Stories of Persistence
I know you are waiting for the blastocyst blog. I am just getting some photos together and will have it ready for next time.
Like it or not, the holidays are here. Maybe it’s a good time to spread a little message of hope. Now hope isn’t for everyone, but let’s face it, it’s probably the number one thing that keeps us going. It’s an emotion than can be applied rather universally, applicable to mostly all of our basic functioning.
Anything we need or want, we hope for.
As stories from the internet have shown, some women with low chances can become pregnant.
Here are a few of my own. And these are only a few out of many others, these just came to mind.
Ms. A was 38 when we met. Her FSH was 22. She was “dismissed” from another program. 2 years earlier she delivered, but this was after trying for 18 months. The sperm motility was a little low, but the sample was close enough to normal, ICSI was not needed.
She first tried a day 2 start, her FSH was 13,4, and was cancelled and converted to IUI because there were only 3 follicles. The plan: keep trying. Her second cycle never got off the ground because of a day 2 FSH of 17.7.
Her FSH was 11.9 on her 3rd attempt and she went on to make 4 eggs, 4 fertilized . On day 3 one looked good, the other fair. This ended in an early biochemical loss.
Her next cycle we changed up the protocol a bit. She had 4 eggs, and 2 embryos transferred, both looked good. This worked, and she just delivered.
So here we have a woman who most doctors would tell there is no chance, but she persisted.
Ms. B was 35 when we met. Her FSH was 14. Her resting follicle count was less than 5. She started a cycle with an FSH of 12, got 6 eggs, poor fert and a cancelled transfer for arrested embryo growth.
Her second cycle was cancelled for no response (not one follicle).
She got pregnant on her own. This theme is an internet favorite. Buy the way, she did not use DHEA.
Mrs C. was 36 and suffered from severe edometriosis. She did 2 IVF cycles before we met.
She did 3 more retrievals with me, always making a good egg number and having good embryo quality. She travelled long distance to get to NYU. On her 3rd cycle (5th total) she became pregnant.
The next one goes under the dumb doctor category (that would be me). Mrs D, a 38 year old from overseas, e-mailed me and told me about her FSH of 25. Realizing she was from far away, I tried to save her some travel time and money and told her IVF was out, but donor egg was in. The couple came to see me, heard the donor egg schpeal and as I finished the husband looked up and said that his wife was going to be day 2 in a few days, could they try IVF while they were still in the States? Without boring him with the low odds speech, I just said, “sure why not.”
Sure enough the FSH was 12, she made 9 eggs and delivered twins. I think they are happy with me, but I am sure they have their reservations.
How can we put these all together?
1) They about women under 40. I don’t mean to exclude the 40 and over crowd from the hope discussion, as there are plenty similar stories about women in their 40’s, but the facts support that it’s easier to beat the odds when you are younger.
2) FSH may not be as important as we once thought. Again, a bad FSH is better under 40. Every so often there is a paper or abstract reminding us that pregnancy rates shoot down with increasing age and FSH levels. Which leads us to the next point:
3) Some infertile women can at times become pregnant on their own. We do use this fact when recommending that some women cancel their cycle or give up on IVF. We say yes you can get pregnant with IVF, but your odds are low, about the same as getting pregnant on your own. Of course this is much more difficult concept to accept when there is a severe male factor.
So for Mrs. A, C, and D, their persistence is what lead to their success. They did not accept the advice of a doctor; they did what they felt they needed to do. Of course we have to keep in mind that it is also true that there are women who try and try unsuccessfully.
Sometimes the fertility establishment is criticized for giving a bit too much hope, while profiting nicely from tons of women who are needlessly spending tons of dough. And sometimes we are criticized for not giving an infertile woman the chance she deserves.
But it will always be true that for most women with low odds, there is a small chance, and sometimes their only chance, using IVF. So it all goes back to getting to the right clinic and getting informed about your odds. After that it’s between you and your doctor, sometimes with a little tug of war.
Dr. Licciardi
Like it or not, the holidays are here. Maybe it’s a good time to spread a little message of hope. Now hope isn’t for everyone, but let’s face it, it’s probably the number one thing that keeps us going. It’s an emotion than can be applied rather universally, applicable to mostly all of our basic functioning.
Anything we need or want, we hope for.
As stories from the internet have shown, some women with low chances can become pregnant.
Here are a few of my own. And these are only a few out of many others, these just came to mind.
