Infertility/Fertility/Perimenopause

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Question
Good afternoon Scott.

In my family, there has long been a history of ovarian deficiency- ranging back to my great-grandmother.
My mother, my two sisters, and my maternal grandmother all had trouble conceiving. However, as I was adopted, this is the only information I have regarding my family background.

I have always had trouble falling pregnant- in the case of our youngest, it took us two years to conceive!( I am twenty-eight next month).
We currently have three children- two from a previous relationship.

My husband and I have been trying again for the last six months, using basal temp method and cervical mucus

I am concerned, that I am not actually ovulating- that, actually I am experiencing the perimenopause.
I have been experiencing a long list of health problems- itchy skin, lengthening periods, increasingly frequent migraines, brittle nails, unstable mood swings, extreme depression, etc.

I have been to my doctor, and she has ordered me a progesterone bloodtest for the week following next, as next week is my supposed 'window of opportunity'.

Following that, an FSH bloodtest.
Its a long time to wait when your after answers.

I guess what am I asking is: can a history of ovarian issues manifest itself after successful pregnancies? Even in someone as young as myself?

Any reassurance, would be very much appreciated.

Kind regards,

Kate

Answer
Hi Kate,

I've seen diminished ovarian reserve and even ovarian failure in 16 year olds, so yes, it's possible.

I test ovarian reserve with:
a) Menstrual cycle day 3 FSH and estradiol and AMH and TSH (blood tests);
b) Menstrual cycle day 3 ultrasound for antral follicle count.

IF I find diminished ovarian reserve, it *may* be worthwhile checking a blood test for a karyotype (chromosome analysis) and Fragile-X.

Discuss this with your doctor.
Dr. Roseff in Florida
(I've had UK patients come here to conceive and return home successfully pregnant!)
www.reproendo.com
www.ivfmd.com

Infertility/Fertility

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Scott Roseff, MD, FACOG

Expertise

I can answer questions relating to ALL aspects of female infertility.

Experience

I am Board Certified in Reproductive Endocrinology/Infertility.

Organizations
Past/Present:
Medical Advisory Board, Serono Labs, Inc.
Speaker's Bureau, TAP Pharmaceuticals, Inc.
The American Society for Reproductive Medicine
American Association of Gynecologic Laparoscopists
The International Society for Gynecologic Endoscopy
The Society of Laparoendoscopic Surgeons
The International Federation of Gynaecologic Endoscopists
U.S. International Foundation for Studies in Human Reproduction, Inc.
The Endometriosis Association
Fellow, The American College of Obstetricians & Gynecologists
American Medical Association
The Academy of Medicine of NJ
NJ Obstetrical & Gynecological Society
The NY Reproductive Medicine Society (Steering Committee)
The Society of Reproductive Endocrinologists
Resolve - National Chapter
Resolve - New Jersey - Executive Board

Publications
Please be so kind as to see my CV at: www.reproendo.com or http://ivfmd.com/our-practice/medical-staff/scott-roseff-md

Education/Credentials
Postgraduate Fellowship training in Reproductive Endocrinology & Infertility was done at The University of California, San Diego, School of Medicine.

Awards and Honors
Mellon Fellow in Reproductive Endocrinology and Infertility, 1988, awarded for academic excellence in the Reproductive Sciences, for research efforts aimed at development of novel contraceptives.

Wyeth Service Award for Physician Education and Training in Norplant Contraceptive Implants.

Certificates of Service and Appreciation from Our Lady of Mercy Medical Clinic, Guadalajara, Jalisco, México, 1978-1982.

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