January Fertility Treatment Chat with Dr Aimee

Jan 19 2011 in Infertility Chat Transcripts, Trying to Conceive by Nancy

This post is a transcript of our 1/17/2011 Fertility Treatment chat with Dr Aimee Eyvazzadeh.  The post is broken up into 5 pages.  Please use the navigation at the end of each section to proceed to the next page of the transcript.

Nancy: Hello all! If you have a question, please feel free to ask it at any time. Dr Aimee will be answering questions begining at 8pm Eastern 

DrAimee: Hi Nancy. Thank you for organizing the chat

Nancy: Good evening, Dr Aimee! Thank you for hosting this chat with us.

DrAimee: You’re very welcome.

DrAimee: Hi Everyone. Welcome to our Live Chat. My name is Dr. Aimee Eyvazzadeh. I’m a Reproductive Endocrinology and Infertility specialist. Which basically means I went to school for a really long time to learn that an egg+sperm= baby.

DrAimee: We’re here tonight to talk about Fertility Treatment.

DrAimee: The topic is broad and there is no question that is off limits.

Maria (guest): Hi Dr Aimee and Nancy. Can you tell me at what point you would move from IUI to IVF?

  • DrAimee: Very personal question.  How old are you:?

Maria: I am 37

  • DrAimee: The most important question you need answered is “what is my fertility diagnosis.”
  • If it’s a male factor infertility (low sperm quality) then move to IVF after a couple of IUIs or go straight to IVF depending on the sperm situation.
  • If it’s an egg issue (higher FSH levels) I would also do a very minimal number of IUIs and then move to IVF.
  • I like to re-evaluate every treatment cycle if it doesn’t work with my patients and you can ask your docs to do the same.
  • If a cycle doesn’t work go back and talk to your doctor and ask your doc: what did you learn from this cycle? What would you differently next time? Should we be more aggressive?

Faith ‘N’ Fertility Journeys: What measurement is acceptable for a womans uterus lining to start IVF, meaning what is too thick?

  • DrAimee: This is a great question.
  • Women with a thick lining going into an IVF cycle may have one of the following conditions:
  • ~ submucosal fibroid, polyp, or endometrial hyperplasia
  • What I would recommend if someone’s lining is greater than 8 mm or so and appears homogeneous is a cavity evaluation.
  • Your doctor can do a saline infusion sonogram, or office hysteroscopy
  • These procedures can then tell you what the next step should be before going into an IVF cycle. You want to make sure the cavity is going to be the perfect home for your embryo.

Becky Bell Delaney: Trying for six years to become pregnant, with no luck. Last February I got Laparoscopy and the doctor found endo all over both ovaries and had my uterus stuck against my abdominal wall. I am yet to become pregnant. My doctor recommends hormone shots. What do you think the chances are of it working?

  • DrAimee: So this is what I worry about in your situation:
  •  1. even if you take hormone shots the eggs aren’t going to find the way to the fallopian tubes because of the anatomic challenges we are facing
  • 2. the endometriosis is toxic to eggs and causes eggs to age faster than they should
  • So my recommendation: Ask your doctor about going to IVF. Take the shots and collect the eggs and put embryos back into your uterus.
  • It sounds like maybe the eggs are going to have a hard time finding their way.

ShellyA (guest): I have been on 100MG of clomid for 3 cycles now. I feel as though my doctor does not want to budge from clomid. What are my options?

  • DrAimee: Chances of shots working without knowing your age or more information is probably about 10-15%
  • Shelly, I don’t think trying clomid after more than 3 cycles is going to help.
  • So questions we need to ask are again: what is your fertility diagnosis. What is the sperm quality? Are your tubes open?
  • If after 3 cycles of clomid, we aren’t pregnant, I would recommend: FSH injections with IUI or FSH injections and IVF.
  • I have my patients do a really cool protocol called a hybrid protocol
  • It’s a combination of fertility pills and shots.
  • 5 days of Femara+3 days of FSH with insemination.
  • It has the same pregnancy rate as FSH-IUI but with lower medication costs and monitoring costs.
  • But your doc should feel comfortable doing this type of protocol.
  • If anyone is interested, email me, and I can email you a mock calendar: email@draimee.org

ShellyA (guest): Thank you

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