Infertility/Fertility/when to take ovidrel

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Question
hi dr rameriz

I am 37 yrs old , with unexplained infertility ,had HSG , found to have right tube blockage , in the last 2 cycles even on femara have good response on right ovary (blocked tube site) but unable to produce mature follicles on left ovary(good side) .my RE would like for me to trigger with ovidrel once my opk is positive even though I ovulate on my own every month .Is this of any benefit ?? do u ever ask your patient to give ovidrel just by doing OPK ??
thanks in advancee

Answer
Hello Mimi from the U.S. (North Carolina)

You do NOT have unexplained infertility.  You have the diagnosis of "Tubal infertility" because one tube is blocked.  What that means is that there is the possibility that the other (non-blocked) tube may have some internal damage.  Because there is no way to know what caused the initial blockage, there is no way to say or know for sure if the left tube is okay so there is an assumption that has to be made.  The most common reason for tubal blockage is due to some type infection or inflammation that started from the vagina and progressed to the tubes.  This then caused damage within the tube and caused the blockage due to scar tissue formation.  It is possible the opposite tube was damaged as well, meaning the internal structure, mainly the cilia, was damaged and although open, it may not be functional.

In terms of your ovulation, I do use Ovidrel regardless of the type of treatment because I don't want to rely on the natural LH surge.  If it doesn't surge, then they cycle is essentially ended.  I, however, do not do OPK cycles.  I leave those to general Ob/Gyn's who don't know any better.  I want more assurance that the appropriate number of follicles were recruited and ready to ovulate and when the optimal timing is to trigger.  This can only be done with ultrasound surveillance.

Good Luck,

Dr. 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.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate  

Infertility/Fertility

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Edward Joseph Ramirez, MD, FACOG

Expertise

I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience

I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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