Sunday, August 29, 2010

RE Consult

My last cycle was short and I ended up being able to do another round of CD 3 tests last Friday (8/20). We had scheduled our RE consult to discuss the high FSH results for Tuesday, 8/24, so it worked out perfectly to have the latest results for our discussion. The nurse called on Monday, FSH = 12, E=33. YAY! :o) As RELIEVED as I felt, it was just as confusing...

We talked to our RE on Tuesday and here is his perspective:
*even though 12 is obviously better, 12 is borderline
*an isolated, elevated FSH is worrisome to him, it could be a sign of a potential problem
*12 doesn't say whether or not I'll get pregnant but when FSH gets to 25, "IVF is no benefit, absolutely no benefit" (CRINGE!)
*12 means a diminished response to stims - but it is good info to know and we can work with it - start with higher stims for a cycle
*there is nothing you can "do" to treat a high FSH
*there is nothing that we can attribute the high FSH to (diet, exercise, alcohol - I was worried about that since we had just got back from vacation)
*he thinks I should get AMH test - it is a cycle independent test (so he says, it doesn't matter if it is taken in a different cycle)
*AMH is a blood test and he thinks a good test to compliment the FSH. If it is <1, then we have reason to be concerned for POF.

Since the early miscarriages in the spring, I have been searching and reading as much information as I can. One topic that I have read a lot about is Luteal Phase Defect (LPD). I asked him about LPD because it seems in some cycles, my luteal phase is short.

He said the luteal phase is directly related to the follicular phase (before ovulation). If the follicles do not develop well, the luteal phase is shorter. He said he wrote an article that was published in 87-88 about this....he was talking over our heads for a bit but basically, he said there isn't a "test" to know if this is a problem - you just treat it as it is a problem. He said the treatment is adding progesterone support after ovulation. I said, well, I guess I'm asking if we can treat it as it is an issue because I think it may be. His thoughts on that:
*if we do a treatment cycle, then they would add progesterone support anyway
*if we want to do natural cycles, then sure, he would be fine with adding that 3 days after +OPK and then do HPT to see what happens

Finally, we asked about clomid for both of us. He said he wants to see DH's S/A first but that again, depending on what we wanted to do with cycling, he would be fine with me doing clomid.

So.....basically, I need AMH and a baseline progesterone test. DH needs a S/A to give us more information and determine where we go from here. We are a little frustrated because REALLY why didn't he just have the AMH done last wk when I did FSH???? If he knew that those 2 tests together would give us a better indication after the 25 FSH.....but WHATEVER, I'm trying to stay positive and see this as the next step for us that will lead us to a wonderful outcome!

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