Ms. A was 38 when we met. Her FSH was 22. She was “dismissed” from another program. 2 years earlier she delivered, but this was after trying for 18 months. The sperm motility was a little low, but the sample was close enough to normal, ICSI was not needed.
She first tried a day 2 start, her FSH was 13,4, and was cancelled and converted to IUI because there were only 3 follicles. The plan: keep trying. Her second cycle never got off the ground because of a day 2 FSH of 17.7.
Her FSH was 11.9 on her 3rd attempt and she went on to make 4 eggs, 4 fertilized . On day 3 one looked good, the other fair. This ended in an early biochemical loss.
Her next cycle we changed up the protocol a bit. She had 4 eggs, and 2 embryos transferred, both looked good. This worked, and she just delivered.
So here we have a woman who most doctors would tell there is no chance, but she persisted.
Ms. B was 35 when we met. Her FSH was 14. Her resting follicle count was less than 5. She started a cycle with an FSH of 12, got 6 eggs, poor fert and a cancelled transfer for arrested embryo growth.
Her second cycle was cancelled for no response (not one follicle).
She got pregnant on her own. This theme is an internet favorite. Buy the way, she did not use DHEA.
Mrs C. was 36 and suffered from severe edometriosis. She did 2 IVF cycles before we met.
She did 3 more retrievals with me, always making a good egg number and having good embryo quality. She travelled long distance to get to NYU. On her 3rd cycle (5th total) she became pregnant.
The next one goes under the dumb doctor category (that would be me). Mrs D, a 38 year old from overseas, e-mailed me and told me about her FSH of 25. Realizing she was from far away, I tried to save her some travel time and money and told her IVF was out, but donor egg was in. The couple came to see me, heard the donor egg schpeal and as I finished the husband looked up and said that his wife was going to be day 2 in a few days, could they try IVF while they were still in the States? Without boring him with the low odds speech, I just said, “sure why not.”
Sure enough the FSH was 12, she made 9 eggs and delivered twins. I think they are happy with me, but I am sure they have their reservations.
How can we put these all together?
1) They about women under 40. I don’t mean to exclude the 40 and over crowd from the hope discussion, as there are plenty similar stories about women in their 40’s, but the facts support that it’s easier to beat the odds when you are younger.
2) FSH may not be as important as we once thought. Again, a bad FSH is better under 40. Every so often there is a paper or abstract reminding us that pregnancy rates shoot down with increasing age and FSH levels. Which leads us to the next point:
3) Some infertile women can at times become pregnant on their own. We do use this fact when recommending that some women cancel their cycle or give up on IVF. We say yes you can get pregnant with IVF, but your odds are low, about the same as getting pregnant on your own. Of course this is much more difficult concept to accept when there is a severe male factor.
So for Mrs. A, C, and D, their persistence is what lead to their success. They did not accept the advice of a doctor; they did what they felt they needed to do. Of course we have to keep in mind that it is also true that there are women who try and try unsuccessfully.
Sometimes the fertility establishment is criticized for giving a bit too much hope, while profiting nicely from tons of women who are needlessly spending tons of dough. And sometimes we are criticized for not giving an infertile woman the chance she deserves.
But it will always be true that for most women with low odds, there is a small chance, and sometimes their only chance, using IVF. So it all goes back to getting to the right clinic and getting informed about your odds. After that it’s between you and your doctor, sometimes with a little tug of war.
Dr. Licciardi
posted by Dr. Licciardi at 3:46 PM
25 Comments:
Thank-you, thank-you, thank-you for this post. I am 37 years old, highest FSH was 12, did my first IUI with an FSH of 7.2, 100iu of Puregon and got 3 follies. Did not end up pregnant, but I still have hope.
I started dhea and acupuncture in April '08 when I got my high FSH diagnosis and was having irregular cycles (30 days, then 19, then 29, then 18 days) for the first time in my life. My cycles have always been short and are now between 24 and 27 days. In August my FSH was 7.2., my cycles are back to normal and I ovulate every month on my own. I attribute this to the acupuncture. My question is -what is your take on acupuncture as an additional treatment for women like me? Also, do you think having a short cycle all of my life was a contributing factor or a sign that I would be "running out of eggs" in my 30s?
Dr. L,
Do you think it matters what the FSH is at the start of the cycle? Do you think it is better to wait for a lower FSH to start an IVF stim?
