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Fertility / Infertility (Expert Forum)
blood work
Questions in the Fertility/Infertility forum are answered by doctors affiliated with USF Health. Topics covered include fertility or infertility issues, egg quality, fertility drugs and side effects, fertility tests, genetic testing, in-vitro fertilization (IVF), ovulation, relationship issues, risk factors, sperm count/quality, and surgery.
blood work
by babyprayers, Jun 22, 2007 12:00AM
I am currently on round 6 for IUI. My period started last wednesday 6/13/07 with very light spotting on day 1 and 2 on day 3 I started to flow heavy, I had my blood work and ultra sound, My FSH level was 0.7 I confirmed with them that it was in fact 0.7 as this seemed extremely low, and it was in fact at that level. now.. I do not regularly get my period. I am 39 years old, and was diagnosed with hypothalmic ammenorhea, I have taken gonal F injections since I started the IUI, and respond well to the meds but have yet to get pregnant. My questions are
1) what would make the FSH so low, and would that be considered OK
2) my progesterone level was also low, and estrogen was super low,. my RE said all levels should be low but estrogen was lower then normal but did not mention taken any supplemental estrogen,. should I be taking supplemental estrogen when taking stim meds for IUI.
3) I know smoking can effect quality of eggs and possibly make it harder for sperm to penetrate. I have quit smoking, how long does it take for eggs to stop being so hard after smoking.
and finally ? 4.. I had an HSG done which was perfect. my question is could my past history of smoking damgage my fimbria at the end of my tubes causing the egg to not be "sucked" up into the tube, and would an hsg show that.
I am currently on day 6 of my stim meds, and have 3 follicles at this point all at 8MM I go back on monday to see how they are progressing.
1) what would make the FSH so low, and would that be considered OK
2) my progesterone level was also low, and estrogen was super low,. my RE said all levels should be low but estrogen was lower then normal but did not mention taken any supplemental estrogen,. should I be taking supplemental estrogen when taking stim meds for IUI.
3) I know smoking can effect quality of eggs and possibly make it harder for sperm to penetrate. I have quit smoking, how long does it take for eggs to stop being so hard after smoking.
and finally ? 4.. I had an HSG done which was perfect. my question is could my past history of smoking damgage my fimbria at the end of my tubes causing the egg to not be "sucked" up into the tube, and would an hsg show that.
I am currently on day 6 of my stim meds, and have 3 follicles at this point all at 8MM I go back on monday to see how they are progressing.
Doctor's Answer
by Forum-M.D.-SP, Jun 22, 2007 12:00AM
Dear babyprayers:
Let me try to answer your questions, and make a couple of suggestions as well:
1) Your FSH at 0.7 is low, but that is not uncommon with hypothalamic amenorrhea. FSH comes from the pituitary gland when the hypothalamus (a part of the brain) sends a message to the pituitary gland. It is the FSH from the pituitary that tells the ovary to release an egg. With hypothalamic amenorrhea, the pituitary gland is not getting a signal from the brain, so it does not release its FSH and blood levels of FSH are low
2) Gonal-F is FSH in drug form, which is how it works to help you to ovulate
3) There is another hormone from the pituitary, LH, that is also important to make an egg healthy. Has your doctor checked your LH level? It too is probably low, and if it is perhaps a better choice of drug for you would be menopur, which is a combination of FSH and LH. Even though you are ovulating on gonal-F, you may also need some LH to make your egg healthier. I very much encourage you to ask your doctor if a drug containing LH would help, particularly after several unsuccessful IUI cycles.
4) There are many causes for low FSH/hypothalamic amenorrhea. These can include eating disorders, excessive exercise, low percent body fat, rarely hypothalamic benign tumors, congenital (that means born with this problem), history of prior brain surgery, history of prior radiation, history of hemorrhaging after delivering a baby. Most often, however, no cause is found. Has your doctor ever ordered an MRI?
5) Smoking will not affect tubal function
6) Any damage that smoking has done to your eggs is probably not reversible after many years of smoking - having stopped smoking the good news is that no further damage will be done.
My guess is that there is nothing wrong with your fallopian tubes.
Has your husband had a sperm count?
Have you had any further hormone testing and/or MRI to look more closely at the cause of your hypothalamic amenorrhea?
I would encourage you to ask your doctor whether or not there might be a benefit to taking a fertility drug containing LH in addition to FSH - that to me has the best potential to be 'where the money is' for you.
Let me try to answer your questions, and make a couple of suggestions as well:
1) Your FSH at 0.7 is low, but that is not uncommon with hypothalamic amenorrhea. FSH comes from the pituitary gland when the hypothalamus (a part of the brain) sends a message to the pituitary gland. It is the FSH from the pituitary that tells the ovary to release an egg. With hypothalamic amenorrhea, the pituitary gland is not getting a signal from the brain, so it does not release its FSH and blood levels of FSH are low
2) Gonal-F is FSH in drug form, which is how it works to help you to ovulate
3) There is another hormone from the pituitary, LH, that is also important to make an egg healthy. Has your doctor checked your LH level? It too is probably low, and if it is perhaps a better choice of drug for you would be menopur, which is a combination of FSH and LH. Even though you are ovulating on gonal-F, you may also need some LH to make your egg healthier. I very much encourage you to ask your doctor if a drug containing LH would help, particularly after several unsuccessful IUI cycles.
4) There are many causes for low FSH/hypothalamic amenorrhea. These can include eating disorders, excessive exercise, low percent body fat, rarely hypothalamic benign tumors, congenital (that means born with this problem), history of prior brain surgery, history of prior radiation, history of hemorrhaging after delivering a baby. Most often, however, no cause is found. Has your doctor ever ordered an MRI?
5) Smoking will not affect tubal function
6) Any damage that smoking has done to your eggs is probably not reversible after many years of smoking - having stopped smoking the good news is that no further damage will be done.
My guess is that there is nothing wrong with your fallopian tubes.
Has your husband had a sperm count?
Have you had any further hormone testing and/or MRI to look more closely at the cause of your hypothalamic amenorrhea?
I would encourage you to ask your doctor whether or not there might be a benefit to taking a fertility drug containing LH in addition to FSH - that to me has the best potential to be 'where the money is' for you.
Member Comments (3)
by babyprayers, Jun 22, 2007 12:00AM
To: in addition
in addition to the above post, I also have a nine year old which was conceived naturally. my blood work and U/S was done on day 3 of my period but listed it as day one as I only spotted day one and 2.. and one last thing. my flow starts exactly 12 days after the IUI,. this has happened the last 5 times, so there fore I am wondering if my luteal phase is to short, they put me on preogesterone 200 mg daily which I take intravaginally at HS. could this not be enough progesterone to support a pregnancy.
by babyprayers, Jun 22, 2007 12:00AM
To: sorry one last thing to add on
My RE office called today, my estrogen is 23.. so it is coming up, progesterone 0.7 and LH 2.8 so I know that as follicles mature estrogen should go up to 150-200 per mature follicle, so its still on the low side but climbing.. I am just trying to fit all this together and figure out why after 5 IUI I am still not pregnant. any insight you can give me would be helpful, I am an RN but not proficient with infertiltiy issues.
by prayergirl, May 07, 2008 10:30AM
A related discussion, progesterone was started.
