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Advanced Maternal Age and Elevated FSH

April 1, 2008 - Tuesday
8:00 PM to 9:00 PM (EST)
Guest Speakers: Mark Leondires, MD, Reproductive Medicine Associates of Connecticut

Categories


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[Tue Apr 01 17:00:38 PDT 2008] Melinda_Welcome everyone. Corey Whelan your Chat Moderator is having technical difficulties so I am filling in for her.
[Tue Apr 01 17:00:58 PDT 2008] Melinda_We want to welcome Dr. Leondires tonight and feel free to start asking your questions.
[Tue Apr 01 17:01:02 PDT 2008] Dr._Mark_LeondiresHello everyone. I would like to start off by saying that biological aging and difficulty conceiving after 35 is a completely normal event.
[Tue Apr 01 17:01:19 PDT 2008] Dr._Mark_LeondiresHi Melinda thanks for your time tonight...let's chat!
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[Tue Apr 01 17:01:52 PDT 2008] Melinda_Thanks, does anyone have a question they would like to post?
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[Tue Apr 01 17:02:09 PDT 2008] Dr._Mark_LeondiresLet's all remember that FSH is not the problem, but the signal of what is going on in the ovary.
[Tue Apr 01 17:02:29 PDT 2008] Melinda_Welcome Our Twins and Wendy
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[Tue Apr 01 17:02:47 PDT 2008] Our_TwinsThank you
[Tue Apr 01 17:03:05 PDT 2008] heleneI am 32 with an FSH of 10. Is my age a POSITIVE factor, or is that FSH looking a bit high? Also, does it have anything to do with my follicles growing rather slowly during this stim cycle for IVF (IVF #1/ICSI).
[Tue Apr 01 17:03:11 PDT 2008] Our_TwinsAnd what is going on in the ovary
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[Tue Apr 01 17:05:12 PDT 2008] Dr._Mark_LeondiresHelene, FSH, AGE, and Basal antral follicle count are all independent indicators. Your FSH of 10 is at the cut-point, and your age is good. You are prob going to be fine. The whole purpose is to do it in your natural cycle so it is a separate marker from your ivf response.
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[Tue Apr 01 17:05:15 PDT 2008] Melinda_Welcome faith2231 and clairei
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[Tue Apr 01 17:05:36 PDT 2008] Melinda_feel free to jump in and ask Dr. Leondire your questions
[Tue Apr 01 17:06:04 PDT 2008] Dr._Mark_LeondiresThe ovary is the storage gland for eggs. Eggs are constantly being used up and breaking down and the FSH is a marker for these events.
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[Tue Apr 01 17:07:14 PDT 2008] JanDr. Leondire, I've had a failed IVF (9months back). Egg quality was an issue (as well as egg production). What do you recommend for the 40 year old who still wants to try?
[Tue Apr 01 17:07:20 PDT 2008] Melinda_What can be done for patients with advance maternal age and an elevated FSH?
[Tue Apr 01 17:07:32 PDT 2008] Dr._Mark_LeondiresWhen the FSH is elevated or slightly elevated it is a sign of a ticking biological clock...ugh!
[Tue Apr 01 17:07:34 PDT 2008] faith2231Hi Everyone. Thank you Dr. I am 43 years old with an FSH of 11. I am getting ready to do a 2nd IVF attempt. Last IVF cycle retrieved 2 eggs and both fertilized and looked great at transfer however negative result. Any thoughts.
[Tue Apr 01 17:07:42 PDT 2008] Dr._Mark_LeondiresJan,
[Tue Apr 01 17:07:45 PDT 2008] Dr._Mark_Leondiresoops
[Tue Apr 01 17:07:48 PDT 2008] osuzzanaHello and thank you in advance. I'm 44 and I know my age is considered a factor. My FSH is 6.4 and Est is 63 so that's good. Even if my numbers are good, can it be that my age is making it so I'm not ovulating?
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[Tue Apr 01 17:08:26 PDT 2008] Dr._Mark_LeondiresJan, I think often times people with a difficult first IVF cycle have to try again with a change in protocol to collect more information.
[Tue Apr 01 17:08:35 PDT 2008] Melinda_welcome teacher422...feel free to ask your questions
[Tue Apr 01 17:08:52 PDT 2008] Dr._Mark_LeondiresOsuzzana,...Yes your age is the biggist problem.
