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Infertility and Reproductive Medicine Moderated by Scott Roseff, M.D.


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Old 12-16-2010, 07:30 PM
fitwannabmom fitwannabmom is offline
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Default IUI Question

I am 41 and conceived naturally in April/May of 2010 and it ended in a chemical pregnancy. I was put on clomid for a luteal phase defect (which worked) however dried out my mucus and made me crazy. Moved onto IUI with follistim 225 iu for 8 days. Produced 4 follicles one of which released as confirmed by ultrasound and again I conceived. Unfortunately, growth stopped at about 5 ˝ weeks and I opted for medical abortion.

Doctor wants to try IUI again however this time unmedicated since my problem doesn’t seem to be conception. He left the decision up to me. My insurance does not pay for the follistim and it about $1500 out of pocket. What would you advise? Does the follistim help produce a “better” egg (if there is such a thing) or does it only help to develop more per cycle. I am NOT interested in multiples but have no problem with natural selection. There are no other problems that have been detected. I have been on a pharmaceutical grade DHEA for about 6 weeks and have also been doing acupuncture. I figured every little bit may help.
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Old 12-16-2010, 09:10 PM
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Scott Roseff MD Scott Roseff MD is offline
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Hi,

Women of advanced reproductive age, such as yours, generally have a high degree of DNA abnormalities in their eggs. While men produce new sperm every 10 weeks or so, women don't make new eggs. Therefore, a 41 year old egg has been around for decades, and the risk of chromosomal abnormalities in the pregnancies produced is increased. Follistim doesn't produce a better egg.

You wrote that "no other problems have been detected", but age is unfortunately a problem, given your history of recurrent pregnancy loss. There may be other factors at work, too, and with a history of two losses, you may want to consider undergoing an RPL workup if not already done (and if you want to continue using your own eggs).

I hope this is of some help, and I hope the DHEA and acupuncture help too!
Dr. Roseff in Florida
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Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
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As you’re not my patient, information herein may be incomplete/inaccurate & I can't be responsible for your actions. This is for educational purposes & should never be used to replace information & care rendered by your own doctor. No part of this message may be reproduced, printed, or posted elsewhere without express written authorization of Dr. Roseff or INCIID.
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Old 12-16-2010, 09:17 PM
fitwannabmom fitwannabmom is offline
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Thank you for your help. Yes, I am very aware that age is unfortunately a factor. Is a RPL work-up the genetic testing? Both my husband and I had all kinds of blood and saliva testing done. All tests were normal.

So basically if I ovulate normally follistim really isn't going to help me get pregnant any faster. I may just wind up with multiples which I don't want.

Thanks again. This forum is great!!!
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Old 12-17-2010, 07:10 AM
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Scott Roseff MD Scott Roseff MD is offline
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Follistim is used to generate more than one follicle (egg).

You're welcome!!!
Dr. Roseff in Florida
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Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
PERSONALIZED/SUCCESSFUL Specialty care....

As you’re not my patient, information herein may be incomplete/inaccurate & I can't be responsible for your actions. This is for educational purposes & should never be used to replace information & care rendered by your own doctor. No part of this message may be reproduced, printed, or posted elsewhere without express written authorization of Dr. Roseff or INCIID.
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