Assessing ovarian reserve as best as possible is the single most importnat thing one can do in the managment of fertility/reproduction. not to say of course other things like male testing are cruical as well, just second in importance to reserve of ovaries. This is because egg issues cannot be corrected to the degree that male factors can. We cannot make mroe eggs and follicles so if thre are low numbers this has profound implications on how one manages things as well as profound impact on treatment outcome, even with IVF.
Assessing reserve with simple blood work an US is key and takes very little time. However the results can change everything.
In IVF with low responders, there are some protocols that are better than others. There are various medications and additional things, especailly in patients with prior failures, that can optimize the results and offer the best chances. Pre-treatment for females BEFORE the IVF cycle can also be of help...antioxidants for example are one thing that may give couples a leg up but have to be taken BEFORE the cycle of IVF. Again, there are other things that also can be used in these cases with the protocol that can be of beneift as well as things t;like HRSS (see elsewhere on this blog) that can optimize fertilization in cases where there are low numbers of eggs.
So keep these things in mind when embarking on fertility evaluation and make sure these are looked at, if diagnosed with low reserve investigate treatment options/regimens.
Peter Ahlering MD
SIRM St Louis
pahlering@sherinstitute.com
Friday, November 6, 2009
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