[Tue Apr 01 17:08:52 PDT 2008] WendyDr. Leondires, I am 33 with diagnosed DOR associated with several prior ovarian cysts. This is my second IVF (my first one 2.5 years ago resulted in a baby boy). My CD2 FSH is 19.2. My CD2 U/S showed 8 pre-antral follicles. I am currently doing an Antagon cylce with using the following - 6 vials Bravelle and 6 vials Menopur. After 4 days of stims I show 10 follicles ranging from 6 - 12 mm and my estrogen was well over 300. What are your thoughts on this? Do you feel the cycle will go to retrieval?
[Tue Apr 01 17:09:35 PDT 2008] JanMy own Dr. didn't recommend this last year. I think they felt like they had put me at very high doses of the follistim. I wouldn't mind trying again-so, should I see another Dr?
[Tue Apr 01 17:09:35 PDT 2008] Dr._Mark_LeondiresOzz...there are 47 yo who are very infertile, with a normal FSH. It is not predictive in everyone.
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[Tue Apr 01 17:09:56 PDT 2008] aijiaDr: I am going to be 40 the end of this year. My FSH has been good (7 something) but my AMH was very low. What does this mean?
[Tue Apr 01 17:10:32 PDT 2008] osuzzanaSo, doctor, you're saying that even if the numbers are good, age is still the main factor?
[Tue Apr 01 17:10:38 PDT 2008] Dr._Mark_LeondiresWendy, I think so, your age trumps your FSH, but it is concerning. WE will have to wait for your stim to progress.
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[Tue Apr 01 17:11:47 PDT 2008] WendyI have heard wheat germ may help lower FSH. What are your thoughts on this?
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[Tue Apr 01 17:11:56 PDT 2008] Dr._Mark_LeondiresJan,...that would be my opinion...I guess it may depend on how much of an egg problem they identified. Another opinion can often be useful or help someone get closure.
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[Tue Apr 01 17:12:53 PDT 2008] Dr._Mark_LeondiresAiija: AMH is a separate marker and it is independent from fsh, it is an ovarian product. It means to me that you should get started in trying to get pregnant.
[Tue Apr 01 17:13:13 PDT 2008] Dr._Mark_LeondiresOsuzz...yes...unfortunately.
[Tue Apr 01 17:13:19 PDT 2008] Melinda_Hi lorraiki and mareinoel. Fell free to ask Dr. Leondires your questions.
[Tue Apr 01 17:13:23 PDT 2008] Dr._Mark_LeondiresWendy,
[Tue Apr 01 17:13:27 PDT 2008] WendyWhat are your experiences with Flare vs. Antagon cycles? Is one better then the other?
[Tue Apr 01 17:13:55 PDT 2008] Our_TwinsWe have been through 5 IVF cycles. Each had been between one and five oocytes, but with greater than 50% getting fertilized. My menstrual cycle is very regular. Taking DHEA 25mg 3 times per day greatly improved the quality of the embryos, in fact two made it to blastocyst. I will be 45 in May and have been actively doing IVF since October of 2006. My FSH is now around 13 or 14 on any given month. It has risen since we started IVF. What can I do and what can I expect?
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[Tue Apr 01 17:14:20 PDT 2008] Dr._Mark_LeondiresWendy, The FSH is not the problem it is the egg pool. If wheat germ helps the eggs in the ovary it may help, but I have not heard that AND the literature does not support that wheat germ changes preg rates.
[Tue Apr 01 17:14:36 PDT 2008] WendyIn addition to FSH, age, and basal follicles...Is DHEA a good predictor of ovarian reserve?
[Tue Apr 01 17:14:45 PDT 2008] insanfranMark, if elevated FSH or advanced age is indicative for the state of ones own ovaries, are there negative issues for using donor eggs?
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[Tue Apr 01 17:15:17 PDT 2008] Dr._Mark_LeondiresOur twins. I hate to say this, but you are doing it. It may be time to consider other options.
[Tue Apr 01 17:15:37 PDT 2008] Dr._Mark_LeondiresWendy. NO...sorry to say by most investigators
[Tue Apr 01 17:16:29 PDT 2008] faith2231FSH IS 11, ESTROGEN IS 86, PROGESTERON IS 2.5. I am 43 and at the last and only IVF cycle retrieved 2 eggs that fertilized and looked great. Any thoughts would be appreciated!
[Tue Apr 01 17:16:36 PDT 2008] sherrya46Have you seen a lot of patients with good Day 3 FSH, but still found to have poor egg quality?
[Tue Apr 01 17:16:45 PDT 2008] Dr._Mark_LeondiresInsan...No you FSH has no bearing on a donor egg cycle and age (within reason) if someone is otherwise healthy is not an issue if the uterus is healthy.
[Tue Apr 01 17:17:11 PDT 2008] JanAre there protocols that you recommend for the mature wannabe IVF mom?
