Archive for the ‘ivf’ Category

Prime Time

Tuesday, December 15th, 2009

I was on Prime Time on RTE1 tonight. I was talking about the ruling in the frozen embryo case that was before the Supreme Court today.

Mary Roche appealed to the Supreme Court after losing her High Court bid to use her three frozen embryos after she split up with her husband. The Supreme Court ruled that her husband was entitled to withdraw consent as there was no explicit contract between the spouses. It also ruled that an embryo is not afforded any legal protection under the Constitution until it becomes implanted in the uterus.

You can watch here.

High FSH

Wednesday, May 6th, 2009

I get a lot of traffic to this site from people searching for information on high FSH. Here is my take on it.

Follicle Stimulating Hormone is secreted by the pituitary gland and stimulates the ovaries to mature follicles in preparation for ovulation. An elevated level (>10mIU/ml) on day 3 of the menstrual cycle indicates that the brain is having to work harder to stimulate the ovaries; this is thought to be related to a diminished ovarian reserve. It also means that the patient is unlikely to respond well to ovarian stimulation medication used in IUI and IVF. Doctors tend to agree that you are only as good as your worst FSH result and that a lower result one month does not cancel out a poor result another month. However, there is no consensus on whether or not a low quantity of eggs also indicates a low quality of eggs. Many reports suggest that a younger woman with high FSH has a much better chance of success than an older one with the same FSH level because her eggs are younger and therefore likely to be of better quality.

Conventional thinking suggests that patients with high FSH have a very reduced chance of pregnancy, either with or without assistance. However, we do not know the FSH levels of those with no fertility problems so it is not possible to say that those who conceive easily always have low FSH levels. It is possible that an elevated FSH level in itself does not predict pregnancy outcome but that coupled with poor egg quality and/or other fertility problems, it may seriously reduce the chance of pregnancy.

Traditional Chinese Medicine believes that FSH and related egg quality can vary extensively from month to month and that this can be improved with the help of acupuncture and Chinese herbs. Practitioners believe that stress can play a big part in raising FSH levels and that this does not necessarily indicate lower egg quantity or quality.

A real life friend recently started trying for a baby. She conceived after a few months but sadly miscarried. She had had day 3 and 7dpo bloodwork done early on, mainly to make sure she was ovulating. Her GP had told her that all the results were normal and she hadn’t questioned it any further. After her miscarriage she asked me advice on a few things and I asked about her FSH level, just to rule that out as a problem. She looked up the number and called me back straight away. It was 13.4, she was 33 years old. I recommended, as casually as I could, that she make an appointment with a fertility clinic, just in case. She did but never got to keep it as she conceived shortly afterwards and everything has gone well since. So, with an FSH level of 13.4, she conceived fairly easily twice. If I hadn’t mentioned it, she would never have known about the high level.

My first FSH test, at age 35, showed my level to be 4.6. I was happy with that and didn’t think to research it any further. We carried on with tests and treatment (we were dealing with male factor infertility) for a year and a half before falling at the first hurdle of IVF. When I went for my first follicle scan after a week of ovarian stimulation, there were only three follices. Not the 15 or so I’d been expecting. I couldn’t believe it. My FSH levels were normal so how could this have happened? The nurse checked my blood test results. Yes, my FSH level was low but my E2 (oestradiol, a form of oestrogen) was over 400 pmol/l. Normal levels are below 275. A very high E2 level can suppress a high FSH level and give a low reading. My FSH should have been retested, the nurse guessed it would have been at least 10. A further week on ovarian stimulation medication yielded no further follicles but we went ahead with egg collection. We got two eggs, miraculously both fertilised and were transferred, pregnancy resulted, miscarriage followed.

The following month, my FSH level was 17. A subsequent IVF cycle was abandoned after only one measly follicle was produced after two weeks of stimulation on the highest dose of meds possible. We triggered, tried on our own anyway. Two weeks later, two lines. Another miscarriage. Another natural cycle, another pregnancy, another miscarriage. What was going on? I wasn’t supposed to be conceiving at all with my FSH level of 17. (As for the MFI, my husband had had a varicocele ligation in the meantime and his semen analyses results were back to normal). It was retested, still 17. At this stage we reckoned IVF was a waste of time and money and invested our efforts in trying to stop the miscarriages rather than trying to conceive in the first place. I was already on Cyclogest, aspirin, Heparin, HCG shots and Prednisolone each cycle and had started Low Dose Naltrexone. I was also doing acupuncture 2 or 3 times a week, depending on the stage of my cycle.

