Pamela: Hi Dr. Scott!!!!
vivian: hello all
angie: DR SCOTT: What role does the female body temp have in causing fertilization, cleavage, hatching and implantation?
drscott: Hello, I am here
Lindy: thank you, we all go through something. Yes I am still trying for number two with my new DH.
ginca: Lauren Dr Vermesh, Michael
wynn: hi doctor scott
Pamela: Okay everyone the star is here!
JANICE: I JUST FINISHED 4 IUI'S WITH MEDS AM NOW ON A BREAK AND CONSIDERING IVF IN JUNE/JULY VERY NERVOUS. UNEXPLAINED SLIGHT ENDO
laurenca: Liz, I wrote down your e-mail. In a couple of weeks I should be able to keep food down :) Would that be a good time?
LisaL: I am doing my last iui with Gonal f.I plan on starting treatments next month. I came here to get info.Right now I see Dr San Ramon in Mineola
Lindy: Hi Dr. Scott...
Liz: laurenca, what's your and your friend's dx?
Pamela: Who would like to ask Dr. Scott a question?
jean: anyone go to reproduct endo providence ri?
angie: Hi DR SCOTT: What role does the female body temp have in causing fertilization, cleavage, hatching and implantation?
JILLNC: Pamela do we just ask questions We need direction
mary: dr scott: i have 2 questions. my retrieval was on monday. i had 19eggs retrieved. 11 out of the 19 were ready for fertilzation. we did icsi and 9 out of 11 fertilized. there were 7 that the lab was waiting fo ron tuesday ...they said they would be mature and ready to fertilize. can these eggs also be used for freezing or is it usually the first day maturation. also...my doctor doesn't prescribe baby aspirin for a cycle...do you ?
Pamela: Yes, just ask your questions, if Dr. Scott doesn't get to you, reask the question...
laurenca: Good luck, Lindy.
Ginca, Dr. Vermesh is wonderful! His success rate is around 60% right now with IVF.
Hello Dr. Scott.
SussieG: Hello to everyone, and Welcome Moderators, and Thank you for your time it is very appreciated by us here at Fertile Thoughts...
Krista: Dr. Scott- I just had 2nd laprotomy for endo. Only have 1/3 ovary and 1 tube (scarred). We are supposed to start IVF in May. Would it be worth it to at least try IUI. I am 29.
jodi: hi dr scott, in dec i had ivf w/ic
they retreived 8 embryos all fertilized 3 were triploid theother
5 multinucleated could you please tell me if i should try agian
or just go on to egg donation
also can you explain multinucleation for me thank you
mary: lisal: where do you go for treatment
jodi: hi dr scott, in dec i had ivf w/ic
they retreived 8 embryos all fertilized 3 were triploid theother
5 multinucleated could you please tell me if i should try agian
or just go on to egg donation
also can you explain multinucleation for me thank you
Lynn28: Dr. Scott-- when is the right time to start progest. supp's after a chem pg/mc following 3rd IUI last month. I had low progest but didn;t start supp's until over 2 weeks post IUI??? Did this cause mc?
drscott: Body temperature impacts embryonic development but is probably more critical in vitro than in vivo. The bodies ability to buffer pH and a variety of other factors mean that embryos do well within normal daily temper fluctuations. Temperatures over 102 are probably deliterious. We always encourage patients to avoid extended exercise - especially after embryo transfer - because we do not know the absolute limits of safety. Nevertheless, routine activity is safe and should not be avoided.
ginca: LAUrenca I know im pg form my 1st IVF with him almost 6 weeks
William: Just so you know, there's 39 of us in here right now, so the chat may scroll by very quickly. I suggest typing a larger number, such as 50, into the Messages: box so you can scroll back further each refresh.
wynn: dr scott my dh has a very low sperm count 3 mil and low motility and morphology we aquired sample through withdraw during intercourse my re said to retest but she said it probably is still low she suggested ivf we have been trying to conceive for a year is ivf too soon for us thank you
angie: Hi DR SCOTT: What role does the female body temp have in causing fertilization, cleavage, hatching and implantation?
JILLNC: Dr. Scott First thank you for taking time to be here with us. What is estrogen's role in obtaining pregnancy? If prescribed when would it be taken and what is a normal dosage? Will this help the endomentrial lining?
laurenca: Liz, The only problem found with me and my DH was a sperm penetration problem (hamster test). But we do fine without ICSI with IVF. Go figure.
My friend had several ectopics and moved to IVF. They have a male factor issue too.
susie: dr scott -- how common is spotting during early pregnancy....i've
just had a successful ivf, but i'm
spotting...
DebOH: hello Dr Scott I have a question does havin high FSH levels
mean that IVF is the only possibility for, pg
orm would the shots help w just IUI
thank you
Cat: Dr Scott -- I just had lap last week to remove my tubes (fluid filled) and now I wait 6 weeks for IVF. Is there anything I should be doing between now and then -- it'll be my first IVF?
ginca: Lauren how far along are you??
laurenca: ginca, Congratulations!
