QuestionQUESTION: Dear Dr,
I am 37 year old and i have 1 child, after 4 try for conceive my dr ask for Hysterosalpingography and it shows that my left fallopian tube is closed but the right one is very good. My prolactine, FSH level are good. My husband (43 years) spermogram are average the motility of the sperm after 6 hours is 25 % after 1 hour 55%. So please advice if i go to natural insemination does i have a chance or i can try to conceive naturally.
Regards
ANSWER: Dear Sabine from Lebanon,
Of course there is a chance for you to get pregnant naturally (by intercourse or insemination), but the chances are low. There are two problems that you present:
1. The fallopian tube has undergone some type of damage in the past resulting in the blockage of one tube. It is possible that the right tube was spared but there is no way to verify that. It is also possible that the right tube was damaged but not to the extent of blockage. If that were the case, the tube would not be functional and natural pregnancy will not occur. You have to make a decision as to whether or not you think the tube is normal or damaged as this will guide your treatment. In addition, keep in mind that you are at increased risk of a tubal pregnancy (ectopic) which can be life threatening.
2. You are 37 years old and therefore your eggs are old and thus less fertile. We call this the "age factor". Your natural chances of pregnancy at this age is 12-15% per year of trying (1-3% per month) and only 5-10% by Insemination. This rate is regardless of the tubal issue. Of course if there is a tubal issue, the chances are significantly reduced.
If you were my patient, I would recommend IVF as the best treatment to overcome both of these problems.
Good Luck,
Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
info@montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf. Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate. I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy). Contact me at ejrmd@montereybayivf.com if you are interested in continuous access to me.
---------- FOLLOW-UP ----------
QUESTION: Dear Dr,
Thank you for your reply. I will try for few times the insemination. I need your opinion the dr gave me fostimon for 10 days. I need to know which will be better for my case to take only fostimon or to add also luveris to improve egg quality. And which give better result gonal or fostimon.
Waiting for your valuable answer.
Regards
AnswerHello Again,
I use only one medication, rather than a combination, when doing IUI, mainly for cost reasons. Luveris does not give any benefit so I would not think you need it. There is no difference between Gonal or Fostimon, so either will do.
Good Luck,
Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
info@montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf. Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate. I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy). Contact me at ejrmd@montereybayivf.com if you are interested in continuous access to me.
