As you may know, there is no one perfect test for egg quality. So we look at a host of different variables. One of the most helpful is your menstrual cycle. Each menstrual cycle is governed by the growth of a single egg. This is how it works: over the course of 10-14 days the… Read more »
How does an AMH test help me?
AMH is the best test that we have for understanding your ovarian reserve. There are other tests available (FSH levels, and ultrasound) but they are not as accurate. AMH is the hormone that is made by the cells surrounding each of your resting eggs. This means that the more eggs that you have, the higher… Read more »
7 days after ovulation, I got a progesterone level of 6.5. What other tests can I do?
I’m 30 years old, have 28-32 day cycles and typically ovulate on days 16-18. My luteal phase is anywhere from 10-12 days. I’m doing IUI with frozen sperm and it is costing a fortune so I’m trying to get this right as soon as possible. The lowest-normal peak luteal progesterone level – measured about 7… Read more »
Is there hope with my own eggs using the estrogen priming protocol or is it truly time to consider donor eggs?
There is no universal “best” protocol. However, there may be a best one for you. You can run a natural start cycle, which simply means that you come in at the beginning of your menstrual cycle, say on day 3, and if there are no cysts, you start taking stimulating medication. This simple approach is… Read more »
My tests showed my prolactin levels were over 100 twice now. Why do I need an MRI?
A high prolactin (PRL) is a common finding in a fertility practice. Prolactin is also called luteotropic hormone. If you google this topic, you will find that high PRL is associated with galactorrhea (discharge from the nipples) and vision changes. But most subfertile women with high PRL won’t have these findings. Some women with high… Read more »
All my fertility tests are normal and my husband has no problems. Will controlling my hyperthyroidism allow me to become pregnant?
When women of reproductive age are hyperthyroid, it can be difficult to become and stay pregnant. An overactive thyroid (hyperthyroidism) can cause irregular cycles or no ovulation. Once you are pregnant – it increases the risk of miscarriage and other complications. How do you know if you are hyperthyroid? The signs can be subtle, so… Read more »
I am 28 and I have just been diagnosed with the lowest AMH possible. I’m starting aggressive IVF. Is age on my side with good quality eggs?
AMH predicts quantity, not quality. The best predictor for egg quality is being under 35 years of age. Yes! Age is on your side. Anti Mullerian Hormone is released by cells involved with the growth of antral follicles and correlated to the number of active antral follicles you have. Usually with IVF, we hope to… Read more »
What are the recent developments in implantation? (Part Three: PGS)
This post is part three of a series where we will discuss how embryos, the uterus and overall health impact implantation. We judge embryo quality in three ways: the number of embryos present, embryo grading, and PGS. In this post, we’ll talk about PGS. Our current gold standard for judging embryo quality is pre-implantation… Read more »
I’m supposed to have a full bladder for my ultrasound/procedure. But how full is too full? And what if I’m retroverted?
First, let’s quickly review why we ask for a full bladder. When you’re lying on your back, your uterus either tilts up towards your belly button (anteverted), or back towards your spine (retroverted). Most women are anteverted. Between your uterus and your abdomen is the bladder. So, when you have a full bladder, it tends… Read more »
My husband has thyroid problems and a varicocele. We’ve tried IUI 6 times. What now?
Unfortunately, IUI cycles tend to have a lower rate of success than we want, usually in the range of 10-20% per cycle, though it’s standard-of-care to suggest 3-6 IUIs before moving on. IVF with Intracytoplasmic sperm injection (ICSI) should provide a success rate that is at least 3-4x better. Recent improvements in lab techniques have… Read more »