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[Tue Apr 01 17:18:05 PDT 2008] faith2231By the way. One more IVF cycle and then we will look into other options.
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[Tue Apr 01 17:18:33 PDT 2008] Dr._Mark_LeondiresFaith. Your prog of 2.5 is really to high to be associated with that fsh level in my opinion. It should be below 1.0. Having 2 eggs retrieved is your biggest hurdle, because at 43 the majority of eggs aren't healthy enought to make an embryo. You could get lucky...I hope so.
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[Tue Apr 01 17:19:07 PDT 2008] Dr._Mark_LeondiresSherrya, Enough...FSH is just one piece of a complex fertility equation.
[Tue Apr 01 17:19:48 PDT 2008] osuzzanaDoctor, what is the oldest patient you have had (or colleague) who has given birth with own eggs (non ivf)?
[Tue Apr 01 17:19:50 PDT 2008] aijiaDr. in the past, what is the oldest age that a woman can get pg via IVF using her own eggs?
[Tue Apr 01 17:19:53 PDT 2008] Dr._Mark_LeondiresJan...Microdose flares or high dose antagonist cycles.
[Tue Apr 01 17:19:58 PDT 2008] auntheatty I'm 36 and my fsh level and lh are inverted due to a small tumor on my pituitary gland, so says my doctor based upon an MRI - I'm taking a drug to dissolve it, have you had experience with any cases like this?
[Tue Apr 01 17:20:09 PDT 2008] Dr._Mark_LeondiresFaith. Good work!
[Tue Apr 01 17:21:07 PDT 2008] Dr._Mark_LeondiresOsuz...there are reports of up to 47, but the likliehood is less than 1 per 10,000 based on normal human data.
[Tue Apr 01 17:21:27 PDT 2008] osuzzanayikes!
[Tue Apr 01 17:21:47 PDT 2008] faith2231Ugh!
[Tue Apr 01 17:21:53 PDT 2008] Dr._Mark_LeondiresAunt...do you have an elevated prolactin:? What medicin are you taking?
[Tue Apr 01 17:22:10 PDT 2008] Dr._Mark_Leondiressorry ladies...just trying to be honest
[Tue Apr 01 17:22:18 PDT 2008] osuzzanai've found that a lot (most) women I've talked to want a baby at our age, like a hole in the head. I guess we're just "special" that's all!
[Tue Apr 01 17:22:25 PDT 2008] auntheattyyes 22 prolactin level and i'm taking dosinex, i think it 's called
[Tue Apr 01 17:22:52 PDT 2008] faith2231At what point do you recommend your patient to seek either egg donor or adoption?
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[Tue Apr 01 17:23:28 PDT 2008] Dr._Mark_Leondiresaunt...that would make sense...you shold be ok once the prolactinoma is gone, but it may not explain your infertility...that prolactin is pretty low
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[Tue Apr 01 17:24:15 PDT 2008] aijiaBut lots of Hollywood star actors were able to have babies over 40, why they can?
[Tue Apr 01 17:24:19 PDT 2008] Dr._Mark_Leondiresfaith...that is really a individual decision...when they are ready or medically indicated by their past history or outcomes.
[Tue Apr 01 17:24:27 PDT 2008] michal69what is the prognosis for someone that is 38 and has a fluctuating FHS (highest being 19)
[Tue Apr 01 17:24:29 PDT 2008] auntheattydoes that explain the fsh and lh being backwards?
[Tue Apr 01 17:24:55 PDT 2008] Dr._Mark_Leondiresaiija..there is a big diference in rates for a 40 yo vs a 45 yo.
[Tue Apr 01 17:25:15 PDT 2008] sherrya46sorry - I asked a question before but my computer froze up....Dr. Mark, have you seen a lot of patients with good Day 3 FSH who still have poor egg quality? And if so - what could be the cause
[Tue Apr 01 17:25:22 PDT 2008] Dr._Mark_Leondiresaunt...nope...they are usally not linked..yours is low?
[Tue Apr 01 17:25:38 PDT 2008] osuzzanaWhat about Nancy Grace with her twins. Does anyone have any opinions/knowledge on her situation?
[Tue Apr 01 17:25:45 PDT 2008] Dr._Mark_LeondiresSherry...look above.
[Tue Apr 01 17:25:50 PDT 2008] michal69aijia - some of the stars may be using donor eggs and are just not saying they are
[Tue Apr 01 17:26:04 PDT 2008] jynkaufmanDr. L, I am 35, with FSH of 13, three miscarriages. Not trying IUI or IVF yet, but trying accupuncture and herbs. I have seen the studies that indicate higher success rates with accu, and IUI & IVF, but any info on improved success rates with accupuncture and trying naturally?
