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What Does My Hormonal Test Results Indicate?

Posted on Fri, 31 Oct 2014

Question: Hello. I am 41 years old and want to have a child. My day 3 hormonal test results were: E2- 38.58 FSH 5.3 LH 1.6 and AMH 2.045 ng/ml. My thyroid hormone levels were: TSH 2.48, T4 1.23 and T3 3.57.
In your opinion, do I have chances of success with IVF or any other conception method, using my own eggs? Also three small fibromyomas (less than 3 cm in diameter) were discovered in the uterus walls, which are giving me no problems so far. Do I need to remove them before conception, or the natural approach will be best?
Thank you for your help and advice!

Answered by Dr. Soumya (8 minutes later)

Brief Answer:
IVF soon

Detailed Answer:
Hello,

Welcome to healthcare Magic.

I have gone through your query and Would like to reply in detail as follows:

1. IVF is better considering your hormonal profile as well as your age.

2. Fibroids if away from cavity need not be operated. But ultrasound scan should confirm it.

3. Hysteroscopy might be needed to check uterine cavity and see if fibroids are encroching endometrium and can be removed if they are there.

4. I dont think you should wait for natural pregnancy. Time to go for IVF soon.

I hope your doubt is clarified. Let me know if you wish any other information.

Regards,
Dr. Soumya

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Soumya (4 hours later)

Many thanks Dr. Soumya!

Based on my tests, shall I be concerned about any component of the results in particular, and is there anything I can do to improve it in the meantime, while I wait for the IVF process to start?

The ultrasound has confirmed that the fybromyomas (ranging 2-3 cm in diameter) are: fundal, interstitial posterior and interstitial anterior. Shall I keep them under control or remove them?

The endo thickness was 6.74 mm, and the uterus was measuring: L 9.38, W 6.72 and H 5.93 (cm).

I forgot to mention that I am also overweight, BMI 34. Shall I try to lose weight before I go for IVF, or shall I start it right away?

Thank you again for your help.

Best regards,
XXXX

Answered by Dr. Soumya (2 hours later)

Brief Answer:
IVF

Detailed Answer:
Hi

I would not prefer you waiting to loose weight as age is increasing.

Removal of fibroids not necessary. But hysteroscopy is necessary to make sure they don't affect implantation.

Your reports are not bad but age is more and thats the only concern.

Go for IVF soon

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Soumya (2 hours later)

Thank you again. Do you think I have chances to produce a sufficient number of good quality eggs for ivf? Given my age, is ivf or icsi the preferred option? Can any remaining eggs be freezed for future use?
Can I take any supplements to improve my chances of successful ivf?

Answered by Dr. Soumya (5 hours later)

Brief Answer:
ICSI

Detailed Answer:
Hi

You may not produce good quality eggs. But in that case you have to opt donor eggs.

ICSI is better than IVF.

No use of taking any suppliments.

If there are sufficient embryos available they can be frozen.

Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Soumya (7 hours later)

Thank you for your response. Is it possible that even with good test results ( better than average for my age) I may still not be able to produce good quality eggs? What factors may be influencing this?
Best regards.

Answered by Dr. Soumya (44 minutes later)

Brief Answer:
Age

Detailed Answer:
Hi,

The best judge is egg itself. Other reports might give an idea about possible quality and quantity of eggs. But checking eggs under microscope is best way to decide egg maturity.

Your age influences it.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Soumya (6 hours later)

Hi Doctor,

Does it mean that even with normal test results (FSH, LH, AMH etc), which are believed to predict good egg quality and quantity, there can still be chromosomal or other problems found with the eggs retreived? Are these all age-related? Is there any way that any such problems be identified in advance?

Thank you and best regards,
XXXX

Answered by Dr. Soumya (9 minutes later)

Brief Answer:
Yes

Detailed Answer:
Hi,

You are right. Inspite of all tests being normal, it is clearly known that chromosomal or other problems are very much likely as age advances ( especially after 40).

One way to identify is get PGD ( preimplantation Genetic diagnosis ) on the embryos after IVF / ICSI procedure to choose chromosomally competent and normal embryos and transfer them into your womb.

Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Soumya (57 minutes later)

PGD is not allowed by law in the country where I live. Is it considered essential for women over 40, and does it substantially increase chances of successful pregnancies by IVF/ICSI?
What about DHEA supplementation? Is it recommenfed in my case?
Many thanks!
XXXX

Answered by Dr. Soumya (8 hours later)

Brief Answer:
PGD

Detailed Answer:
Hi

DHEA is not of much use in youur case.

Yes. PGD increases successful normal embryos transferred and there by decrease miscarriage possibility.

Regards

Above answer was peer-reviewed by : Dr. Yogesh D