Medical Issues Questions

Fibroids

Hi
I am 37 and have uterine fibroids
After trying to conceive for over two years we have been referred for ivf.
We have been told that fibroids shouldn’t be an issue however on a previous occasion when my gynaecologist wanted to see my ovaries they couldn’t be seen on ultrasound both on the tummy and vaginal because of the fibroids so I needed a mri scan to confirm that my ovaries were fine.
Will I be able to go ahead with ivf in particularly egg retrieval if my ovaries can’t be seen on ultra sound.
Many many thanks for your reply

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

It is a rather rare situation and you are absolutely right, if there is difficult access to your ovaries by vaginal ultrasound scan, it will be difficult to collect eggs. It is possible to do via laparoscopy (keyhole surgery), your local NHS clinic usually have access to theatre but special expertise would be required. You may also benefit from visiting a fibroid centre to see if you wood benefit from fibroid reduction procedure before IVF.

Clomid and excessive bleeding

Hi. I am patient at the clinic, with dr. Peter. I did had a question and call clinic, talked to the nurse but she couldnt help me. I am hoping that maybe dr. Peter or anybody else could because I am concerned and confused about it. Last time I seen dr. we agreed to wait for my next cycle to start clomid , injection and then iui treatment. It was June. On the 12/07 I finally started period but was bleeding for 9 days till 20/07. (I had been taking clomid before for 3 months with no results) I thought its normal spotting few more days since its my 1st month without medication. I have decided that will start clomid from next cycle. Sp on 14/08 my period start. I took clomid from day 2nd till 6th of my cycle. Today is 24/08 (11days) and I am still spotting which makes me very worry. I dont know if its normal? I would very appreciate an answer from dr or nurse.

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

Thank you for getting in touch. If you are already receiving treatment with us it would be much better to have this discussion face to face, or over the telephone so we can go through your patient notes and provide precisise information. Please could you telephone us on 0161 300 2730 and ask for either Dr Peter Kerecsenyi or Sister Samantha Potts and we will be pleased to help answer your questions.

What is the best option for us?

Hi, I hope you can help with this query. I'm not sure, but I feel that it may be an unusual issue and we are struggling to know who to turn to for advice.
Due to physical issues that my husband suffers with, we are almost completely unable to have full intercourse. We are desperate to start a family but really struggling to get any help from our GP other than "quick fixes" which don't really provide adequate solutions. We feel like we will never get anywhere at this rate.
Currently going through regular fertility testing, but if we come through this and find that all is OK, please could you advise the best course of action for us? Would IUI be a good option in our situation or would we be better to go straight for IVF? We are so keen to start a family and desperate for help but feel that we have hit a brick wall and unable to move forward. Really hope you can help. Thanks in advance!

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Our Expert's Answer

This information was published 1 year, 7 months ago and was correct at the time of publication. It may not reflect our current practices or regulations.

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

IUI treatment may be a better option for you both but we would need to understand more surrounding your situation. Please telephone our team on 0161 300 2730 and we can explain the benefits of both IUI and IVF treatment once we have a clearer picture of what treatment and support you have undergone via your familiy GP.

Primary testicular failure - SSR?

My husband has been diagnosed with primary testicular failure due to him having non obstructive azoospermia, low testosterone level (7.9nml) and high FSH level (22.3nml) . Is there any point in him going through SSR or should we just opt to using a donor?If SSR is still an option can you recommend which technique is most suitable.

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Our Expert's Answer

This information was published 1 year, 10 months ago and was correct at the time of publication. It may not reflect our current practices or regulations.

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

Research carried out at Manchester Fertility by our Urologist Mr Stephen Bromage showed that men with non-obstructive azoospermia and FSH level >10 had a 30% chance of retrieving sperm from an SSR procedure. The technique recommended would be an open testicular biopsy. Mr Bromage would be the best person to advise you as to whether this is the best option for you. If the result of the SSR is negative then we would be able to help you with treatment with donor sperm.

Do treat post UFE ?

Have recently underwent Uterious fibroid embolisation and am trying to get pregnant can you help?

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Our Expert's Answer

This information was published 2 years, 10 months ago and was correct at the time of publication. It may not reflect our current practices or regulations.

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

You need to wait to see the response of the fibroid treatment. If everything  else is normal like the egg reserve and your partners sperm, we can help you to plan a pregnancy.

Miscarriage

I am 43 years old and have suffered five miscarriages since November 2013. I have had all my recurrent miscarriage tests done and they have all come back as normal. Two of the miscarriages resulted in a D&C and after these I did not have a period for six months each time. My AMH was tested at 1.0 and the consultant that I saw said that I was in peri-menopause because of my blood results (these were taken after my first D&C in 2014. I know that because of my AMH that my chance of a live birth is very low but I cannot understand how I can get pregnant so easily. My last D&C was in May 2015 and I didn’t have a period until December. I then found out I was pregnant in January. Surely if my eggs were so bad I would not be able to conceive so many times and so quickly? I am looking at using a donor egg but wanted to know if there was any point doing IVF with my own eggs?

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Our Expert's Answer

This information was published 2 years, 11 months ago and was correct at the time of publication. It may not reflect our current practices or regulations.

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

Egg quality naturally declines by age and there is no exception. However even low quality eggs can form embryos. Whether the embryo implants depends on both embryo quality and the endometrium. In your case frequent implantation may mean your endometrium is less selective and poor quality embryos are implanting giving a positive pregnancy test. Your infrequent periods suggest early ovarian failure so I would advise donor egg treatment, as using good quality eggs/embryos gives a better chance of a successful pregnancy.

High FSH Low AMH

I am 37 years old and have been trying to conceive for about nine months. After visiting a fertility specialist, I found out I have high FSH (19) and low AMH (.3). The specialist has offered me three options - ovulation induction with insemination, IVF and donor egg. From all that I have been reading, my chances of conceiving with OI or IVF is slim to non. Advice?

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Our Expert's Answer

This information was published 2 years, 11 months ago and was correct at the time of publication. It may not reflect our current practices or regulations.

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

I would agree with your fertility specialist that your best chance to have a live birth is using donor egg treatment.

Do AMH levels predict menopause in PCOS women?

Do AMH levels predict menopause in PCOS women? I am 37 years old and AMH is 9.41 ug/l and I suffer from PCOS.

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Our Expert's Answer

This information was published 2 years, 11 months ago and was correct at the time of publication. It may not reflect our current practices or regulations.

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

Your AMH level is well above average in your age group. It is really good news. AMH is usually high in patients with PCOS as by definition it means high follicular activity. There is no test to predict when your ovaries will decline their activity and especially when you will go through menopause. At the moment the best predictor is to ask your mum and any older sisters. If no one went through menopause before age 45, then you do not need to worry.

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