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Infertility Cubby

Pregnancy With Elevated FSH Level
By Sam Thatcher, MD, Ph.D.

Sam Thatcher, MD, Ph.D.Q. I was diagnosed with possible ovarian depletion in summer '98 (FSH of 11.9-13: other values normal) at the age of 40. With the help of alternative therapies, I got pregnant in a couple of months, just before I was to start Gonal F treatment. I've never been sure if my original diagnosis was too doom-laden, if I turned it around with my own research and treatment (my cycles certainly became longer and my periods much fuller), or if I just got really lucky. I have a beautiful son of 18 months, who is still nursing heavily, including at night. I have only recently returned to regular cycles, and my question is: has the prolonged amenorrhea (over two years including the pregnancy) done anything to preserve whatever fertility I have left? In other words, can I assume that I am more or less where I was two years ago? I ask this because I am 42.8 and would love to have another child, but my husband has no interest in trying for one till his professional life (and our financial situation) turns around. I can't seem to get a straight answer to this question - maybe there isn't one! Thanks for your input.

A. An elevated FSH, which yours was, does not exclude a pregnancy, just predicts the response to ovarian stimulation with medications. The body attempts to preserve ovulation for as long as it can. With massive amounts of fertility drugs still you may have only ovulated only a single egg. Your story is not uncommon, but unfortunately, the miscarriage rate is increased. Obviously, you were smiled upon. I would repeat the FSH level. I do not know of significant risks, other than financial, of fertility therapy, but it may be a rough trip emotionally and one you might decide to avoid.

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