[Tue Apr 01 17:26:17 PDT 2008] Dr._Mark_LeondiresMichael is very right...reproduction is private even if you are a star.
[Tue Apr 01 17:26:27 PDT 2008] sherrya46i cant see above - only the chat since i just got back!
[Tue Apr 01 17:27:17 PDT 2008] insanfranMark, what are the questions we should be asking but aren't?
[Tue Apr 01 17:27:18 PDT 2008] auntheattywhat should your fsh level be?
[Tue Apr 01 17:27:20 PDT 2008] Dr._Mark_Leondiresjynk...You can try, but the data is limited, just don't take up too much time...it is ok to try alternatives, but don't avoid known therapies that work. Why no do both.
[Tue Apr 01 17:27:41 PDT 2008] Melinda_sherrya46...sorry but you will be able to see the full transcripts on our web site tomorrow.
[Tue Apr 01 17:28:15 PDT 2008] Dr._Mark_Leondiressherry...fsh is an independent predictor,...but not the only answer...I have seen your situation.
[Tue Apr 01 17:28:21 PDT 2008] osuzzanaDoc-I just had an endometrial polyp removed. Do you have any information on that being a factor in infertility (regardless of age) Also, what does having a polyp do to the timing of the cycle?
[Tue Apr 01 17:28:36 PDT 2008] Dr._Mark_Leondiresaunt preferably less than 10.
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[Tue Apr 01 17:29:20 PDT 2008] Dr._Mark_Leondiresin san fran...in what context donor egg or your own?
[Tue Apr 01 17:29:58 PDT 2008] michal69I am 38 my FSH fluctuates, highest being 19, anti-mullerian a little off, but the Inhibin B was good. We tried a year of IVF and I had 1 misscarriage, them my Hypertyriod kicked in so I am now on PTU, what is you prognosis for someone like me
[Tue Apr 01 17:30:05 PDT 2008] Dr._Mark_Leondiresosuz...polyps can negatively effect the chance for implantation. It usually does not effect cycle timing.
[Tue Apr 01 17:30:14 PDT 2008] insanfranLikely donor egg as too many IVFs, and likely time to move to donor egg
[Tue Apr 01 17:31:04 PDT 2008] michal69sorry I meant to write Hyperthyriod. We do not want to use donor eggs
[Tue Apr 01 17:31:05 PDT 2008] Dr._Mark_Leondiresmichal...overall a concerning picture...how many ivfs did you do? what is the success at your clinic for your age group as reported to sart?
[Tue Apr 01 17:31:57 PDT 2008] Dr._Mark_Leondiresinsanfran: who are your donors, how is my uterine lining and uterus, do you follow fda guidelines what are the take home baby rates
[Tue Apr 01 17:32:37 PDT 2008] Dr._Mark_Leondireswhew...
[Tue Apr 01 17:32:41 PDT 2008] jynkaufmanThe plan is to do both alternative med and IUI/IVF. But I am worried about miscarrying. I am also on Lovenox from ovulation until the start of my menstrual cycle. Since starting it, I have not gotten pregnant for 10 months. Can Lovenox prevent pregnancy?
[Tue Apr 01 17:33:04 PDT 2008] insanfranExcellent. Many thanks.
[Tue Apr 01 17:33:16 PDT 2008] michal69I have a son from previous IVF 4 yrs ago, that worked on the third try. This past time we did 4 IVF's one resukted in a preganancy but then I had a miscarriage (probably genetic, yolk sac was larger than fetus)
[Tue Apr 01 17:33:30 PDT 2008] Dr._Mark_Leondiresjy...no, so are you doing both...i thought you were doing herbs and acupunture...also lovenox...???
[Tue Apr 01 17:33:59 PDT 2008] auntheattyare your fsh and prolactin levels related or the same?
[Tue Apr 01 17:34:28 PDT 2008] michal69I do not know success of my clinic I can find out, if it is not so good is it worth looking into another clinic that has better success rates. Why would it be better elsewhere?
[Tue Apr 01 17:34:32 PDT 2008] jynkaufmanyes, I had several abnormal blood tests so as a precaution, I am on lovenox from ovulation. Not tried IUI yet, but will get there eventually
[Tue Apr 01 17:34:54 PDT 2008] Dr._Mark_LeondiresMichal,...I think you need to resolve your hypothyroidism first and then perhaps try again...I would need more info on eggs retrieved and embryo quality.
[Tue Apr 01 17:35:16 PDT 2008] Dr._Mark_Leondiresaunt..they can be related, but usually separate.
[Tue Apr 01 17:35:50 PDT 2008] claireiwhen in a cycle is FSH level determined? How do we find out this information from our dr?
