Each month we host a live online seminar where patients can ask questions about infertility. The topic for each seminar changes, whether it is IVF, tubal reversal, egg donation, or more. In our first online seminar, the subject was decreased ovarian reserve. We were so pleased with the turnout and look forward to hosting many more!
(08/17/2011)
7:02
Fertility Solutions:
Welcome to Fertility Solutions Live Chat. Today’s topic is on decreased ovarian reserve. If there are questions on other topics, please save them for a future live chat.
Wednesday August 17, 2011 7:02 Fertility Solutions
7:04
Fertility Solutions:
Age is an important predictive factor of treatment success, although it is not the only factor doctors consider when making treatment recommendations.
Wednesday August 17, 2011 7:04 Fertility Solutions
7:04
[Comment From Tracy Tracy : ]
Does decreased ovarian reserve mean you can’t get pregnant on your own?
Wednesday August 17, 2011 7:04 Tracy
7:06
Fertility Solutions:
No, decreased ovarian reserve only means that there are perhaps fewer eggs than would be expected for a woman’s biological age, but it does not mean that she can’t conceive on her own.
Wednesday August 17, 2011 7:06 Fertility Solutions
7:06
[Comment From Kathie Cole Kathie Cole : ]
What causes Decreased Ovarian reserver, especially at a younger age?
Wednesday August 17, 2011 7:06 Kathie Cole
7:08
Fertility Solutions:
There are many factors: a history of previous surgery, prior chemotherapy, genetic causes and unexplained.
Wednesday August 17, 2011 7:08 Fertility Solutions
7:08
[Comment From Vidya Vidya : ]
Is day 3 FSH the only indicator of ovarian reserve? Could one have low reserves even with normal day 3 FSH levels?
Wednesday August 17, 2011 7:08 Vidya
7:10
Fertility Solutions:
This is a good question! Day 3 FSH hormone levels are not the only indicator of low ovarian reserve. A low antral follicle count (few numbers of small follicles at time of baseline US) and a history of low response to fertility medications even with normal hormone levels can be predicative of low ovarian reserve.
Wednesday August 17, 2011 7:10 Fertility Solutions
7:11
Fertility Solutions:
Here is a educational fact sheet from the American Society of Reproductive Medicine that describes some of the tests to evaluate ovarian reserve.
Wednesday August 17, 2011 7:11 Fertility Solutions
7:12
Fertility Solutions:
Aging and Infertility In Women
Wednesday August 17, 2011 7:12 Fertility Solutions
7:13
[Comment From Kathie Cole Kathie Cole : ]
Does low reserve also reflect in the quality if the eggs?
Wednesday August 17, 2011 7:13 Kathie Cole
7:16
Fertility Solutions:
In younger women, low reserve may not reflect the quality of eggs, only the number. In women, especially >40, low reserve may reflect lower quality as well as a lower response to fertility hormones or your own hormones.
Wednesday August 17, 2011 7:16 Fertility Solutions
7:17
[Comment From Adriana Swann Adriana Swann : ]
What can we do to have a better quality og the eggs at age 41?
Wednesday August 17, 2011 7:17 Adriana Swann
7:21
carol:
Improving the quality of the eggs is difficult, however, we can expose the ovary to different types of protocols and stimulation medications to maximize the number of eggs obtained at the time of the egg retrieval.
Wednesday August 17, 2011 7:21 carol
7:21
[Comment From Vidya Vidya : ]
what is the role of inhibin B in follicular development?
Wednesday August 17, 2011 7:21 Vidya
7:26
[Comment From Kathie Cole Kathie Cole : ]
What are the treatment options for decreased ovarian reserve?
Wednesday August 17, 2011 7:26 Kathie Cole
7:28
Fertility Solutions:
There are several protocols for low ovarian reserve, but they must be customized for each individual. Alternatively, egg donation can be a successful option for women with low ovarian reserve, resulting in clinical pregnancy rates of 50-60% in women who otherwise might have a success rate of
Wednesday August 17, 2011 7:28 Fertility Solutions
7:29
[Comment From Meghan Meghan : ]
Can Decreased Ovarian Reserve and age play a significant role in secondary infertility?
Wednesday August 17, 2011 7:29 Meghan
7:30
Fertility Solutions:
Yes. For example,some women who did not have a problem in conceiving their first pregnancy may have more difficulty or a longer time to conception with their second attempt for pregnancy because now they are older.
Wednesday August 17, 2011 7:30 Fertility Solutions
7:31
[Comment From Eileen Conway Eileen Conway : ]
In follow up to Vidya’s question. Is there anything I could do to help regulation of inhibin A and inhibin B?
Wednesday August 17, 2011 7:31 Eileen Conway
7:31
carol:
Concerning Inhibin B, this is a hormone that is felt to be a refection of the number follicles that are remaining in the ovary. This hormone works in conjunction with FSH. The higher the inhibin B the better, lower levels indicate fewer follicles. A better marker than Inhibin B is felt to be AMH antimullerian hormone, which gives us similar information and can be measured at any time in the cycle. Inhibin B needs to measured in the early part of a cycle.
Wednesday August 17, 2011 7:31 carol
7:33
[Comment From Vidya Vidya : ]
Is testing for this hormone part of the regular day 3 test? Do we usually have to request that this test be performed?
Wednesday August 17, 2011 7:33 Vidya
7:35
carol:
I am not aware of any reliable studies in which we can increase the inhibin B levels. There are a couple of small studies that have looked into using growth hormone, but it is unclear what the best dosages are and if this is truly an effective treatment. Male hormones… in very small doses have also been looked at with very variable results
Wednesday August 17, 2011 7:35 carol
7:37
Fertility Solutions:
Some labs will test for inhibin as part of a panel that includes the FSH and estradiol levels. It is unclear if an inhibin level adds more clinically useful information than just the FSH and estradiol level.
Wednesday August 17, 2011 7:37 Fertility Solutions
7:37
[Comment From Kathie Cole Kathie Cole : ]
How about embryo donation? Is that also an option? I wish it was discussed a lot more.
Wednesday August 17, 2011 7:37 Kathie Cole
7:39
Fertility Solutions:
Embryo donation is a viable treatment option, although there may be limited numbers available and the quality of the frozen embryos is variable.
Wednesday August 17, 2011 7:39 Fertility Solutions
7:40
Fertility Solutions:
We want to thank everyone for participating in our first live chat. Comments are welcome to [email protected]. Please take the time to take this poll about the best time for our next live chat.
Wednesday August 17, 2011 7:40 Fertility Solutions
7:41
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Wednesday August 17, 2011 7:41
7:43
Fertility Solutions:
Thank you so much for participating ! Please join our next live chat in a few weeks, time and date to be announced on our FB and twitter accounts, as well as our website.
Wednesday August 17, 2011 7:43 Fertility Solutions
7:48