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Mark Perloe on Fertility Issues, Page 8{Read more of Dr. Perloe's responses: Page 1 / Page 2 / Page 3 / Page 4 / Page 5 / Page 6 / Page 7 / 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 have been trying to concieve for almost ten months now. I have been off
depo provera for a year. I did Clomid this cycle on days 5-9. I'm currently on
cycle day 15 and no signs of ovulation yet. I have had five negative ovulation predictors. I am charting my temps and they seem all over the place. My question is what is
the usual time I should be ovulating? I have a progesterone test I have to get done between cycle days 18-21 and am hoping I
ovulate before then.
This is not how I would utilize clomiphene. I believe that closer monitoring while on clomiphene gives the best results. During the first cycle, I check the LH and FSH level to see the ratio one or two days after the last tablet. Then four days later, urine LH testing is started. If no LH surge is seen by the 16th day, I recommend an ultrasound to see if any follicles/eggs are developing in the ovary. If not, it may be that the depo provera is still active.
There seems to be a lot of knowledge about women with a hyperthyroidism and pregnancy problems. Is there any research available concerning hyperthyroidism and male infertility?
I am interested in any treatment ideas you have for a high male DNA fragmentation rate (34). Also, it's been suggested that my eggs (in a previous IVF cycle) were of a decreased quality because of the high numbers and varying range of sizes -- a different protocol is to be used with the aim of less eggs but of higher quality on our next cycle. I also suffered from OHSS. We have been told to take Vitamin E, ibuprofen and retest. If this does not lower the DFI (DNA fragmentation rate), then testicular sperm would be used. My husband is also taking Proxeed, selenium, zinc and Vitamin C. Do you have any other information on the success of lowering the DFI with antioxidants? I would add a month of antibiotics such as Cipro as well as antioxidants such as Juice Plus, see www.juiceplus.com/+mp64311 and retest after a minimum of 10 to 12 weeks. If you proceed with IVF and the DFI remains high, an additional embryo may be transferred.
I have been prescribed Tetracycline for boils. We have been trying to pregnant for two years. Will Tetracycline reduce our chances? No.
What is the effect of steroid use on sperm count? I am too afraid to ask my doctor since I know that it is an illegal drug. My husband says that there is no effect & won't say how long ago it was that he used them. He is/was into body building, says he is not taking them anymore, and it would not be a big deal. Can you tell me what you know about little or prolonged use of steroids and what it does to the sperm count/fertility of men? He says that he will go get a sperm count done, but I was just curious. Steroid hormones come in many varieties. Progesterone, estrogen, testosterone and cortisol are all steroid hormones. The hormones associated with body building can be problematic and suppress the production of sperm. Cortisol on the other hand will not likely have an effect except if used at high doses for prolonged periods of time.
I am a 27-year-old female with PCOS. I am currently being treated with 150 mg of Clomid on cycle days 2-5 and 200mg on cd 6-7. My doctor's reasoning is that starting the clomid earlier results in more follicles (I only made one follicle on 100mg and it measured 16.5 at hCG injection), and going a day longer will result in bigger follicles. I have tried to do some research on this timing of Clomid, and all I found was a study done on 23 people that was bogus. Do you have an opinion about my doctor's methodology? While I don't know your particular situation, I do not feel that clomiphene is the best treatment for PCOS. Nor do I believe that doses higher than 100mg are effective. You either need to consider metformin, diet and exercise (read www.ivf.compcostreat.html) or injectable therapies. If you are seeing an RE, find another. If your MD is not fellowship-trained, find someone who is and who is familiar with modern day management of PCOS. Please visit www.pcosupport.org for more info on PCOS.
I am looking for information for my daughter and son-in-law. She has been trying to get pregnant since they married five years ago. My daughter has endometrosis and has had surgery several times. The last time she got pregnant after the surgery but miscarried after about six weeks. She has now had in vitro twice and has had no luck conceiving. She has had lots of eggs (11 and 13) but when they are fertilized they seem to be fragmented, and the others never make it to the freezing stage. She now wonders if there is something wrong genetically because her husband is adopted and has no medical history. My daughter has a child from a previous relationship, so she knows she can conceive. She is 25 and he is 27. Can you explain any of this or steer me in another direction as this is breaking my heart, too? There are so many factors that go into successful IVF -- with this amount of information, it is impossible to advise you. Please read www.ivf.com/artmanindex.html to learn about those issues that might effect success. {Read more of Dr. Perloe's responses: Page 1 / Page 2 / Page 3 / Page 4 / Page 5 / Page 6 / Page 7 / 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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