July 13, 2010 @ 10:30 PM — by Laurence Jacobs M.D.
LOWER YOUR INFERTILITY COSTS (Part III) discusses:
Tips for trying on your own.
When should you see your Gynecologist for an infertility evaluation?
When should you see a Reproductive Endocrinologist?
- Age 38 or older or diminished ‘ovarian reserve’ at any age
- Documented tubal disease or a history of damage
- Pelvic disorders causing adhesions (scar tissue)
- Significant male factor problems or
- Unexplained (idiopathic) infertility
- Recurrent pregnancy losses (miscarriages)
- Donor egg, donor sperm or gestational surrogacy
February 05, 2010 @ 01:29 PM — by Laurence Jacobs M.D.
Female age is a critical factor in determining the chances for getting pregnant. Increased infertility with female aging is well-documented and very common in our society. In general, egg quality and quantity start to decline slowly starting in the early 30s, and then much faster in the late 30s and early 40s. At any given time, the number of good eggs that remain is very dependent on the woman's age plus other factors, such as genetics and previous ovarian surgeries. In general, 'ovarian age' closely parallels the woman's chronological age. However, since this is not always the case, it is very important for REs and gynecologists to assess the patient's ovarian reserve of eggs. That's why screening for ovarian reserve is such a vital part of the initial evaluation for infertility patients of any age.
The following ovarian reserve screening tests are used by reproductive endocrinologists to predict a woman’s remaining ‘egg supply’.
FSH & Estrogen (Estradiol) serum levels (FSH & E2) on cycle day ‘3’
Ultrasound- Antral Follicle Counts (US-AFC) on cycle day ‘3’
Anti-Mullerian Hormone (AMH) levels
Other: Clomiphene Citrate Challenge Test- CCCT; Inhibin serum levels