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What Does The Following Blood Test Report Indicate?

Posted on Fri, 10 Apr 2015

Question: Hello doctor, I am 29 year female and got married 2 years ago. I have been trying to conceive from past one year.
I have done several blood test and the reports are as follows
1.) AMH=2.31
2)TSH = 1.74
3)FSH= 8.66
4)E2(serum estradiol)= 22
5) testosterone (total)= 0.31
6)ESR=19

Doctors says Badeline Ovarian Reserve, or diminishing ovarian reserves.
I have been given Xtracal tablet, Ovares tablet,Livogen-Z tablet, MHR tablet.

Can u suggest me regarding my problem with infertility.

Answered by Dr. Mahesh Koregol (16 minutes later)

Brief Answer:
Please get semen analysis and HSG

Detailed Answer:
Hi,

Thanks for your query.

I read your query and I understand your concerns about infertility.

Following is my reply:

1) Get Semen analysis of your husband to know sperm parameters.

2) Get Follicular scan for antral follicle count which is best method to predict ovarian reserve.

3) Get HSG ( Hysterosalpingogram ) to test patency of fallopian tubes.

4) You dont have borderline ovarian reserve.

I hope I answered your query. I will be available for any follow up query you have.

Regards,
Dr. Mahesh Koregol
IVF & Infertility Specialist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (39 minutes later)

Sir,
i have uploaded the reports which u have asked. Can u tell me the reason of infertility.
can u give any suggestions for improving the chances of conception after going through the reports.

thank you sir

Answered by Dr. Mahesh Koregol (5 minutes later)

Brief Answer:
Left tubal block needs evaluation

Detailed Answer:
Hi,

Thanks for additional reports. I saw them and they look fine except for HSG..

HSG shows left tubal block.

Tubal block makes pregnancy difficult.Please get diagnostic laparoscopy done to confirm tubal block and to open it if there is block.

Let me know if there are any more doubts.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (10 minutes later)

Sir,

In the reports the E2(estradiol)=22 seems to be out of range is it normal.I wanted to know whether it normal. My gynecologist has said that with one tubal open also there are chances of conception and if not able to conceive she said she will go for IUI. She said endometrium lining is thin on 10day and the no. of follicals are also low.
I have severe cramps and pain during mensuration while urination and bowel movement in my right abdomen. she said it may be endometriosis. I have blood clots during mensuration. And bleeding occurs to me only on first day and spotting on 2nd day and stops. I want to know whether this is normal.

sir are there any more suggestion that u can give me regarding the above.

Answered by Dr. Mahesh Koregol (9 minutes later)

Brief Answer:
Laparoscopy is needed

Detailed Answer:
Hi

If one tube is blocked the other tube is also generally abnormal. Hence Laparoscopy must before IUI.

Endometriosis is a possibility which is best diagnosed by Laparoscopy again.

Thin endometrium, blocked tube with reduced bleeding during menses also suggest possible tuberculosis infection. Please get PCR test done for tuberculosis During laparoscopy.

Let me know if you have any more questions.

Regards
Dr. Mahesh Koregol

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar