One of the good things about being a bit type-A (oh did I not mention that I am an organization freak?) is that I like to be well informed about things. IF is no exception. So as I undergo my IF self study program I shall attempt to pass on these nuggets of wisdom in the hopes that other type-A’s (and type-B’s) can learn.
Before I discuss today’s topic I must provide this disclaimer: I am not in any way a medical specialist, nor do I work in the medical field. My information comes from Dr. Google and as such, please defer to your own medical expert before relying on the information I link to.
Today’s lesson: Eggs
A rather dated article from 1998, provides a good summary of why IVF can be such a crap shoot for some of us reproductively challenged, and explains what all those test results actually mean. Or you can read my short and dirty version:
We (women) are born with a limited number of eggs. We are born with millions of eggs, but by the time we get our first period, the numbers are in the hundred thousands. Then it is all down hill with each subsequent period. Much of the research Ive done says ovarian reserves are significantly depleted after age 35. But age is only one factor, two women of similar age can have very different eggs.
So how do we go about determining egg quality? This is where we start speaking in IF-speak:
FSH – Follicle Stimulating Hormone is the chemical that the brain releases when it wants the ovaries to mature. Once the egg has matured, the ovaries send a message back to the brain, and the FSH level drops. According to the article, this communication between the brain and the ovaries is somehow linked to the cells surrounding the eggs. So if there is miscommunication it boils down to the quality of the egg. So what is the ‘normal’ FSH level? Apparently this differs from clinic to clinic, the point is that at the beginning of a woman’s cycle (days 2,3 & 4) FSH should be low, around 2 – 7 units seems to be normal, anything above 25 is high. Anything in-between is the question mark. Also FSH will change from month to month. Abnormal FSH levels may indicate sub-par quality eggs, which means that IVF may not be so successful, because these eggs will be more fragile, and may not stand up to the rigors of IVF.
Estradiol (Estrogen) – Also known as the E2 level, goes hand in hand with FSH. An abnormally high E2 level (something over 100) will cause FSH to be lowered, so you need to determine both FSH and E2 levels to get a better understanding of egg quality.
LH – Luteinizing Hormone, this is tied to pituitary function. Sometimes the test for LH is used in conjunction with GnRH (Gonadotropin Releasing Hormone), the hormone produced by the hypothalamus, which stimulates the pituitary to release LH and FSH. High levels of both LH and FSH indicate primary ovarian failure. Lower levels indicate secondary ovarian failure, which is a problem with the pituitary or hypothalamus.
Progesterone – This should be elevated right around ovulation time, progesterone is the hormone which assists in developing the uterine lining. A test for progesterone is normally done within 7 days of ovulation.
Overall, if a woman is diagnosed with low ovarian reserve, poor ovarian function, or worse yet ovarian failure, the best course of action may be oocyte donation, or egg donation. Which brings us back to me. I guess I am lucky enough to know, without all that testing, that I do indeed have ovarian failure. I predict that my initial blood work-up shall result in a text book case of ovarian failure.
This saves me months, maybe even years, of wondering and stressing about IF, not to mention the money saved on unsuccessful IUI or IVF cycles. I am skipping the line right to egg donation!