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Mark Perloe on Fertility Issues, Page 6{Read more of Dr. Perloe's responses: Page 1 / Page 2 / Page 3 / Page 4 / Page 5 / 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 went off birth control pills in June after being on them for 13 years. My
husband and I have been trying to conceive, but my period has been very
irregular for the past four cycles, and I have had an extremely light flow
when it does arrive. I have a doctor's appointment to make sure that
everything is normal with my cycle. Are there any specific tests I should
ask for, or is it normal for my period to still not have returned to normal
after four months of being off the pill?
Guess that depends on how old you are. Please read www.ivf.com/protocol.html to learn about all the testing that is advisable. You may start with ovarian reserve testing with day three FSH and estradiol levels along with TSH and Prolactin to check the thyroid and pituitary gland. If you are overweight or note excess hair growth, I would add a two-hour insulin glucose tolerance test as well as male hormone tests.
I am currently going through infertility treatments. I am on my fourth cycle of
IUI. My question is, What is the difference between the injectibles? I
currently inject 75 I.U. of Follistim, then trigger with 10,000 I.U. of
Profasi. I have heard people talk about Pergonal -- is there any
difference between Follistim and Pergonal?
I am a 31 year old woman who has had problems with my period from early on. I have a son (11 years old) who was conceived rather easily. I was overweight and having sporadic periods. Doctor put me on the pill to regulate, but I quit due to blood pressure increases and became pregnant with my daughter. Since then (4 years ago,) periods again are slim and no pregnancy. I have lost 90 pounds with the help of gastric-bypass surgery -- now weigh about 174. I would like another child but have been diagnosed with hyperthyroidism and am being treated. Last month, I had a period that lasted 12 day, this month a period that lasted about 10 and was very heavy. Doctor started me on Norethindrone. I would love to have another child soon. Any suggestions? I would check a two-hour insulin glucose tolerance test to see if you are insulin resistant and would benefit from metformin therapy (see www.ivf.com/pcostreat.html). Often, estrogen levels are adversely affected if you have significant diarrhea associated with the bypass. If all is normal, then ovulation induction therapy with clomiphene may be a good starting therapy (see www.ivf.com/clom.html). Using basal body temperature charts can determine if you are now ovulating regulary. If you have severely restricted your calories, that may also adversely effect your menses. A low serum leptin level may indicate that nutrition restriction is also a problem. Hopefully, correction of the thyroid problem will restore normal menstrual cycles.
Given a 44 year old healthy woman with no known reason for not becoming pregnant except age, what is the percentage (or percentage range) of a successful pregnancy (i.e. giving birth) by using a donor egg for each try? After, say, four tries? That would depend on the age of the egg donor. We try to find egg donors in the late twenties to get the best results. The likelihood of having a baby on the first attempt is over 50% if you are healthy and no other factors would interfere, such as uterine fibroids, polyps or medical conditions.
I'm looking for answers in Canada. My husband has never been diagnosed but we believe he has a disease called primary ciliary dyskinesia. His sperm have no tails which means they're immotile. Are there men with this condition who have had children? Is there any information that you have that could help us? We were told we could never have children, and I read something about a procedure where they inject the sperm right into the egg. The procedure where the sperm are injected into the egg is called ICSI. Along with IVF, this procedure should offer an excellent chance for success. There is some concern that this condition may be associated with lung diseases and infertility in the offspring. Before considering IVF and ICSI, a meeting with a genetic counselor is advisable. The technique for ICSI is readily available at most IVF centers in the US and in Canada. Please read www.ivf.com/artmanindex.html to learn more about this procedure.
I miscarried five days ago after 9 1/2 weeks since last period. This is my fourth pregnancy and first miscarriage. My Doc says it was just bad luck. I do not want "bad luck" to happen again. At the same time, I do have some concerns: I just turned 35, previous pregnancy was in my early 20's, my cycle after taking birth control pills is 23-26 days in length. My Doc said everything was okay, but they discovered fibroids after ultrasound, two small and one larger. I would like to get pregnant again soon, but I no longer feel confident with my Doc. What doctor should I look for? I would likely consider surgical removal if there is a large myoma. Often this is sufficient to correct a problem. Unfortunately, there is likely no way of knowing at this point if the fibroids were a factor or if the pregnancy was genetically abnormal. A reproductive endocrinologist can assist you with concerns about both getting pregnant and maintaining a successful pregnancy.
I am 19 years old and I have had an ectopic pregnancy. I was told it will be hard to conceive. How old do I have to be to be a candidate for IVF? Most programs would ask you to wait until you are 21. Whether or not you are able to conceive depends on a number of factors. First, did they remove the tube with the ectopic? If they did, what did the other tube look like? Did they use methotrexate injection to "dissolve" the pregnancy? If so, the odds of success on the other side can be as high as 80% with a risk of another ectopic at 25%. {Read more of Dr. Perloe's responses: Page 1 / Page 2 / Page 3 / Page 4 / Page 5 / 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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