New to fertility testing - are these numbers decent? What do they really mean?


#1

Hi,

I’m 42 and have been TTC for about 9 months. We found out that my partner definitely has issues which would have been a large part of my inablity to conceive - regardless of my age…but I’m guessing that even with “perfect” sperm I would likely have problems at this point. I am using donor sperm to take his issues out of the equation and we are both fine with that.

Day 3 FH 8.9, Estradoil 51, ultrasound found 10 follicles.

My doctor seemed to be “happy” with those numbers and said that while I am on the decline that there is still a chance for me. The thing is, I have no clue what they mean.

We have decided to do IUI first because: 1) I’m not sure I want to go through IVF, and 2) because my insurance requires that we do at least 2 cycles of IUI before moving to IVF. My doctor says this is unfortunate as normally he would consider the IUI wasting time, but due to my partner’s issues he thinks it’s worth a shot. He also says it’s a good thing that this is not something I am depressed or stressed about - if it happens it happens, if not then I’m okay with that too. IDK if being stressed or relaxed or whatever matters but I’d love to hear if someone has any thoughts on the above numbers or can point me to another thread maybe that discusses this.

Thanks and best wishes to you all!


#2

:welcome: to the forum!

I’m not a fertility expert, but I’ll try to answer some of your questions. Your lab values do look pretty good to me. Your FSH and estradiol reflect how well you might respond to stimulation meds. If your FSH is high, then your body is already working hard to get you to ovulate and it will be harder for the drugs to boost that any further. They want your estradiol to be lower than a certain cutoff b/c if its high, it can make your FSH look artificially low.

Your antral follicle count shows how many potential follicles (or eggs) you might get if you do stim meds. The higher the number the better.

Another lab test the RE might have done is for AMH. This is supposed to tell you how many potential eggs you have left.

This is a link to a great website that explains a lot of the fertility tests and options. It’s for a fertility clinic, but not the one I go to. I just use it for reference.

Day 3 FSH Fertility Test of Ovarian Reserve

The problem w/ all of this testing is that it doesn’t quantify how many good eggs you have left. Unfortunately that mostly correlates to your age. Once you hit your 40s it’s a fast downhill slide. :frowning: the reason (I think) most REs prefer IVF for ladies over 40 is the eggs are taken out and fertilized, so you know how many fertilize and what they look like before they go back in. Plus, you can try for more eggs, giving you a better shot at finding the ‘golden’ one. W/ IUI they are usually not quite as aggressive in trying for egg numbers (they don’t want you to have a litter of babies) plus they don’t know how many actually fertilize. Although for us older ladies they will usually do an IUI w/ more potential eggs than they would let someone in their 20s. I had a successful IUI at 39 1/2 yrs w/ three follicles. Only one child resulted. But if I had been 25 yrs they probably would have canceled the cycle w/ 3 follicles.

I hope that answers a few questions! Oh, and try not to let that web site depress you too much. It has some depressing discussion of TTC when older.


#3

Thanks for getting back to me. The folicle count is what really confused me - I have no idea what that meant at all. I also have no clue if other tests were taken to determine how many eggs I have left. Guess I’ll have yet more questions when I go back Wednesday.


#4

Hi Eldo:welcome: Agr72 gave you some good info. Is it possible that based on your circumstances and age that your insurance will allow you to go to IVF after one IUI if that is not successful (if you decided to give IVF a try.) Time is a crucial part of this process at our age. They may require documentation to say why you need to do IVF vs IUI but I would advocate for that. Good luck.


#5

I would also suggest you nudge your insurance about IVF. Every month is precious at your age and the difference between 42 and 43 is huge. Also, your partner may have sperm issues that prevent him from being the biological father for IUI but you may still be able to use his sperm for IVF. That alone SHOULD put your insurance in a position of approving that you bypass IUIs. Another factor to consider is that if you do medicated IUIs you are actually impacting your antral follicle count and putting stress on your ovaries that will likely affect your response if you go straight to IVF after your IUIs. My doctor required that you have at least one cycle of rest. You also increase the chances of developing a functional cyst with IUI which would potentially mean you’d have to wait longer to do IVF. Anyway, I would talk to your insurance and to your doctor. As for your numbers, they are just one tiny piece in the puzzle of infertility. Unless you checked everything else (make sure your tubes are open, make sure your uterus is healthy, check other hormone levels, etc) then it’s hard to get the big picture. Also, FSH and Estradiol do a tug of war and sometimes your true levels can be masked. AMH is a much better indicator in this regard. Or doing a day 3 clomid challenge.


#6

Thanks again for all of the replies. My partner’s sperm is a no-go for any type of procedure and we are both okay with that so no point is “wasting time” with his! My insurance absolutely requires me to IUI first as there is nothing wrong with me aside from being old apparently (tubes fine, reproductive organs fine - all testing done now and everything is a go apparently). They indicated if I had a “medical problem” such as blocked tubes then they would forgo the IUI requirement - and honestly (as an attorney who deals with insurance companies for a living) I probably would have to spend more time trying to get them to forgo the IUI requirment than if I just did them! I did have a smally ovarian cyst that we treated with birth control pills and is now gone so I guess we are going to try IUI this month.

I’m really not 100% sold on doing IVF - if I don’t physically have a baby I really will be okay with that. We are pursuing adopting either way anyway so this was kind of a “let’s try” and see what happens procedure when we found out that insurance covered it. Initially we wanted to see if there was a problem with one of us (I have been pregnant before several years ago with a different partner so I really thought the only issue would be my age - his problems were a surprise to both of us and he has likely had them his whole life and just didn’t know). I really don’t like the process of IVF and my job is such that going through it may be a bit difficult to work around. I do know that every day counts in this situation, but again I think I’m not going to worry about deciding on that just yet…

I have no idea what AMH is or a Clomid challege or if that has been done. If it is the real indicator why wouldn’t the MD do one everytime? (Sorry, really clueless as to all this still! :))