I have started the initial tests for infertility and found my FSH is good at 8.2, my AMH is low at .23 so my doctor is definitely very focused on the AMH and is anxious for me to start IVF. I have wanted to postpone …I’d also like to try to 2 more months naturally to see if we have any luck becaus they have been monitoring me naturally for 3 months and each month I have ovulated with follicle of 18cm which makes me positive and less concerned with the AMH. Will my AMH really diminish that much in 2 months?

Jen

TGH replies

Jen, AMH doesn’t predict how many egg you’ll mature on a natural cycle; you would expect the one each month as you have noticed.

AMH is quite good at predicting how many eggs you will get with stimulation from fertility medications. If the AMH value is right, you may expect 1-3 eggs with maximum doses. That’s not a very high number (we prefer 10-15 with IVF) so it is no surprise that you clinical team is “rushing”. I can’t tell you what the best choice is for you. I am sympathetic to your desire to continue to try naturally for a little while longer, and two months would not be expected to make a difference.

I have been a hypo thyroid patient after my pregnancy 2 years ago and have been trying to get get pregnant now since 6 months with no luck.

thanks

TGH responds:

Dear Linda:

Hypothyroidism should be treatable with thyroid replacement, such as L-thyroxine.

When you are pregnant, your estrogen levels will rise, and that will necessitate a 30 to 50 percent increase in your L-thyroxine dosing.

Estrogen levels may also rise if you find yourself in a fertility clinic. It has been six months, so it is not unreasonable to start the process through your doctor to see if treatments are required. Many treatments will involve raising estrogen levels, so be sure to speak to your clinical team at the time, as to the necessity of increasing your thyroid replacement medications as you go through treatments. I hope that helps.

Was just wondering, how do you deal with high levels of natural killer cells? I have had recurrent pregnancy losses, and have high nk cells.

Thanks,

TGH replies

We test for Natural Killer (NK) Cells as part of our autoimmune screen, part of a panel of tests for recurrent pregnancy loss.

The most frequently recommended treatment for elevated NK counts will be intravenous immunoglobulin. Both the test (NK cells) and the treatment (IVIG) are controversial. Consequently, it can be very difficult to find IVIG treatments in Canada, even if your personal physician is believes in the intervention.

Just recent my doctor discovered that i have a pre-cancerous cells in my cervix, now my question is, is this affect for me having a chance of having a baby?

Dear CJ

An abnormal pap test can sometimes lead to a referral for a special examination (”colposcopy) and ongoing treatments. The most common treatment is a LEEP procedure.

You should absolutely be able to have a baby after a LEEP procedure, though very occasionally intrauterine inseminations (IUIs) are necessary to get the pregnancy started.

Best,

TGH