Thanks
Caryn in Chicago
I did notice a BIG difference between RE's attitudes about IVF once my hydrosalpinges were diagnosed. DH and I just are not comfortable with DE from several perspectives. This may change later, but, I am doubtful.
This is not to disparage DE as a choice for others, but I really think doctors are "too comfortable" with it as a solution. There are some very real ethical and religious issues that seem to be ignored by many in the medical community.
I hate, hate, hate hearing these stories. I had a miracle pregnancy (we had severe mfi) with IUI - he died shortly after birth in the early third trimester. We did IVF 4 times, once with half ds. Once chemical, 2 miscarriages (one after a heartbeat). We only had one BFN - the one with DS.
Always had at least one top grade embryo - this at a clinic with an 80% success rate with DE. Normal FSH, good looking eggs (between 10 and 20 each cycle) good looking embryos.
In desperation, at 39 tried DE. It worked. Happy that it worked, but did I try hard enough with my eggs?
Thanks for such an encouraging blog. I just found out this morning that I have another canceled cycle (first due to mono, second due to ovulating through the drugs I was on). So I am feeling a bit discouraged, but will try again in January.
Thanks for your blog, I have really appreciated all your insight.
-Rachael
Hi Dr. Licciardi,
Thanks for your blog- it is very informative. There isn't much info on unexplained infertility though. I have been trying for more than 5 years now with no success, everything is normal, bloodwork, S/A, ultrasounds, ovulation, HSG- I recently did a lap and hysteroscopy and it came out normal too.
My only issue is EWCM- I never got it before, NEVER. My CM is always creamy and/or thick. I haven't tested sperm antibodies or post coitals, my RE won't cooperate, thinks it's insignificant.
She's jumping right into IUI but i really need to know if there are reasons my cervix isn't producing EWCM.
I was a victim of molestation starting at age 5, no penetration, but I did masturbate with various objects on my own starting around 7 but did rub against things since 5 - i really think now that that could be my problem... what would you say?
any thoughts?
Please help!
-XYZ
I'm new to this blog, but I've heard you answer questions posted in the comments section.
I just failed my fourth IVF (three local, fourth at CCRM). I'm 34, highest FSH is 9, AMH 1.8, treated for endo. First two IVFs (FSH only) low maturity rates but good fertilization, but only a few embryos because of low maturity rates to start with. Third and fourth IVF better maturity rates (finally pushed follicles to 21-22 mm at trigger) but horrible fert rates (all with ICSI). Third and fourth cycles FSH + LH.
On the last cycle, the embryologist said the eggs looked dysmorphics--dark and grainy with some fragmented polar bodies. The embryologists on IVFs 1-3 did NOT see this.
Fourth cycle: E2 soared quickly, after 4 days of stims was 2600, LH got to 7.8, and E2 eventually hit 6900 despite coasting for 1/3 of the entire stim phase.
My question is this: could protocol, super high E2 so fast, high-ish LH (that fell to 1.0 by the end), and so much coasting have made poor eggs/dysmphoric eggs, or am I grasping at straws here??
OK, sorry that was so long. Just desperate for answers.
Thanks--ADD in TX
ADD in TX: Additional Info
I realized it might be helpful to have details of the cycles:
IVF #1: long lupron, FSH only, 11 eggs retrieved, 6 mature, 5 fertilized, 3dt of 8 cell and 7 cell embryo.
IVF #2: long lupron, FSH only, 15 eggs retrieved, 6 mature, 4 fertilized, 3 dt of 9 cell compacting, 8 cell, and 4 cell
IVF #3: Antagonist with FSH/LH, 8 eggs retrieved, 7 mature, only 1 fertilized, 3dt of 6 cell (finally waited until follicles much bigger to trigger,trying to overcome maturity issue)
IVF #4: microdose flare: 20 eggs retrieved, 14 mature, 2 fertilized initially, one fertilized on second day, 3 dt transfer of 7 cell embryo and day two 4 cell (lots of coasting on this cycle, lots of LH, very high E2)
Sorry this is so long :)
Hoping you can give some advice.
ADD in TX
By far, the medical profession gives people like me with an FSH of 15, age 38, no hope. We have to "forum shop" from RE to RE to find someone just willing to treat us. My first RE would not treat me in any given cycle unless my levels were under 12, while at the same time she warned me that I was running out of time and needed to act quickly. Talk about a no win situation! Thank you for this important blog, so that others with high FSH know that it is not necessarily a fertility death sentence.