[Tue Apr 01 17:36:34 PDT 2008] osuzzanaDoc- With normal FSH/Est and menstration (sp?) what woud cause non-ovulation?
[Tue Apr 01 17:36:43 PDT 2008] Dr._Mark_LeondiresEveryone should ask about rates or look on www.sart.org. To see if their clinic in close to average or better. Some clinics are just not very good. You are right the data must be interpreted and individualized.
[Tue Apr 01 17:36:56 PDT 2008] aijiaMichal: were all your IVFs done at the same clinic? (just curious)
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[Tue Apr 01 17:37:11 PDT 2008] auntheattyso in your opinion is my infertility most likely related to my fsh level and not really the issue going on with my pituitary gland?
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[Tue Apr 01 17:37:36 PDT 2008] Dr._Mark_LeondiresClaire...day 2,3,4 or a normal cycle.
[Tue Apr 01 17:38:00 PDT 2008] Dr._Mark_Leondiresaunt...what what your fsh?
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[Tue Apr 01 17:38:05 PDT 2008] michal69I'm currently on hold with the IVF until I am euthyroid. usually I have btwn 7-12 eggs. In September I had 2 so they had to cancel the cycle. The last cycle I did they retrieved 7 and put 3 back, I'm wondering if it did not take b/c my thyroid had started acting up and I did not know. I went to my endocrinologist a few weeks later for a regular check up and that is when he discovered I was hyperthryoid again
[Tue Apr 01 17:38:27 PDT 2008] DanielleI am 32 with 3 previous failed IVF cycles, My latest FSH was 12....why it is not working??? the sperm cout was fine.
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[Tue Apr 01 17:38:45 PDT 2008] Dr._Mark_Leondiresmical...I am sorry your path has been so complicated...,
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[Tue Apr 01 17:39:10 PDT 2008] michal69aijia - We did are IVF's at 2 different clinics only b/c we moved
[Tue Apr 01 17:39:27 PDT 2008] Dr._Mark_LeondiresDanielle...prob it is an egg issue, but I would need more info...how were your embryos?
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[Tue Apr 01 17:39:53 PDT 2008] spreeHi. I am 32 as well and have to unsuccessful IVF cycles. I have retrieved 6 eggs each time but only had 1 and then 2 fertilize. None took. My FSH is 18. Is a third attempt likely to be the same?
[Tue Apr 01 17:40:16 PDT 2008] faith2231What could elevated prog levels indicate?
[Tue Apr 01 17:40:28 PDT 2008] Dr._Mark_Leondiresspree...unfortunately probably...have you tried different protocols
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[Tue Apr 01 17:41:02 PDT 2008] Dr._Mark_Leondiresfaith....that you were not in the right part of the cycle to check your fsh...your fsh may not be valid..retest it.
[Tue Apr 01 17:41:03 PDT 2008] spreeYes I have tried 2 different protocols. The last one with Lupron had a better response with one very good embryo but no pregnancy
[Tue Apr 01 17:41:19 PDT 2008] faith2231Thank you!
[Tue Apr 01 17:41:29 PDT 2008] Dr._Mark_Leondiresspree...a good looking embryo still may not be reproductively fit.
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[Tue Apr 01 17:41:38 PDT 2008] Dr._Mark_Leondiresfaith...you are welcome...
[Tue Apr 01 17:42:34 PDT 2008] spreeMy initial preg test was positive but only with a level of 25. We are planning to try again in July but I don't want to get my hopes up too much. Any suggestion on protocols?
[Tue Apr 01 17:42:40 PDT 2008] DanielleThe quality of my embryos was not very good I guess, there was a division but they didn't look like they were deviding right?/!
[Tue Apr 01 17:43:16 PDT 2008] Dr._Mark_Leondiresperhaps a microdose flare with extra lh.
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[Tue Apr 01 17:43:42 PDT 2008] faith2231I'm curous about patients getting 2nd opinions. When you are comfortable with your RE but have not been successful when should one seek a 2nd opinion?
[Tue Apr 01 17:44:03 PDT 2008] spreeIs there some way to determine qualtity of eggs besides waiting on the division of cells? My doctor says we should try one more time and then discuss other options such as donar eggs or adoption
[Tue Apr 01 17:44:18 PDT 2008] Dr._Mark_LeondiresDan...you may need to try a different clinic and consider other options if you do one more and you are unsucessful.
[Tue Apr 01 17:44:30 PDT 2008] aijiaDr. I heard some progressive clinics in this country are using the so-called CGH testing, what is your take on this new tech? Is it going to be used more and more?
