Infertility/Fertility/ivf

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Question
respected sir
i am from Pakistan..my husband had severe male factor and i have PCOS..we tried two attempts for ivf with icsi but no luck...
actually during stimulation the doc told me that growth rate of my follicles is low...they are increasing in size very slowly....as a result it took more days for the eggs to b matured...more over it was common for both the cycles.....
Q what could be the reason of my slow responce and is it related to the failure if yes then tell me how.....
and what is highFSH and its adverse effects and how it can be cured...
im going for the next IVF as it is the only option left.....plx tell me what i can do to maximize the success chances

thanks

Answer
Hello Hina from Pakistan,

1.  I can't give you a reason for a low growth rate of the follicles in your situation.  PCO patients to respond quickly and too strongly.  Patients will increased ovarian resistance tend to have a slow growth rate with very few follicles.  In that case, you would NOT have PCOS.  The only other factor influencing growth rate is the amount of stimulation.

2.  This slow growth rate was not the cause of your failure.

3.  An elevated FSH done on cycle day #2 or 3 indicates that the ovaries are already compromised and won't respond strongly to stimulation.  The increased FSH in the blood (above 10) means that the ovaries are not picking up the FSH from the blood.  The less FSH the ovaries pick up means the ovaries are already oompromised and so won't respond well to stimulation by growing lots of eggs.  We call these patients "poor responders."  There is no way to reverse this.

4.  In terms of how to proceed, I cannot give you specific information because I am not the doctor caring for you and also because I would need to look more closely at your medical records to see what has and has not been done.  Each doctor and clinic use different protocols and approaches to patients.  You just need to make sure you are going to a good clinic.  The quality of all clinics are not the same.

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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