QuestionI discovered my FSH ranges are between 10.5- 11.9. I am only 32 yrs old. I went to a new doctor and now I have been trying to do a IVF. I had a ultra sound the first day of my cycle and I had one follicle last month and two this month. My doctor has I need 3 to 4 follicle before starting the IVF process. Is 3 to 4 follicles enough? Can my follicles increase from month to month?
AnswerHello Amber from the U.S.,
If you are doing IVF then your doctor should have explained to you what an elevated FSH level means. That puts you in the category of a low ovarian reserve. I am assuming that the FSH levels were taken on the second or third day of your menses because that is the only time that they can be interpreted correctly.
Low ovarian reserve is the same as a low responder. That means that the ovaries are not taking up the FSH output from the brain. The less FSH that the ovary takes up from the blood stream, the higher the FSH level is in the blood. The fertility medications that we use for IVF is FSH. We increase the amount of FSH that is available to try to stimulate the ovaries harder than normal, but even then the ovaries will only pick up as much FSH as it wants. As a result, despite the highest stimulation protocols, these type of patients do not grow very many follicles and hence have less eggs to work with. The good news is that because you are still young, you don't need a lot of eggs to become pregnant. You only need one or two.
I don't know why your doctor requires you to have 3-4 follicles before starting the IVF process because not all of us do.
In terms or you last question, yes, the ovary can respond differently with each cycle and so there can be more follicles and more eggs retreived with each IVF cycle. That is why I encourage my patients to keep trying. Remember, you only need one good embryo to get pregnant.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.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
