Mas asked about Rogaine and low sperm motility. My urologists tell me Rogaine has no effect on sperm production or motility. However, just like everything else, maybe he is the one out of hundreds whose system is very sensitive. See if stopping the drug changes anything.
QVC has had elevated FSH levels but recently had a 1.9. Make sure there was an estrogen level done at the same time. Once the estrogen (or estradiol- same thing) goes over 50, it will artificially make your FSH lower. Once the estrogen is over 100, levels like 1.9 are common. You should still be on a protocol designed for women with high FSH levels.
Stephanie had a low egg number using a long lupron protocol. I suggest removing the lupron. I rarely use lupron anymore. I have also started using the estrogen priming protocol. So far I can’t say it’s better, but it seems to be at least as good.
The infertility acupuncturist asked about progesterone after IVF. There is a theory that you need more progesterone for IVF because the follicles, which become the progesterone producing corpus lutea(CL), become disrupted by the needle at retrieval. This may not be the case, but we are not sure. I would think that even in this is true, there are so many CL with IVF, progesterone production should be just fine. However there is more to the story. IVF drugs, especially lupron, but possibly antagon or cetrotide, may lower progesterone production. This is because lupron stops your pituitary from making LH, and LH drives progesterone production. Once you stop lupron, LH function returns, but it takes a few days and by then it may be too late. There are many studies showing if you use lupron, pregnancy rates are higher with progesterone. I don’t believe such studies have been done with antagon. Most studies show no improvement in pregnany rates with fertility drugs and iui. This may be because Lupron or antagon are usually not used for iui.
Melinda asked about ectopic pregnancy. She had one and is worried about another with IVF. Yes you are at increased risk, however the odds are still low, even lower if they took out the tube with the ectopic. I do not know the status of the remaining tube. Your odds could be anywhere from about 2-8% for having another ectopic. It’s good that they told you about potentially having an ectopic, but ask them to check their numbers.
Hopeful in Arkansas asked about clomid iui with male factor. It depends on the total motile count. This number is arrived at after the wash. It’s the total number of sperm you are getting back. The higher the better. Less than 5 is bad, 5-10 is ok, 10 or more is good. If you are getting low number back, consider IVF. If you are getting good numbers, then it’s up to you.
M asked about embryos that were frozen when her husband was drinking excessively. There is just not enough information out there to answer your question. Sorry, I wish I could help you with this one.
Helen asked about taking estrogen pills during her cycle. It is not a good idea to take estrogen pills as part of a natural cycle. It will interfere with ovulation, making it come early, late, or not at all.
Michelle asked about her iui cycle # 12. I am sorry you cannot afford IVF right now, I hope you can find a way. I hope this iui works.
Aimee asked about the necessity of an HSG. I skip it in only a few patients. I have to be really comfortable with their age, history and ultrasound to let it slide. If your doctor is even hinting at it, get it done. You will know soon if your first doctor was wrong. Odd are he was right, but you will see.
Nina asked about extra fertility testing before getting further treatment. I can’t really know what you specifically may need; however for most people the testing is pretty basic. It’s a HSG, SA and day 3 bloods. After that it’s all about your history and the philosophy of your doctor. You can waste a lot of time and money on tests that are not mainstream. Progesterone problems are rarely the cause of infertility. Remember, they go up and down throughout the day. Ask your doctor, taking some extra may not hurt, but don’t go on progesterone for 6 months without doing something else at the same time.
Della hit the jackpot! Very nice.
Julie has immature eggs. DO NOT GIVE UP!! Get a second opinion. I am not sure if you had the same problem both cycles. Taking more HCG may be the answer, but not if your levels were high enough. Let another doctor look at your records. Some women make a huge percentage of immature eggs no matter what we do, but even they can be successful with persistence.
Jen-Jen is 42, PCOS, considering IVF. Well, the good news is that you have PCOS. So many women think this is a bad thing for IVF, but it is a good thing, and as you get into your 40’s it’s a great thing. If the diagnosis is correct, you will make many eggs. IVF success in your 40’s is increased but getting high egg numbers. On the other hand, iui should make many eggs and your odds may be higher than expected. But, IVF rates are always 2-3 times higher than iui. So if you are considering IVF, do it soon, because you will never be younger.
Stacey came to see me and has 3 year old twins. Thanks for writing; let’s hope for good luck to all who need it.
Dove has a very high estrogen from IVF drugs. I am sure you had to make a decision before today. I hope it worked out.
