-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: Infertility Patient**Attention Repro Endos** From: Garry E. Siegel, M.D. (garrys@mindspring.com) Fri Oct 31 17:56:02 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Zach Newton: "Re: Oral Boards" Previous message: Diana Ewing: "[Fwd: HUMOR:Newsflash]" In reply to: Laurie Lovely: "Re: Infertility Patient**Attention Repro Endos**" > >>1. With the 2nd period after this event resolves, she'll do an FSH, LH, >>TSH and Prolactin on day 3. > >Okay. I would add estradiol (if it's elevated, it can lower FSH and >falsely reassure you as to ovarian function). Also, she's 38; why wait >for two periods? Well, I just figured that the next one after this event wouldn't be hormonally hunky dory just yet! >>2. If these are within reason (ie the FSH isn't too high, such as 12 or >>15 or what?), > >This depends on your assay. (Leeco, IMX, Abbott). We use Abbott and >levels >18 are abnormal. Also, would she still want to try to get >pregnant, no matter what her chances as indicated by FSH and/or Clomid >challenge test screening? For the readers, would you explain in simple terms how and when one does that (references for Bob, please). If that is an excessive request, never mind, or email privately. >proceed to an HSG since she a) might have had a recent >>tubal pregnancy, and b)her tubes haven't been assessed in years , and c) >>her tubes haven't been assessed since her laparotomy. > >okay. > >>3. After the above, if all is "go", that her husband have a Semen >>Analysis. > >Or S.A. first. could be abnormal, even if they just were pregnant. And >if it's really abnormal and her best chances are ICSI vs. donor sperm, >do they want to continue? If it is, and they don't, you save her the HSG >expense, pain, small risk of infection. I proposed the order of business as blood on day 3, and, if really crappy, then forget the HSG and SA (up to the patient to decide), as she may not wish to go the whole nine yards. His SA was normal over 15 years ago, so that is why I put the cycle analysis first, followed by the HSG (remember she's had a laparotomy and hasn't had her tubes reassessed). However, a SA is cheap, easy, and painless kinda. I'm going to give her a buzz and suggest they do the SA sooner, so that we can have the SA and the bloodwork, and then decide on the HSG. My intent was to get this done quickly, as time's a wastin' >>4. That she get an appointment with the local Repro guy after the above >>is in. > >Yeah cool. Sounds like this couple have a lot of decisions to make, as >they will likely be COH/IUI candidates vs. IVF candidates. I will be >interested to hear what the "real" RE folks on this list think. > >-- >Laurie Lovely, MD >RE fellow, UNC-Chapel Hill > -- Garry E. Siegel, M.D., FACOG Private Practice Roswell, Ga. Next message: Zach Newton: "Re: Oral Boards" Previous message: Diana Ewing: "[Fwd: HUMOR:Newsflash]" In reply to: Laurie Lovely: "Re: Infertility Patient**Attention Repro Endos**"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Mon Nov 2 05:24:54 2009

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.