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Mark Perloe on Fertility Issues, Page 5{Read more of Dr. Perloe's responses: Page 1 / Page 2 / Page 3 / Page 4 / Page 6 / Page 7 / Page 8 / Page 9}Dr. Mark Perloe is an innovator in the use of Internet communication for educating patients via his groundbreaking site, IVF.com. Perloe is director of reproductive endocrinology, infertility and in vitro fertilization at Atlanta Medical Center and Medical Director at Georgia Reproductive Specialists, and is noted for the individualized and in-depth attention he gives to his patients in their efforts to conceive. Send your question to Subscribe to The Blueprint to be notified of his responses {Please refrain from sending detailed lab results, as specific translation of such results without additional examination is of minimal benefit.}
I am not hoping to start a family at the moment, however I and my partner have thought about it. I am convinced that I can't have children naturally. I think I am going to encounter difficulties because I have had a lot of sexual relationships, have never taken the pill until recently, and had lots of unprotected sex. I have never been 'caught', even though (and I know it sounds dumb but I have never tried for a baby ever in my life) I just think that I can't be that lucky, that many times. Because I am not intending to start a family at the
moment, I think it would be pointless going to my doctor and asking him to
check, because then he would ask all sorts of questions like 'how long have
you been trying for a baby.'
I need to know how to find if I am indeed fertile, without looking
stupid, and how to go about it. You see, if I can't have babies naturally
but there is a chance with IVF, my husband and I could start saving (money) now. I
am really worried about this and need some answers.
One needs to undergo an infertility evaluation to know if you will be able to conceive. Testing is expensive and only covered by insurance if your physician has made the diagnosis of infertility. Therefore before initiating an evaluation of infertility, you must have tried to conceive. If you wish to undergo specific testing at your own expense, consider BBT charting, HSG and a semen analysis on your partner.
At age 29, I was diagnosed with blocked tubes (unexplained, but most likely due to silent infection.) I went straight to IVF and over the next three years had five unsuccessful attempts. I was able to get to the transfer stage each time transferring anywhere from 2 to 5 mid-range quality embryos. We have moved on and in 1998 adopted two beautiful children who are now four and five years old. I am now soon to be 38 and find myself thinking about one more try. We have since moved to a state that offers full coverage (our previous attempts were paid for out of pocket.) Since I have no tubes (removed after the third IVF attempt,) my only chance is IVF. I don't know if science has advanced at all to help in the implantation effort. I have also been taking the pill for the past six years by recommendation from three different GYNs. My cycles are extremely regulated. I am looking for your thoughts on whether I should try one more time. Do you
think that since I had five failed attempts, my chances would be even less
because of my age?
In my semen analysis report, 'viscosity' is high. Is this a serious matter? Is there any treatment for this? Viscosity is often seen on semen analysis and does not necessarily mean there is a problem. If it is associated with signs of infection, then appropriate treatment is indicated. No further treatment is warranted. If you have unexplained infertility, intrauterine insemination can address that concern as well as improve the odds of success during any given month. If sufficient sperm are obtained for insemination, then no need to worry.
I am 36 yrs old and trying to conceive my second child. I have one daughter who is now three years old. I had a miscarriage a few months ago, then I waited until I had one period to start trying again. I have been using an over-the-counter ovulation kit and for the last two cycles, I have not ovulated (per the test kit.) The lines would get continually darker each time, but not dark enough to match the standard line, and then the lines would disappear. I have never had this problem before. It is likely you are ovulating. Often the lines are not actually darker than the reference line. Monitoring your basal body temperature (BBT) chart will likely indicate that you are ovulating normally. You could also check your progesterone level after 7-10 days after the first sign of color change. If these tests do not indicate ovulation, you may wish to undergo testing to determine why you are not having regular cycles rather than just rushing into clomiphene treatment. You can learn more about testing at www.ivf.com/protocol.html and basal temperature monitoring at www.tcoyf.com.
I have severe endometriosis. I have had surgeries and tried the hormone therapies to no avail. Fortunately I have children and had them all prior to diagnosis. My symptoms did not begin until after a tubal ligation. Is is possible that there is a connection and would it help to have a reversal? I do not want a hysterectomy, I would rather have another baby if it would help -- but I am tired of fighting and very confused. Frequently, adhesions form at the site of the tubal sterilization or endometriosis treatment. Severe endometriosis can persist with inadequate surgical incision. It is impossible for me to know which is causing your pain. You may wish to consider treatment with Lupron along with addback therapy. By combining ovarian suppression with low dose daily estrogen and progesterone, you can get the pain relief associated with Lupron without the nasty side effects. This treatment is not restricted to six months as it is when used without addback. Lupron is generally only effective when you are taking the medication. Pain usually returns after the medication is discontinued. At that point, or if you choose not to take medication, surgery would likely be necessary. Be certain you see a surgeon who is skilled in excising all endometriosis, not just burning it with electrical current or burning it with the laser. {Read more of Dr. Perloe's responses: Page 1 / Page 2 / Page 3 / Page 4 / Page 6 / Page 7 / Page 8 / Page 9}}{Disclaimer: Every effort is made to present accurate and reliable information, but this column is intended to provide general information, not direct psychological or medical advice to the person posing the question. Use of such information is voluntary and should only be undertaken after independent review of its accuracy, completeness, efficacy and appropriateness to your specific situation. If medical or psychological advice is needed, seek the services of a competent, licensed professional.} |
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