Hi Dr Licciardi - thank you for your blog!
My question is about multiples: at 34, am I better off getting 2 embryos put back and living with the increased risks of pre-eclampsia, low birthweight etc, or going for one, which means a lower chance of success (and that, in an ideal world where everything works, will also mean trying for a second baby when I am 36 or 37?)
Thank you!
Mrs C, UK
Thank you for this blog! I am 37 and my husband and I have had four miscarriages, no live births. (We seem to conceive easily, at least -- all conceptions were on the first try, and natural with no medical interventions.) At least two of them were chromosome issues (one was Trisomy 16, and one had Turner syndrome).
I just had CCCT... day 3 FSH was 6.5, day 10 FSH was 7.8, which my doctor claims is good... any idea then as to why all our pregnancies end up chromosomally abnormal? Four losses can't be a fluke, right? (All RPL testing is also normal across the board.) We want to TTC again but I don't have the heart to go through yet another loss.
Thank you so much for this post. I have commened several times during the past months and you've always answered my questions. We had three failed IVFs this past year trying for a second child. I asked you every protocol question I could think of.
You posted to me that you thought we should keep trying. And we did. Our forth IVF, a year to the date of our first, just ended with a beta of 587 at 18dpo. We made some major changes and had the best cycle we've ever had.
Thank you for saying that we shouldn't give up. I'm so thankful we didn't.
Dr. L,
Been reading your blog for a while, and it's been really great. I am one of those many people who was told I had a bicornuate uterus until I went to a specialist, after having multiple ultrasounds and an MRI done, and then I was informed of the septum. I hope this question is in the right place :)
My question is that I have PCO, and haven't had regular periods since I was about 16/17 (I didn't even start until 15). Basically, unless I'm on birth control, even after Provera, I don't have a period at all. I was prescribed metformin, which I have been on for about six months, and then in September I tried a cycle of clomid, at the lowest dose. It didn't do anything at all, and it was during the monitoring ultrasound from the clomid that they saw that my uterus was unusual. I'm seeing a fertility specialist in Atlanta now for the septum, and getting ready to plan and schedule the surgery to remove it. My question just was that since the PCO/no-ovulation problem hasn't been resolved, and I have never been pregnant, much less had a miscarriage, should I get the surgery done? Or should I get the PCO straightened out and then try a couple of cycles and see what happens? My doctor himself mentioned that he had a patient that had three healthy pregnancies, no miscarriages, and she had a very large septum that they discovered after the fact. Do you think it's worth trying my odds first, before getting it removed?
Thanks!
Thanks you Dr. L for the stories or perserverance that inspire hope. What keeps me going is knowing that at some time there will be light at the end of the dark, long tunnel. Thank you for providing such an informative blog.
Dear Doc,
Every compliment about this blog is more than deserved! Big cheers for writing it.
In very short: I'm 30, the mister is 33, we're both overweight (huge BMI for me) but healthy and active. Non-smokers, non-drinkers, we eat right and exercise. My FSH was 6.1 I believe, everything else looked right. I have had a pregnancy ended with an elective abortion a few years ago with another man.
He is azoospermic -non-obstructive they said- so we hurried into a self financed ICSI try. SSR was performed and 40% of the testes are producing healthy, motile sperm, the hormone results were right, the genetic profile was perfect.
I was on a short protocol with 300 ui of Puregon, Ovitrelle (I think for the trigger) and Aspirin. 11 ovoccites retrieved at EC, 8 mature, 80% fertilization so 6 embryos of which 3 grade A. We had two put back at day 2 -the result was a BFN/suspected chemical and 4 were left to achieve blasto and according to the clinic they all died before they did.
We're waiting for our only free try (and the only other IVF try I am wanting to try before we move on to DIUI) and so I'd like us to give it the best chance possible, I have a few questions.
- How damaging is high BMI really? - My hips/waist ratio is not bad at all, I'm quite muscular and proportionate and all my blood results are perfect-
- My lining was only 6 at transfer, could this be why? What can I do to determine if my lining is insufficient, HSG, lap?
- Fresh sperm is preferable to frozen sperm I understand, is this true? Could it be that embryos arrested in development after day 3? Should we insist on MESA on the same day and fresh being used?