[Tue Apr 01 17:44:45 PDT 2008] auntheattyi'm not sure what my fsh level was, all i know is my doctor said the lh was what the fsf was suppose to be and the fsh was what the lh should be - they were inverted. any idea why?
[Tue Apr 01 17:45:02 PDT 2008] Dr._Mark_LeondiresFaith...I usuelly encourage one after 2-3 failed ivfs...your doctor will not or should not be offended.
[Tue Apr 01 17:45:15 PDT 2008] Dr._Mark_LeondiresI try to send people to other mds I respect
[Tue Apr 01 17:45:22 PDT 2008] wendalaGood evening... FSH around 11, going for 4th try - 37 now - 2nd try - baby boy - 3rd try miscarry at 5 weeks. Microdose protocol with endometrial co-culture. Do you recommend anything else for 4th and final to be positive? Thanks
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[Tue Apr 01 17:45:55 PDT 2008] Dr._Mark_Leondiresaiija...CGH is new...and may help find more abnormal or normal eggs.
[Tue Apr 01 17:46:02 PDT 2008] DanielleThank you ... I thought that the more I try I increase my chances for sucess...
[Tue Apr 01 17:46:07 PDT 2008] michal69good question faith
[Tue Apr 01 17:46:13 PDT 2008] michal69Thank you
[Tue Apr 01 17:46:15 PDT 2008] faith2231Thanks you. You are in my area and I would like to possibly consult.
[Tue Apr 01 17:46:23 PDT 2008] Our_TwinsTo all...spend the time to do the research to find a doctor with the success rates for your age and situation. Travel expenses are cheaper than a failed IVF. Also do it now, do not wait...time gets away very quickly. I will be 45 and am basically left with the option of egg donor because we wasted our time with a doctor that was not as proficient with maternal aging, etc. as some out of town doctors.
[Tue Apr 01 17:46:29 PDT 2008] Dr._Mark_Leondiresaunt...it sounds like you had a profile that is like a PCOS pt.
[Tue Apr 01 17:46:35 PDT 2008] Dr._Mark_LeondiresI am in Norwalk CT.
[Tue Apr 01 17:46:43 PDT 2008] osuzzanaDoc- with normal hormone levels/periods, what would cause non-ovulation and how to fix?
[Tue Apr 01 17:46:57 PDT 2008] Dr._Mark_LeondiresDanielle...Yes true...within in reason.\
[Tue Apr 01 17:47:22 PDT 2008] faith2231I know. I am in Stamford and Fr. Poulos and I spoke about you.
[Tue Apr 01 17:47:28 PDT 2008] Dr._Mark_Leondiresour twins...thanks for the comment.
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[Tue Apr 01 17:48:02 PDT 2008] auntheattyyes i have several symptoms of pcos. does that mean i'll never get pregnant?
[Tue Apr 01 17:48:08 PDT 2008] Dr._Mark_Leondiresosuz...could be PCOS, stress, weight, meds, and a few other things..
[Tue Apr 01 17:48:36 PDT 2008] Dr._Mark_Leondiresaunt..no usually pcos pts do well with the proper treatment...have you taken clomid?
[Tue Apr 01 17:48:44 PDT 2008] osuzzanahmmm, got lapband in november, already down 30#! What meds do you refer to?
[Tue Apr 01 17:48:55 PDT 2008] wendalaGood evening... FSH around 11, going for 4th try - 37 now - 2nd try - baby boy - 3rd try miscarry at 5 weeks. Microdose protocol with endometrial co-culture. Retrieval was 8 oocytes last time - quality around 3. Do you recommend anything else for 4th and final to be positive? Thanks
[Tue Apr 01 17:49:07 PDT 2008] Dr._Mark_Leondiresosuz...sometimes psyche meds.
[Tue Apr 01 17:49:22 PDT 2008] osuzzanawellbutrin?
[Tue Apr 01 17:49:32 PDT 2008] wendalaquality grade 3
[Tue Apr 01 17:49:37 PDT 2008] auntheattyyes, on metformin now. had one unsuccessful IUI
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[Tue Apr 01 17:49:52 PDT 2008] Dr._Mark_Leondireswendala...it sounds like you are doing everything...what dose of meds are you one?
[Tue Apr 01 17:50:02 PDT 2008] Dr._Mark_Leondiresaunt...on met and clomid?
[Tue Apr 01 17:50:17 PDT 2008] brenndr. are you aware of DES exposure?
[Tue Apr 01 17:50:19 PDT 2008] Dr._Mark_Leondiresosuz...usu not wellbutrin
[Tue Apr 01 17:50:33 PDT 2008] chart joined.
