Infertility/Fertility/High FSH

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Question
Hello Dr.

I am 37 years old with multiple fibroids. My gynecologist gave me Clomid and asked me to test FSH simultaneously and my result came out  22.9, I did ultrasound today and to his surprise there was an egg. He said that I have 3 factors that hinder pregnancy, age, high FSH and the fibroids, the biggest one is 4 cm.
He suggested considering removing my fibroids. I am worried I dont know what to do.

Answer
Hello Mirna from Jordan,

Removing a 4 cm fibroid is not indicated unless it is impinging into the uterine cavity.  I would think that to be a needless surgery.

I presume that he did what is called a "Clomid challenge test", in which case the FSH level is taken on cycle day # 3 and then day #11.  If that was the case, then your FSH is almost menopausal levels, but since you created a follicle, you are probably "peri-menopausal".  At 37 years old, IVF is the treatment of choice, and more ideally would be to use donor eggs.  IVF is more effective than trying naturally, but your chances may still not be great.  The only way to overcome the age factor, which causes eggs to deteriorate in quality, it to be able to get lots of eggs.  An elevated FSH means that your ovaries probably will not respond much.  But, it is worth a try.  After all, it only takes one perfect egg to have a baby.

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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