Questions from last month
Dear Doctor,
Hello, I would be very grateful if you could help me. I ahve GP in the Uk, that unfortunately only gives you 10 mins for a meeting. He told me that my test results were noraml but does not go into anymore detail.
I reaaly need an insight into what the hormone levels mean in terms of fertility.
my plasma FSH is 9.8 iul/L,?LH 4.51?serum testosterone 1.9 nmol/L?serum presterone 1nmol/ L
serum oestradiol 83pmol/L
apart from the FSH, I do not understand what thes figures mean, could you please give me some indication and direct me some websites whereby I can learn More . Thank you
Dear Daniella
Thanks for the question. I’m sorry to hear that you were only given 10 minutes with your doctor on a complex issue such as infertility. I understand that you have government-run healthcare over there in the UK, but do you have any option to choose another doctor? The thought of being given 10 minutes with zero choice of choosing a different doctor would scare a lot of the people here in the US as we try to fight off our own government’s attempts to take over this vital part of our lives.
In any case, with respect to your question above, what you have shared are test results regarding your hormones. The FSH and LH are made by your pituitary and are involved in your body’s way of modulating your ovaries to make eggs. The next three ( testosterone, progesterone and estradiol ) are the products of your ovaries.
Depending on your age, you could have a less than average chance of conceiving or an average one. Based on those tests, you probably wouldn’t expect to have a higher-than-average chance of conceiving. As for what you should do, it depends on your age, how strongly you want to have a baby, how long you have been wanting one and what treatments you have already tried in the past. The value of doing those tests is not that great unless one of them comes back as off the charts and grossly abnormal. That’s about the best answer that I can give you without knowing your history and goals. Good luck!
I just went to the Re office for my 3 day fsh level to start ivf last month it was 10.5 and e2 was 69 this month i wanted to start and now my fsh is 15.5 and e2 is 89 my follicle count was 9 no other problems is it possible i need egg donor they told me I have to wait till it goes down what would my options be at 37
Dear Tracey,
At 37, your options would be to go ahead and attempt a stimulation and then see how many follicles your body produces or to not take a chance, but go directly to donor eggs. Without knowing the rest of your history, I can try and assume that you have never done IVF before. Depending on how much it would cost you if you were to have a cancelled cycle and how much value it is to you to try with your own eggs, you would balance these two factors out and make a choice that is best for you. Best of luck!
hello
in 2007 I had a fsh of 6.9 in 2008 I had a successful ivf resulting in my little girl.?from that ivf I got 9 eggs out of 13 follicles.with low drugs
we have been considering ivf no2 in the hope for a sibling
my fsh is now 10.2 ( which is the higher end of normal ) and my AMH is 8 not sure is that is normal ???
I am 27 and ivf is the only way for me as have no tubes ( 3 ectopics )
so my question is with my fsh on the rise should I be having ivf sooner rather than later ? are my levels abnormal for my age ?
any advice would be much appreciated
natalie
Dear Natalie,
Yes, assuming that your FSH was drawn near day #3 of your cycle, then the value is considered less favorable than what would be expected in the average 27-year-old. As for going after your second baby sooner than later, in general, you know that conceiving at a younger age results in higher odds of success, lower risk of miscarriage and lower risk of birth defects. So if you mentally and financially ready and are really sure that you want more children, then what’s the reason for waiting? Right? Good luck!
Hi Dr. Lee,
I have followed your blog for several months now. It has been so helpful, and I thank you for that. My husband I have been trying to conceive for 3 years now, and under the care of an RE since October of ‘08. We’ve had 5 IUI’s and 2 IVF’s. Long story short, the first IVF resutled in OHSS and the 4 embryos were frozen. The second IVF only resulted in 2 embryos surviving to day 5 and they were both transferred, but I was hospitalized with the flu AND we got a negative on a pregnancy test. We had a FET this past summer and transferred 2 of the embryos. (Many details to my story but they believe the blood thinners helped us as I was diagnosed with MTHFR.) I had a successful, singleton pregnancy but delivered stillbirth at 20 weeks, 5 days. I was diagnosed with an incompetent cervix. I have read on line that this is not uncommon in infertility patients. In a nutshell, I was wondering if you would consider blogging about any of these topics in the future: blood disorders like MTHFR, recurrent pregnancy loss, incompetent cervix, and high risk issues in IF patients like incompetent cervix or placent previa. Thanks for your time, Jennifer A.
Dr. Lee,
So sorry… I left a few things out in my post. I was diagnosed with PCOS and poor egg quality. My husband was diagnosed with slightly low testosterone (I want to say just two points below normal). He had the varicocele surgery and now the urologist in the IF practice says his testosterone levels are ‘great.’ The most important part I left out was this; I have two frozen embryos left. We want to try another FET. What could/should I know about incompetent cervix that could make a different and save the next baby’s life, or is it a ‘crap shoot.’ Also, would it be safe to trasnfer two? If we chose to transfer only one at a time, are we lowering our chances of that ‘one’ embryo implanting? I have heard that women often transfer several because it increases their chances at getting pregnant. So, does that mean transferring only one will ‘lower’ your chances? Hoping my story will inspire future blog topics for you to research and discuss. Thank you again, Jennifer A.
Dear Jennifer,
In my 14 years of practice, I’ve encountered at least 20 patients who after getting pregnant with IVF or IUI have gone on to be diagnosed with incompetent cervix. Most of them went on to have a healthy baby in future pregnancies. In the majority of cases, the presence of an incompetent cerivix is picked up only after a tragic pregnancy loss. The only other way to detect it would be to monitor the cervical length meticulously. For you next pregnancy, I take it you will be under the care of a high-risk OB specialist who will likely discuss with you the option of having a cerclage, which as you may know, is a stitch to tighten up your cervix. As for your question of transferring one vs two embryos, bear in mind that each embryo you transfer gives you one “roll of the dice” to get a baby. So, of course, rolling the dice twice makes the odds of hitting a winner more likely. However, you would have the same general chance in the long run whether you transferred both embryos in two separate transfers or if you transferred them both at once. I hope that makes sense. I have discussed recurrent pregnancy loss in previous posts, but I appreciate your suggestion and I will likely revisit this issue in future posts. I hope all goes well with your next pregnancy.