[Tue Apr 01 17:50:35 PDT 2008] osuzzana=D
[Tue Apr 01 17:50:36 PDT 2008] auntheattyon met, not currently on clomid right now
[Tue Apr 01 17:50:41 PDT 2008] Dr._Mark_Leondiresbren...yes...but very unusual in this day of age
[Tue Apr 01 17:50:50 PDT 2008] wendala0.2 microdose luprin, 2 menopur (150?), Gonal F started at 300
[Tue Apr 01 17:51:04 PDT 2008] Dr._Mark_Leondiresaunt...if you do not ovulate in 2 months...add in clomid
[Tue Apr 01 17:51:14 PDT 2008] brenni was told by my dr that i was exposed
[Tue Apr 01 17:51:20 PDT 2008] Dr._Mark_Leondireswen...sounds good...good luck
[Tue Apr 01 17:51:47 PDT 2008] Dr._Mark_LeondiresIt really was not used after 1979...how old are you?
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[Tue Apr 01 17:51:53 PDT 2008] brenn35
[Tue Apr 01 17:51:59 PDT 2008] wendalathank you! Do you know if studies are being done to try to improve embryo quality?
[Tue Apr 01 17:52:02 PDT 2008] brennborn in 73
[Tue Apr 01 17:52:10 PDT 2008] Melinda_We have about 10 minutes left. If you have any questions, don't wait to post.
[Tue Apr 01 17:52:14 PDT 2008] auntheattydo you have any faith in the ov watch?
[Tue Apr 01 17:52:18 PDT 2008] Dr._Mark_LeondiresIt is very unlikely your mom took it did she live in the us?
[Tue Apr 01 17:52:25 PDT 2008] brennyes ohio
[Tue Apr 01 17:52:54 PDT 2008] Dr._Mark_Leondireswend...everyone tries to assess embryo quality, but it is hard to change it
[Tue Apr 01 17:53:07 PDT 2008] wendalaMaybe someday smile
[Tue Apr 01 17:53:09 PDT 2008] Dr._Mark_Leondiresbren..I doubt it...why were you told this?
[Tue Apr 01 17:53:13 PDT 2008] osuzzanaDoc-what is the "oldest" mom you are associated with having natural conception?
[Tue Apr 01 17:53:27 PDT 2008] Dr._Mark_LeondiresWend..I hope so ::biggrin
[Tue Apr 01 17:53:45 PDT 2008] brennmy uterus is misshaped and after hsg my ovaries are "aged" also I had conization
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[Tue Apr 01 17:54:11 PDT 2008] Dr._Mark_Leondiresosuz...I know of a 47 yo...but there are reports of much older, but very rare.
[Tue Apr 01 17:54:12 PDT 2008] wendalaWhat are your thoughts on endometrial co-culture?
[Tue Apr 01 17:54:16 PDT 2008] brennmy mom also remembers getting a series of 3 shots after she was bleeding during her pregnancy with me
[Tue Apr 01 17:54:39 PDT 2008] Dr._Mark_Leondireswend...we do not do it...prob does not hurt and can help some
[Tue Apr 01 17:55:03 PDT 2008] faith2231ANy thoughts on PGD?
[Tue Apr 01 17:55:03 PDT 2008] Dr._Mark_Leondiresbren...I suppose it could be...can she not find out what she took?
[Tue Apr 01 17:55:09 PDT 2008] osuzzanaThank you, doctor. Have a great night!
[Tue Apr 01 17:55:15 PDT 2008] wendalaok- I swear it helped me concern my son, but last time not so lucky - also getting older
[Tue Apr 01 17:55:20 PDT 2008] brennno she has tried to get her records but the dr is deceased
[Tue Apr 01 17:55:49 PDT 2008] Dr._Mark_Leondirespgd should be done after careful consultation and with an indication: genetics, mult failed cycles, recurrent preg loss.
[Tue Apr 01 17:56:14 PDT 2008] Dr._Mark_Leondiresbren...well how about the pharmacy she used?
[Tue Apr 01 17:56:19 PDT 2008] Dr._Mark_Leondiresor the clinic
[Tue Apr 01 17:56:28 PDT 2008] aijiawendala: I heard Cornell in NYC does co-culture, did you get successful there?
[Tue Apr 01 17:56:29 PDT 2008] brennall out of business
[Tue Apr 01 17:56:42 PDT 2008] brennthe dr gave her the shots in her office so she didn't use a pharmacy
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[Tue Apr 01 17:56:50 PDT 2008] WendyThank you for your time tonight!
[Tue Apr 01 17:56:56 PDT 2008] Dr._Mark_Leondiresbren...ok..I guess it is possible...it can be a big problem
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[Tue Apr 01 17:57:06 PDT 2008] Dr._Mark_LeondiresWendy...I hope I helped some of you.