So there it is. See you soon. Read the disclamer 5/17/06.
Dr. Licciardi
QVC has had elevated FSH levels but recently had a 1.9. Make sure there was an estrogen level done at the same time. Once the estrogen (or estradiol- same thing) goes over 50, it will artificially make your FSH lower. Once the estrogen is over 100, levels like 1.9 are common. You should still be on a protocol designed for women with high FSH levels.
Stephanie had a low egg number using a long lupron protocol. I suggest removing the lupron. I rarely use lupron anymore. I have also started using the estrogen priming protocol. So far I can’t say it’s better, but it seems to be at least as good.
The infertility acupuncturist asked about progesterone after IVF. There is a theory that you need more progesterone for IVF because the follicles, which become the progesterone producing corpus lutea(CL), become disrupted by the needle at retrieval. This may not be the case, but we are not sure. I would think that even in this is true, there are so many CL with IVF, progesterone production should be just fine. However there is more to the story. IVF drugs, especially lupron, but possibly antagon or cetrotide, may lower progesterone production. This is because lupron stops your pituitary from making LH, and LH drives progesterone production. Once you stop lupron, LH function returns, but it takes a few days and by then it may be too late. There are many studies showing if you use lupron, pregnancy rates are higher with progesterone. I don’t believe such studies have been done with antagon. Most studies show no improvement in pregnany rates with fertility drugs and iui. This may be because Lupron or antagon are usually not used for iui.
Melinda asked about ectopic pregnancy. She had one and is worried about another with IVF. Yes you are at increased risk, however the odds are still low, even lower if they took out the tube with the ectopic. I do not know the status of the remaining tube. Your odds could be anywhere from about 2-8% for having another ectopic. It’s good that they told you about potentially having an ectopic, but ask them to check their numbers.
Hopeful in Arkansas asked about clomid iui with male factor. It depends on the total motile count. This number is arrived at after the wash. It’s the total number of sperm you are getting back. The higher the better. Less than 5 is bad, 5-10 is ok, 10 or more is good. If you are getting low number back, consider IVF. If you are getting good numbers, then it’s up to you.
M asked about embryos that were frozen when her husband was drinking excessively. There is just not enough information out there to answer your question. Sorry, I wish I could help you with this one.
Helen asked about taking estrogen pills during her cycle. It is not a good idea to take estrogen pills as part of a natural cycle. It will interfere with ovulation, making it come early, late, or not at all.
Michelle asked about her iui cycle # 12. I am sorry you cannot afford IVF right now, I hope you can find a way. I hope this iui works.
Aimee asked about the necessity of an HSG. I skip it in only a few patients. I have to be really comfortable with their age, history and ultrasound to let it slide. If your doctor is even hinting at it, get it done. You will know soon if your first doctor was wrong. Odd are he was right, but you will see.
Nina asked about extra fertility testing before getting further treatment. I can’t really know what you specifically may need; however for most people the testing is pretty basic. It’s a HSG, SA and day 3 bloods. After that it’s all about your history and the philosophy of your doctor. You can waste a lot of time and money on tests that are not mainstream. Progesterone problems are rarely the cause of infertility. Remember, they go up and down throughout the day. Ask your doctor, taking some extra may not hurt, but don’t go on progesterone for 6 months without doing something else at the same time.
Della hit the jackpot! Very nice.
Julie has immature eggs. DO NOT GIVE UP!! Get a second opinion. I am not sure if you had the same problem both cycles. Taking more HCG may be the answer, but not if your levels were high enough. Let another doctor look at your records. Some women make a huge percentage of immature eggs no matter what we do, but even they can be successful with persistence.
Jen-Jen is 42, PCOS, considering IVF. Well, the good news is that you have PCOS. So many women think this is a bad thing for IVF, but it is a good thing, and as you get into your 40’s it’s a great thing. If the diagnosis is correct, you will make many eggs. IVF success in your 40’s is increased but getting high egg numbers. On the other hand, iui should make many eggs and your odds may be higher than expected. But, IVF rates are always 2-3 times higher than iui. So if you are considering IVF, do it soon, because you will never be younger.
Stacey came to see me and has 3 year old twins. Thanks for writing; let’s hope for good luck to all who need it.
Dove has a very high estrogen from IVF drugs. I am sure you had to make a decision before today. I hope it worked out.
So there it is. See you soon. Read the disclamer 5/17/06.
Dr. Licciardi