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advlghtcon - April 28th, 2006 12:32 AM

I was on day I think day 8 of IVF. I had my 2nd u/s and the physician said I am not responding to the stem meds like he would like to see. I have one dominant follicle and two follicles that are small and I guess no good. So, the nurse called me today after my u/s and estradiol level results and said they could not continue with IVF because my body is not responding like it should. My husband has a very poor sperm analysis low, slow, clumpy... and my fsh was elevated shortly after IUI meds clomid... several months before I entered into IVF> I thought it was elevated d/t having taken fsh meds. However, I found out today that those meds have no effect on fsh blood test. How can that be?? If I am increasing my fsh level via medication why would that not reflect in my blood work. I thought after a period of time it would return to normal. I was tested a couple of months after the elevated result and my fsh was normal. So, I thought everything would be ok with the exception of my husband. So, today when the physician said if my FSH is elevated than I have a decrease in ovarian reserves. Is this true?? could it not have tested elevated because of the meds I was taking for IUI. Or is this the end. If your FSH is high just one time will you still will have a very difficult time becoming pregnant even if subsequent FSH result are normal. sorry to ramble on but I wish someone would have told me this before entering into IVF. Please let me know what you think.


Dr Smith - April 28th, 2006 10:51 AM

Once your FSH is elevated (and it does bounce around a bit at the beginning of the perimenopausal period), it is indicative of a low ovarian reserve. The half-life of FSH is very short (that's why you have to take it every day during the stimulation). FSH from a stimulated cycle is completely gone from your system by the beginning of the next cycle. So, your elevated FSH is from your pituitary gland, not the FSH you took for IUI's. From here on you will produce very few follicles each cycle. The FSH/LH containing medications you take during the stimulation do not increase the number of follicles that begin to grow on a cycle, they merely maintain the growth of the one's that have already started. You may have a better cycle another time (say 1-2 more follicles), but its going to be low from now on. As a rule of thumb, a minimum of 6 growing follicles is required to have a reasonable chance of success through ART (IVF or IUI). This is why your cycle was cancelled. If you have another cancelled cycle, you should seriously consider other options.


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