it possible that my uterus just has to much scar tissue?

    Thank you

  • PC

    Dear Dr,

    I am 32 years old and have been trying to conceive for almost 4 years, including going for 2 SOIUI and 1 IVF cycles, without success. I have read that high FSH:LH levels can affect fertility, lowering implantation rates. (On my most recent Day 3 blood test, my FSH was 8.3, but my LH was only 2.5.) Is that true? If so, besides incorporating LH in my IVF protocol (I was on 150 IU Puregon and 75 IU Menopur for my IVF cycle – produced 10 follicles, fertilized 7 embryos, transferred 3), is there anything I can do to improve my LH level or FSH:LH ratio?

    Thank you.

  • Dave B.

    Do you charge for life coaching? I certainly need one.

  • Christin

    Dear Doctor

    I am hoping that you can clarify two questions relating to IVF. First, what are the probable causes of fertilized eggs developing through day 3, but not past day 5 (blastocyst), in an IVF cycle. I have read that the development process through the first three days depends primarily on the egg quality, and thereafter the development depends primarily on the sperm quality. Is this accurate? Second, if this is a problem for the couple, would a transfer of some fertilized eggs at day 3 improve the chances of pregnancy? As background, we are in our mid-30s, have one child who is 2 years old, and we had two ectopic pregnancies (both had a heartbeat, and most recent one was one year ago), so I have no tubes left. IVF has resulted in multiple )(six) eggs fertilized and “looking good” at day 3, but then none making it to day 5.

    Thank you

  • shau

    I am 34 years old,and i am hypothyroid since 2008 (taking eltroxin 75mcg presently)I didn’t get my periods for 11 months now and the blood hormonal tests show that my FSH & LH is high while Oestradiol and Progesterone is low.Prolactin and TSH is normal. Now I have got lot of hyper-pigmentation on my face (which used to be spotless just 2 years back).I find it really difficult to loose weight even after dieting and exercises.PLEASE HELP…..

  • guest

    Hi Dr. Lee,
    I had a question about clomid. I am currently taking 50mg cd3-7 and this is my first round. I do not have any problems of PCOS, insulin resistance or any throid issues. My cycles are irregular and thats why my OB/GYN prescribed clomid. I am waiting to hear back about my progesterone results from cd 24. I was wondering what if I did ovulate, but did not get my period by say cd40 and pregnancy test turned out negative, what would that indicate? 

  • Anncary35

    Dr. Lee, I came across your site and saw that you have actually replied to readers questions.  SO, I am hoping you see this and reply to it.  I will try & be brief. But, I really, really need input.  The doctors I have gone to have been less then helpful. I am 38, single. Being a mom is the one dream I have in life.  My best friend has agreed to donate sperm to me. I have done 4 at home inseminations with no success.  I had hormones tested. FSH 6.4, LH, AMF, E2 all normal. Day 20 progesterone 11.2. Have endometriosis, last surgery 10 years ago, at time tubes, uterus were normal. No issues since then.
    I am inseminating the sperm within 30 minutes of him ejaculating. He uses a condom without lube or spermicide, or a baby bottle. I pour contents into¬†a sterile container- and draw it up with 10ml needle-less syringe.¬† my GYN gave me clomid- to start this cycle day 3- which is in 2 days. I also use OPK’s and having only one day to pick b/c inseminating- I do the day of Lh surge. I am keeping the sperm warm, body temp during transport. What can I do to help the sperm have the best chance of survival in this process? My donor is a healthy- 28 year old by the way. I am so distraught every time it doesn’t work. Any advice would help!! THank you in advance

  • gray

    Hi, i am 34 yrs old. Its my first time to watch your video and i can feel that your a good doctor and hoping that you can help me. I have just received a bad news recently coming from my ob gyne, she said i have a polycystic ovarian syndrome and i have a thallasemia. She said i have a higher chance not to be get pregnant, im still single but i really wanted to have a baby. Will i be cured? Is there any ways for me to get pregnant? Is the intrauterine procedure or the invitro fertilization can help me to get pregnant?