Re: Ovarian Reserve
From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Thu May 6 20:20:57 2004
Thanks; I had the reference for Scott and actually got a copy today.
Also, local REIs came to lunch at our office today (they're marketing
and introducing a new physician) and I discussed it with them.
Garry
At Thu, 6 May 2004, Elrod Glen Maj 3 MDG/SGOB wrote:
>
>Scott RT, Hofmann GE. Prognostic assessment of ovarian reserve. Fertil
>Steril. 1995;63(1):1-11.
>
>Hofmann GE, Danforth DR, Seifer DB. Inhibin B: the physiologic basis of the
>clomiphene citrate challenge test for ovarian reserve screening. Fertil
>Steril. 1998;69:474-477.
>
>http://www.obgmanagement.com/content/obg_featurexml.asp?file=2000/10/obg_100
>0_00061.xml
>
>Here are a few references to look at. Dr Hofmann trained me and we used the
>clomid challenge test often in his practice. He used cutoffs for the day 3
>and day 10 FSH of greater than 20. I have seen IVF places recently that
>have used anywhere from 10 to 15 as abnormal in their population. He also
>looks at day 10 progesterone levels of greater than 1 as being abnormal.
>
>Indications for clomid challenge are age greater than 35, history of ovarian
>surgery in the past, poor response to stimulation or unexplained
>infertility. An abnormal test is an indicator of poor response to any
>treatments, clomid, IUI or IVF. Successful pregnancy is less than 5% with
>abnormal test. I've heard, but never read anywhere that miscarriage rate is
>as high as 70% if pregnancy does occur. I counsel women toward donor eggs
>with an abnormal test.
>
>I hope this helps,
>
>Glen
>
>D. Glen Elrod, Maj, USAF, MC
>Medical Director
>Women's Health Center
>Elmendorf AFB, AK 99506
>
>-----Original Message-----
>From: garrys@mindspring.com [mailto:garrys@mindspring.com]
>Sent: Tuesday, May 04, 2004 4:17 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: GYN: Ovarian Reserve
>
>OK, it is late and I've done a medline and looked in Speroff, but can't
>find an answer. My wife and child are waiting for me for dinner. . .
>
>Can anyone comment on FSH and estradiol levels in testing ovarian
>reserve?
>
>I am used to doing a day 3 or so FSH, and if it is 10 or more, that's
>trouble.
>
>I have heard that a day 3 estradiol is also helpful, but can't find
>information on that easily, or on a "clomid challenge."
>
>Might anyone be able to explain this and/or give a reference?
>
>Thanks,
>
>Garry
>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>
--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA
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