[Tue Apr 01 17:57:09 PDT 2008] brennit has been i am strongly considering adoption
[Tue Apr 01 17:57:10 PDT 2008] wendalaaija, Yes, I was successful on my 2nd IVF try (1st with co-culture). Liked Dr. Spandorfer very much
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[Tue Apr 01 17:57:21 PDT 2008] Dr._Mark_Leondiresb ren...prob a good idea
[Tue Apr 01 17:57:30 PDT 2008] brenngee thanks
[Tue Apr 01 17:57:33 PDT 2008] faith2231Thank you all for a great discussion.
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[Tue Apr 01 17:57:58 PDT 2008] Daniellethank you Doc....
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[Tue Apr 01 17:58:22 PDT 2008] wendalaThank you Dr. Leondires. Have a nice evening.
[Tue Apr 01 17:58:30 PDT 2008] Dr._Mark_LeondiresI hope all of you achieve your family building goals.... ::biggrin
[Tue Apr 01 17:58:39 PDT 2008] aijiaThank you doctor.
[Tue Apr 01 17:58:40 PDT 2008] brenn left.
[Tue Apr 01 17:58:42 PDT 2008] insanfranMelinda, Thaks for standing in for Corey tonight. You did a great job. And Mark, you are fantastic at this -- brilliant, quick and thorough. The women of Conn. are fortunate to have your expertise. Thanks for enlightening us this evening.
[Tue Apr 01 17:59:02 PDT 2008] Dr._Mark_Leondirestoo kind...thanks
[Tue Apr 01 17:59:02 PDT 2008] aijia left.
[Tue Apr 01 17:59:36 PDT 2008] Melinda_Thank you so much for being here. You are all welcome to stay in the chat room and chat amongst yourselves.
[Tue Apr 01 17:59:56 PDT 2008] chart left.
[Tue Apr 01 18:00:02 PDT 2008] Melinda_A special thank you to Dr. Mark Leondires who did a wonderful job tonight fielding all these questions.
[Tue Apr 01 18:00:21 PDT 2008] Dr._Mark_LeondiresOk...everyone thanks to melinda and hope I did not make too many typos or was too slow.
[Tue Apr 01 18:00:24 PDT 2008] Dr._Mark_Leondiresgnight.
[Tue Apr 01 18:00:27 PDT 2008] wendalaDr.. where are you out of?
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[Tue Apr 01 18:00:44 PDT 2008] Dr._Mark_LeondiresNorwalk and Danbury CT...www.rmact.com
[Tue Apr 01 18:00:52 PDT 2008] Melinda_Dr. Leondires practices at Reproductive Medicine Associates of CT
[Tue Apr 01 18:00:59 PDT 2008] wendalaThank you
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[Tue Apr 01 18:01:29 PDT 2008] Melinda_Again, thank you and good luck to everyone. Our chat is officially over but feel free to stay and chat amongst yourselve.
[Tue Apr 01 18:01:50 PDT 2008] Dr._Mark_Leondires To[Private] Melinda_thanks...for you help...Did I do ok?
[Tue Apr 01 18:01:54 PDT 2008] Our_TwinsThank you very much and good evening.
[Tue Apr 01 18:02:05 PDT 2008] JanTHanks
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[Tue Apr 01 18:02:43 PDT 2008] wendalaDr. I live in New Windsor Orange County, NY - how far is it from you?
[Tue Apr 01 18:02:45 PDT 2008] Melinda_ To[Private] Dr._Mark_LeondiresYou're very welcoem. You did a GREAT job. it's hard to field all those questions.
[Tue Apr 01 18:03:00 PDT 2008] Jan left.
[Tue Apr 01 18:03:18 PDT 2008] Dr._Mark_Leondires To[Private] Melinda_ok...good night...till next time.
[Tue Apr 01 18:03:19 PDT 2008] Melinda_ To[Private] Dr._Mark_LeondiresCorey sends her apologies. She was on the phone with me the whole time trying to get her internet working
[Tue Apr 01 18:03:28 PDT 2008] Melinda_ To[Private] Dr._Mark_Leondiresgood night, and thanks again
[Tue Apr 01 18:03:34 PDT 2008] Dr._Mark_Leondiresabout 1.5 hours
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[Tue Apr 01 18:03:56 PDT 2008] wendalaThank you, again
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[Tue Apr 01 18:39:23 PDT 2008] dre2677My wife has high FSH levels, and we have tried donor eggs which did get some embryosbut the she didn't get pregnenat? Any suggestion?
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