- Blasto is a better idea than 2dt, of course but with 6 embryos it's no surprise we didn't get any, right? Is there any way more eggs can be produced or was I on a very high dose already? Would you advise Lupron instead of Puregon?
- With 40% working tissue and good hormone levels, why would they diagnose it as non-obstructive? Is it possible that sometimes sperm appears in the ejaculate? -we believe we have had another chemical while TTC naturally-.
Thank you in advance for even reading this!!!
MissAma
Hi Dr. Licciardi,
I found your blog linked through another site and I have been reading through your entries this morning. Great information!
I was wondering if you wouldn't mind giving me input on what our next step should be. I had one 8 week miscarriage with D & C, 2 chemical pregnancies, then had a daughter in 2006, totally normal and healthy pregnancy and child.It took seven months after last chemical pregnancy to conceive her.
During our recurrent miscarriage testing, I have one copy of MTHFR, but my Homocystine levels are normal, so I take Folbic. No other issues for my husband or I. I also have congenital aortic stenosis with a tricuspid valve, but have no symptoms. Daughter has no murmur.
We began trying again last December, I ovulate normally every month, but we haven't been able to get pregnant. I take Progesterone 3dpo due to possible short luteal phase. I know the Prometrium can make my periods heavier, but they keep getting worse and worse every month. I consulted an RE last month, had all bloodwork redone, no problems. Had first sonohystogram and HSG this week, both totally normal. Tubes open, uterus tilted backwards, but said that wouldn't be a problem. My husband's SA had normal volume, 83 million total, 75% motility, slightly low morphology at 5%. Previous test last month had good count and motility again, but worse morphology.
RE said I may have some endo, but no way to tell unless we do a lap. What are your suggestions on what to do next? I also have a very small amount of fertile CM, if at all, every month. (Not sure if that is important.) We are both teachers here in Nevada and have minimal infertility coverage - IVF is out of the question. I would love to know your thoughts!! Worth trying IUI?
-Sara in Las Vegas
Dr. L -
As a sidenote to my previous entry, my Day 3 tests showed my FSH is 5 and my antral follicle count was 27.
Thanks!
-Sara in Las Vegas
Dr. L.
I am a 31 yr old guy. My wife is 33yrs old. We have been trying for over a year now. After doing the initial set of tests for my wife and I, we found out the following about my sperm quality. I have done 2 tests so far:
Test 1
======
Volume: 3.0 mL
Count: 35 giga/L
Motility: 60%
Morphology:
-- normal forms: 1 %
-- abnormal forms: 99 %
-- immature forms: 5 /100 sperm
Viscosity: Normal
Test 2
======
Volume: 5.0 mL
Count: 19 giga/L
Motility: 50%
Morphology:
-- normal forms: 1 %
-- abnormal forms: 99 %
-- immature forms: 15 /100 sperm
Viscosity: Normal
Does the low morphology mean I have no chance? What exactly does my test result entail? my wife's results turn out to be normal. What course of treatment, if any, has the highest chance given that we do not have a lot of time? Is it true that moms over 35 have a higher chance of delivering a baby with downsyndrome condition?
hope to hear from you on this.
Have a happy Xmas Dr.
I stumbled across this blog today, and I can't believe how much information is here! Thank you so much for taking the time to share this will of us who are TTC.
I wanted to ask a question about my situation. I'm 31 years, was on birth control pills for about 15 years. We've been TTC for 11 months. After coming off the pill, my periods were very long (36-40+ days). Finally tried ov tests, which came back negative and I went 90 days between cycles (that cycle started only after progesterone). OB/Gyn put me on clomid for 4 months, and ov tests were positive for ovulation, but no pregnancy. At that point I went to a fertility doc.
Fertility doc did an ultrasound and I had the "string of pearls" that you often see with PCOS. However, so far my bloodwork has come back normal (waiting on AMH and repeating LH because I had just ovulated). I also don't have any of the physical symptoms of PCOS (not overweight, no hirsutism, no acne, no thinning hair, etc.)
Despite normal bloodwork and no physical symptoms, my fertility doc says she thinks I have a "PCOS-like condition." Ok, fine. But I'm wondering, could my anovulation be caused by something other than PCOS?
(By the way, I had an HSG which showed everything was open and a Sonohystogram which should a relatively large polop (8mm by 10mm) that I need to have removed).
hello,
thank you for your blog. it is very encoutraging. I am at the beginning of my infertility journey. am 33 and ttc for 2 years.
