# FSH



## Guest (May 19, 2008)

I have finally got my test results back.  What does an FSH Level of 13.7 and oestrogen of 134 mean?  is there anything i can do to change these levels if the results are poor?


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## Violet66 (Dec 28, 2007)

Hi Shad 

Were these tests taken on day 2 or 3 of your cycle? 

From a fertility point of view the FSH is on the high side. Doctors vary in what they like it to be - some like it to be under 9 and (I think - i hope others will correct me if i'm wrong) that clinics like you to have an FSH of 12 or below to treat you for IVF. Although, the Lister will take patients with elevated FSH if other tests are satisfactory. 

However your FSH is entirely in keeping for your age and levels can vary from one month to the next. 

It's been a while since I had my tests done but I think your E2 levels are on the low side for the follicular phase but, again, probably perfectly fine for somebody of your age. 

Some people swear by accupunture to lower FSH, wheatgrass juice is said to help and DHEA is also thought to help improve egg quality. 

I think your result are absolutely fine for your age, however, I wouldn't have thought you'd be a good candidate for IVF - I think you'll be advised to look at donor eggs. 

I know how difficult it is - and I am sure that in the next six months or so I am going to have to look at the DE possibility - something I don't feel ready to at the moment. 

Hope this helps. 

The best chance of getting PG at your age would be via natural conception but I guess this isn't an option for you?


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## Guest (May 19, 2008)

Hi Violet
if you ignore the first day of starting then the tests were done on day 3.  I was told they should be done when you are bleeding heavily however that would have been day 2 and it was a bank holiday - so i couldnt go for the test.  one of the reason i want to try IVF is because i want the best embryos chosen since at my/our age the risk of genetic disorders in embryos is high


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## daisyg (Jan 7, 2004)

Shad,

IVF does NOT choose the best embryos - it is onlyPGD (Preimplantation Genetic Diagnosis) that can do this.

Your FSH is highish and may be slightly falsefly suppressed as your E2 seems on the higher side. These are not unusual results for your age.

BUT, FSH can not give any indication of the quality of your eggs and at 45 your chances with ivf are very, very slim I am sorry to say. FSH levels may give an indication of how well you may respond to FSH stimulating drugs. Have you had an antral follicle count at all? This also provides useful info. However, you may obviously want to try a cycle for closure and I totally understand this.

The biggest advantage of ivf is that it produces as many eggs as possible (and hopefully embryos) which will increase chances hopefully. Studies at Cornell showed that women of 45 did best when they produced 5 or more oocytes. About 3% had a live birth and 85% miscarried, so that does indicate that is is much harder and more of a lottery getting a normal embryo - but not impossible of course.

I have replied in detail to you on this subject before but I think one has to try an ivf cycle for closure before moving on to DE or whatever you and DH choose as the best option for you.

In my previousl reply I also outlined that very, very few women have had a live birth via ivf with own eggs in the UK (top 2 US clinic's have better results but still only a handful of women have achieved this).

I think I also stressed that you and DH would be well advised to check out other issues as well to give you optimum chances for conception whether with own eggs or DE and these would include sperm dna fragmentation, karyotyping, thyroid, uterine checks for fibroids etc, bacterial checks and basic blood tests to eliminate basic clotting and ANAs etc. Your GP can do many of these.

Finally, the vast majority of women aged 45 who do conceive to so naturally - and this is still a small number. There is a very good website for women over 40 ttc which can give lots of info. you may be interested in.

http://www.fertilityover40.com/Forums/FertilityOver40Forum/tabid/60/view/topics/forumid/4/Default.aspx

Just to address the last part of your post. IVF will not choose chromosomally normal embryos as you describe. Only PGD can do this (and this is not guaranteed either). You cannot know whether the embryos are genetically normal just by looking sadly.

I have also noticed you do have fibroids - have you checked these out recently as I would strongly recommend you have an hysteroscopy and removal of any fibroids which may hamper conception and pregnancy. This will affect a DE pregnancy should you decide on this route.

Best of luck,

Daisy
x


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## Guest (May 20, 2008)

daisyg said:


> Shad,
> 
> IVF does NOT choose the best embryos - it is onlyPGD (Preimplantation Genetic Diagnosis) that can do this.
> 
> ...


when i went to a bridge clinic seminar they showed how they could reject embryos which were chromosomally abnormal the good embryos are then implanted back in the womb. they were talking about using this process with IVF


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## daisyg (Jan 7, 2004)

Shad,

This process is called PGD (Preimplantation Genetic Diagnosis) as I described in my first post.  This is the only way you can check which embryos are chromosomally normal before transfer.  You have to do ivf to do this as you need to remove cells from the fertilised egg and sperm (embryo) in order to test this for abnormalities.   The embies will end up being grown to day 4 or 5 so the rate of attrition here may be high. These embryos are then transferred.  

However, PGD has not been shown to increase live birth rate in over 40s but may reduce miscarriage rate.  Be aware however, that it can only test for a limited number of chromosomes and cannot guarantee either a pregnancy or avoid a miscarriage.