I took a month off and took a huge dose of antibiotics, designed to combat any low grade infection in my uterus that may be hampering my pregnancies. Next cycle I took 50mg of Clomid days 3-7 and all the above meds from ovulation. It worked. At the age of 37 and with an FSH level of 17, I supposedly had a statistical probability of about 2% of conceiving and even less of carrying to term.

There was something preventing me carrying to term but I don’t think it was high FSH. I had six miscarriages in a row – what are the odds that I recruited six bad eggs in a row, that were eager and willing to be fertilised but unhappy to stay the distance?

This time around I was too chicken to test. I was just too terrified that the result would be in the twenties and that would be the end of it. We were going to try anyway so I didn’t see the point in knowing, at least not at the start. And here I am, seven weeks pregnant with a healthy heartbeat, conceived with the help of nothing but acupuncture and a HCG trigger shot on my third postpartum ovulation. I am 39.

I completely understand if my few remaining readers are reaching for the Unsubscribe button. I have done that. I’m not even sure if this post is the start or the end of something.

Seoige

Wednesday, November 26th, 2008

I was on the Seoige show on RTE1 last Wednesday (Wed 19 Nov – about 28 mins in).

Last Monday the Irish Independent reported that a Galway fertility clinic was refusing to treat unmarried couples. David Quinn of the Iona Institute was on to argue the case that married couples make better parents than unmarried ones and therefore should be the only recipients of fertility treatment and I was there to speak for normal people.

Infertility is a medical condition. It is not up to doctors to choose which patients they treat on the basis of their own religious beliefs or morals. If you think children’s lives are at risk from their parents’ marital status then outlaw it completely. Don’t pick on those with physical disabilities and make examples of them. Just cos you can.

Incidentally, these are the same doctors that won’t prescribe the morning after pill for women who don’t want a child, yet refuse treatment to those that are desperate for one. Guys, a little consistency is needed here if you want to be taken seriously.

Why wait for babies when you can fast-track with IVF?

Tuesday, July 29th, 2008

According to today’s Guardian, couples with no fertility problems may be opting for IVF to cut out the time and hassle of babymaking. One of these couples may be Angelina Jolie and Brad Pitt who, apparently, didn’t have the time or patience to try the usual way. It is possible that this trend may be encouraged by fertility clinics that aim to improve their success rates by treating fertile young couples instead of infertile old crocs.  This may be happening at a clinic near you, “although no one can put a figure on this phenomenon”.

What I would like to know is, where are these magical clinics where you can get an instant appointment and then get pregnant, almost guaranteed it seems, on your first go?

You just have to wish really hard…

Tuesday, March 25th, 2008

I am gobsmacked at JLo’s recent People magazine article, via Julie.

Despite trying to conceive for several years, “I knew there was nothing wrong with me. I knew that I could. Deep down, I really wanted it badly…”

Unlike the rest of us who only want it a bit, Jenny’s faith, determination and general all-round perfection won the day. Despite trying for several years, she never once thought there was something “wrong” with her, it never entered her head that it wouldn’t happen. Well, if you weren’t convinced before that she is completely loola, here is all the evidence you need.

Hubby Marc Anthony’s reasoning for the twin pregnancy is even funnier than the “twins run in the family” excuse – he says that twins were inevitable because everything his wife touches turns to gold! Has he ever seen Gigli?!?

There is something wrong with JLo and MAnt. They tried unsuccessfully to conceive for several years. They are infertile. If their twins were conceived naturally, then they were dealt a really big slice of good luck, and not just because they wished really hard for it. A spontaneous pregnancy after 3 years TTC has about a 1% chance of happening each cycle. Of course it is possible but most people would describe in terms of a “miracle” and a “blessing”, as opposed to an inalienable right due to their own perfection.

And there’s the crux of the matter. Infertility is perceived in the media as an imperfection, in Jenny’s own words, something “wrong with me”. It makes her look old, weakened, more like us. Unlike the shot of “Jennifer and Marc clowning around with their $3,000 prams”. See, Jenny’s not like us, only good things happen to her. That is why she has $3,000 prams and we don’t.

I am going to preempt the “You can’t judge her, she has a right to her privacy” comments with this:

BOLLOX!!!! She has paraded her newborn twins in public for a reported $6m fee. She has put them on show, people are bound to ask questions about them because she has put them out there. Live by the media, die by the media.

Bollox Fuck Pox

Sunday, January 21st, 2007

Welcome to the wonderful world of IVF.