Dr Smith
3 Replies
Christie - November 14

Hi,

I had my FSH tested on schedule but after a cancelled IVF cycle. Would the FSH level(s) results be high or false because of the hormone drugs given during the IVF cycle?

They cancelled me without giving no or any other med(s) to tell my body to either release the eggs, or, to tell it that it is not pregnant, so it, my body, can get back on a normal menses cycle. My period was three weeks late from my very very normal end of the month menstrual cycle. I went to another Doc because my body was acting pregnant (I am not pregnant) and he gave me a shot to start my menses in approx. 10 days after. Could this have messed up the test as they tested my FSH on this first menses of the cancelled cycle?

The hardest part of the cancelled cycle to to wait for a period that may not happen.

I have a recurring cyst, that has been disruppted twice BTW, and I just think I should go to donor. I am already exhausted of all of the negativity and hopelessness form my Docs, even after producing 6 seemingly healthy eggs with only one ovary on my very first stimulation. I have been told that it simply will not happen again.

Christie

 

Dr Smith - November 15

I understand that it is difficult to wait for your next period to come after the disappointment of a cancelled cycle, but its not unusual to have a delay in the onset of menses following a cancelled stimulation. The delay can sometimes give you the false hope that you somehow got pregnant on your own and that makes for a double let down when you find out that you're not pregnant after all. Sometimes it is necessary to induce menses with a shot when it doesn't come on its own. Since this is fairly common, try not to get too upset about it.

The shot, and the induced menses, does not have an effect on the Day 3 FSH value. At that point, you body is back to "nomal" and the FSH value is real.

 

csabapathi - November 16

Hi Dr. Smith,

I had an IVF cycle which made it to egg retrieval, but did not make it to embryo transfer. I was very disappointeed and saddened by it. My first FSH in 3/05 was 8.85. They recommended IVF for me since my husband also had some issues and since my FSH was high-normal despite my age of 32. My first cycle was in October and it didn't go through transfer. My FSH after birth control periods (day 3 of the period after stopping birth control pill) was 14.1. They told me that it was a high FSH and they don't expect too many eggs. I went through microdose lupron flare protocol (Lupron 20 units twice/day and Gonal-F 225 units twice/day). I had 6 eggs, they retrieved only 3 (since only 3 was mature enough) and out of the 3 only one was okay for icsi. The one they tried to fertilize fragmented and did not make it to transfer.

I went for a second opinion and they wanted an FSH drawn on day 3 of my next period. I had that done and it was 9.1.

I understand that REs use the highest FSH (atleast that is what my first doctor who did the IVF said). But since my most recent FSH was 9.1 (without the birth control pill), I was wondering two things - 1) if the FSH was elevated by BCP; 2) if I had a better chance at an IVF cycle without BCP. I also understand that Lupron, at high doses, can be a suppressant. I was wondering if Lupron, though dosed at small doses for me, could have behaved as a suppressant in my body.

It is just surprising to me that my FSH went from an 8.85 to a 14.1 in 6 months. My first doctor tells me that they only use the highest number. My second opinion doctor said that for every high FSH, your chances of pregnacy decrease by 1/3. So, at my age, my chances of getting pregnant with normal FSH would be 60%, but with this high FSH, she says it would now be 40%. My first doctor also told me that they got mixed messages from my body because though my day 3 FSH was high, my ovaries (on ultrasound) showed that there were more than 8 antral follicles, which is expected for someone my age. Thus, they decided to go through with IVF.

I want to go through another cycle. How are my chances? Why is my FSH so high? Which number is most accurate for me? Did I just have a bad run in this IVF cycle and is it possible for me to have a better response next time, based on my numbers?

extremely concerned,
chitra

 

Dr Smith - November 16

A1. The oral contraceptive pills did not effect the FSH or how you responded to the stimulation medications.

A2. Lupron, when used in the flare protocol, does not suppress the ovarian respone.

A3. No one knows why your FSH is elevated, but when it exceeds 10 IU/ml it does indicate that fewer eggs will be available on any given cycle (compared to the average for someone your age). You are getting good advice from your doctors. I think you are looking for answers when there simply aren't any.

If you develop at least 6 mature follicles on a subsequent stimulation, then I would say go ahead and try another IVF cycle. The number of follicles that develop on different cycles varies to some degree. You might have a better cycle next time. Good luck.

 

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