You also need a good number of embryos to make the procedure worthwhile as there maybe false postives and neg. which will mean some potential normal embryos may be discarded.  You would be hopefully left with embryos to transfer.

It is certainly something to consider, but is expensive.  Have you talked to the Bridge about using PGD/PGS and what their success rates are with women of your age etc?

Best of luck,

Daisy
x


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## Guest (May 20, 2008)

daisyg said:


> Shad,
> 
> This process is called PGD (Preimplantation Genetic Diagnosis) as I described in my first post. This is the only way you can check which embryos are chromosomally normal before transfer. You have to do ivf to do this as you need to remove cells from the fertilised egg and sperm (embryo) in order to test this for abnormalities. These embryos are then replaced.
> 
> ...


Hi Daisy I will discuss my options with Lister since i have decided to go there


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## daisyg (Jan 7, 2004)

Shad,

Wish you the very best of luck - the Lister are a very good clinic and I got pregnant there with my own eggs at age 44 (but sadly miscarried).

Daisy
x


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## Guest (May 21, 2008)

daisyg said:


> Shad,
> 
> Wish you the very best of luck - the Lister are a very good clinic and I got pregnant there with my own eggs at age 44 (but sadly miscarried).
> 
> ...


Hi Daisy

went to LWC who have advised me not to do IVF since no live births for 43+ ever. they dont do PGD either. they said IUI would be the best. they have advised me to look at my fibroids - to find out if they are encroaching or distorting. since i am going to see my gyno for this they said it was ok if she did it they would write a letter just to let her know what tests to do. they also advised myectomy and not embolisation if an op was necessary


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## anna the third (Jan 15, 2008)

I agree with Daisy; unfort looking at embryos doesn't give ANY info at all about the chromosomes. you need PGD and even then that is debatable as it takes ONE cell away and that cell might not be representative of the whole. Good luck with the Lister; they are certainly one of the best. xx


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## daisyg (Jan 7, 2004)

Hi Shad,

Stick with the Lister - they at least have had live births with older women than the LWC (who do not have good ivf rates for over 40 by the way...).

Even if you do decide to persue IUI I would still choose the Lister personally.  If you can afford it then I am sure the Lister will let you cycle if only for some kind of closure which is important before moving on to DE or any other avenue you decide.  The Lister also do PGS/PGD...

I agree that your top priority is to get rid of any fibroids and get some basic checks done which will help you whether you do own eggs or DE.  e.g. fibroids, thryoid, insulin resistance, karyotyping, some basic clotting factors, etc. 

It is good that you are getting going and starting with the fibroids sounds positive.

Wishing you lots of luck,

Daisy
x


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## Guest (May 23, 2008)

daisyg said:


> Hi Shad,
> 
> Stick with the Lister - they at least have had live births with older women than the LWC (who do not have good ivf rates for over 40 by the way...).
> 
> ...


Hi Daisy
I spoke to IVI Valencia but they dont import sperm. When i asked about their donor database they just said they would try and match - which didnt sound very useful. I am now seriously considering the US because then i dont need to import sperm to the UK. Colorado said they had a 18% live birth rate for women over 42 but they could not tell me how many of them were 45.

I notice on this site the donor bank Xytec and Xytex are mentioned. Are they one of the same place? I did a bit of research into sperm donation and i understand sperm motility needs to be established otherwise the sample can be useless.


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## daisyg (Jan 7, 2004)

Hi Shad,

No, Valencia don't import sperm themselves. However, I imported my own ID release sperm from California Cryobank to IVI. I got Cal. Cryobank to organise this NOT ivi Valencia, so you need to investigate it from this point of view not from the clinic importing it as no European clinic will do this. YOU have to do the work yourself I am afraid... so unfair I know...

Most European clinics will only do anonymous sperm and egg donation. If a known donor is important to you (I think it is very important personally, but I was unable to do this...) then the UK or US for sperm and/or eggs would be the way to go. Success rates in the US are of course much higher for both own eggs and DE.

Maybe the Euro. law has changed on sperm importation since I did it...not sure about that...

The company is called Xytex. Here is a link

http://www.xytex.com/sperm-donor-bank-become-donor/

Sperm count and motility is crucial. However, any sperm bought from a reputable company will have been tested for this and results will be known to you. They should also tell you whether a donor has achieved any pregnancies as well.

To be honest Shad, given the time factor with your own eggs, maybe you would consider an ivf cycle with someone like the Lister asap to see how you respond to stimulation etc. etc. (obviously once your fibroids etc have been dealt with). You can then see what your hormone profile is like and see how you respond. It would be less stressful and cheaper than the US and may give you some more information about whether to move on etc etc? Just a thought. I do think either CCRM or Cornell are wonderful though, but what worries me in your case is the time factor for organising it etc etc. They will be able to advise you more though...

Finally, CCRM's stats are very good for over 40s but they will only have had very few 45 year olds have a live birth - this is the reality at all clinics in the world as you know. However, no one knows how you will respond individually, which is why it is good to have a cycle asap to see how you respond.

Best,

Daisy
x


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