I just started temping and noticed that my temp does not spike till 4 days after my LH surge pee stick result?
Is that bad? do you put much stock in temping?
thanks!!
Dr L: Thank you so much for your hope words. I am just starting with IUI cycles. Yesterday my doctor told me that since I am over 40, my FSH was 18, and I am out of eggs, and then she will only do 3-4 IUI cycles and then stop.
Despite I cried all night, I don't feel like giving up so easily. I believe that individual probabilities are not the probabilities that come out from the studies for a certain population.
I am so grateful because I have a wonderful 5 year old (on my own, and only tried 2 months),just 6 months after my husband had a colon and a liver cancer surgery. I remember doctors telling me how low were his chances of just surviving. But here we are alive and happy together.
To everybody, good luck with baby making and also and with all the other things in your life.
Thanks for your blog, I've referred to it often during days of despair.
I was diagnosed with POF in March 2008, 39 years old; FSH was tested twice--25 and 35.
I was told by my doctor to monitor and try on my own, but I was still getting monthly periods, so the diagnosis was wrong.
After months of herbs and acupuncture I was curious and so went for another day 2 FSH. The result? 3.7!
The next month my FSH was low enough again to start Clomid. My doctor said he'd never seen anything like it.
Again this month, my FSH was 3.5, but my doctor tells me I still have a 10% (only!) chance of conceiving (and this is with IUI). I am not 40 years old and wondering what you think of this.
Thank you!
I just wanted to say that I am part of an online community of women dealing with infertility. Among us, we probably have every problem in the book but never has anyone been explained such problems in the manner and understanding that you have. You are not only an amazing Dr. for taking the time to do this but an amazing person. Thank You!
I do have a question and understand if you aren't able to get to it because honestly, Im not really sure where I belong anymore. My husband (30) and I (26) ttc for 2 years. HSG was normal. Bloodwork: normal. I ovulate every month...albeit it with some variation (29 days, 33, days, 27 days ect.) Lining is perfect, uterus tilted but good shape. Husbands SA was good; count 170mil; morph was normal, motility was normal but he did have "moderate" agglutination (clumping?) but Dr. said not a big deal since enough were doing the right thing and no antibodies or white blood cells were found. Did Clomid for 2 months. 2nd month with trigger and conceived. Baby had slow hb and fetal growth from the beginning and no hb at 9 weeks. Considered missed ab since the growth was at 7wks and levels still rising. Had to have D&C.
My question. Is this sperm clumping thing really a bigger deal than Dr. is making it out to be? Also, do I continue on and assume clomid with trigger is my solution or do I move on to IUI ect..? Am I still considered infertile since I conceived? I guess I really don't know my odds of conceiving again. Will they be higher?
I go to the clinic that likely dismissed one of your patients (is it in Colorado?) ... anyhow, I love them.
I am 31 years old, FSH is 12.3. I have had 4 natural m/c's - we tried on 4 cycles, we conceived all 4 times.
I make TONS of follies when stimulated. One clinic (based out of Vegas - with lots of branches) couldn't get but 5 mature and 1 mature egg in 2 respective retrievals. I went to the infamous Colorado clinic and they got 14 mature eggs. (and now I'm pg with 1 great ultrasound behind ... here's hoping for more good news as the weeks and months pass)
Here, here for Doctors who don't dismiss elevated FSH girls!!!
I posted about 1.5 years ago on the high FSH blog, despairing about my high FSH level -- my first FSH test came back at 43, and I was 38 (almost 39) at the time. Subsequent FSH tests showed high levels, too.
I'd like to share my "story of persistence": About 3 months before my first FSH test, I got pregnant naturally but miscarried. My specialist in the Bethesda area told me I had a 15-18% chance of getting pregnant, but was willing to work with me and my husband. On my third try (first IUI round, next IVF round cancelled due to poor response, and third IVF round got 3 eggs, only 2 were good) I got pregnant and now have a beautiful, healthy baby girl. And, now at age 40 (will be 41 in a few months), I found out I'm pregnant naturally. As my doc said, his practice doesn't test the FSH of every woman driving down I-270, so FSH is only one factor that goes into the equation. If you're trying to conceive, I encourage you to get to a GREAT doc; it makes a difference. And, Dr. Liccardi, as always, thanks for sharing your knowledge and advice. Your blog is a wonderful resource for those going through infertility.
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