SussieG: Dr. Scott - I have a question, I am on my 5th attempt with IVF, I have great eggs, which produced a viable pregnancy for my recipient in a shared cycle, but no pregnancy for me. Would I benefit from Estrace or some type of Estrogen Therapy ( as I read that on days 6-9 post retrieval Estrogen tends to drop significantly)?? Please share your thoughts and advice with what I can do next. I have tried Crinone 8% and Progesterone In Oil as a combination, and it does not work. I am willing to try anything....
Noelle: Hello Dr. Scott,
I started my first icf/icsi cycle last month.
I was on depot lupron, then bcp and started
daily lupron (.10cc) on Feb 23. I decreased
this to .05 on Monday and started 2 amps of
Gonal-F at 8am and 8pm today. My question
is this. I had a sono today and there were
only 4 follicles. I have another sono on Monday.
Will the Gonal-F make me produce more follicles?
Was I taking too much Lupron?
Thanks!
Liz: Hi Dr. Scott, I was wondering about E2 levels? I have been on stims 10 days and my E2 level is only 317. I have pcos and RE is being careful so I don't hyperstimulate. They increased my stims from 2 amps gonal-f to 3 amps. I'm so worried...What do u think?
mary: dr scott: is it common for the first ivf not to work. we had a perfect cycle and now we are doing number 2 ...we had alot more eggs this time and am doing all icsi to have mroe embies...is it common for ivf to not work the first time and to eventually work the second and third timel. i go to north shroe in manhasset.
laurenca: ginca, 8 weeks tomorrow.
ginca: Thanks lauren i have followed your posts in the past!
angie: thx Dr Scott; What type of implant rate does transferring a compacting morula have?
sam: hi, Dr. Scott,
ANy suggestions about side effects of progesterone IM..specifically severe constipation..I took citricil, altered my diet...drank lots of h2o..still no relief?
bebe: Dr. Scott, my husband has very low sperm count and moderately low sperm motility. he has slighly enlarged bilateral varicocele. Should be go for varococele surgery, or straight for icsi/ivf?
ginca: Lauren heres my email let me know how your doing!
sam: is dr. scott in??
KF: Hi and welcome Dr. Scott, I'm wondering what new info is out regarding treating implantation problems? We have had quality 8 cell embryos with 2 transfers, and no success, DH has normal SA quality, we think this may be our problem...Any thoughts? Thanks Dr. Scott
susie: i see great questions, but no answers...where are the dr. scott's answers??
drscott: In answer to Lynn 28 question regarding progesterone. The most common time to start is in the early luteal phase. It is actually unusual for Progesterone to fall low prior to 10 days after ovulation so that we have a pretty big window to safely start medications. It would be a significant error to start to soon. In regards to low progesterone and miscarriage. Please remember that in the substantial majority of cases, Progesterone is low in patients who are destined to miscarry because the hcg signal from the pregnancy to the ovary is too weak to keep the ovary producing adequate amounts of progesterone. The low progesterone is typically the result of a pregnancy with a problem and not vice versa. That is not an absolute rule and thus most RE's are conservative and prefer to treat with progesterone at any time there is a question of inadequate support - we probably over treat most patients. The progesterone is safe thus we would rather over treat than undertreat.
William: For those of you new here, hit the "refresh" button whenever you want to update the screen to follow the discussion. When you want to ask questions or make a comment, type your comment into the box and hit "send". If you "log out" by accident, hit your "back" button on your browser to get back in.
Also, if Dr. Scott doesn't answer your question the first time, just repost it a few minutes later. Use your "copy" and "paste" features to save time rather than typing the whole question back in.
JILLNC: Dr. Scott thanks for being here. What is the role of estrogen for pregnancy? If prescribed when is it usually taken and whats? the dosage?
jodi: hi dr scott, in dec i had ivf w/ic
they retreived 8 embryos all fertilized 3 were triploid theother
5 multinucleated could you please tell me if i should try agian
or just go on to egg donation
also can you explain multinucleation for me thank you
laurenca: Dr. Scott, I have a friend who has done IVF 5 times with a very reputable RE here in Los Angeles. She has yet to get pregnant. What implantation testing could she do? (Her embies are wonderful).
Jill: Dr. Scott, I had a normal pg from a previous marriage. My current HB and I have tried 3 IVF/ICSI cycles w/ 2 m/c. I am overweight, 60 lbs, does this effect anything?
sam: to bebe//my dh had the same problem..he skipped the surgery, we went ti reg IVF and had a great fert. rate....
Pamela: Dr Scott is trying to answer, but he is a little long winded...give him time...
laurenca: ginca, I will. I'm at .
Krista: Dr. Scott- Just had 2nd laprotomy for endo. Only have 1/3 ovary and 1 tube left. Supposed to be doing IVF in May. Would it be worth it to try 1 cycle of IUI first? (tube is slightly scarred)
Jasmine: What does FSH stand for?
ginca: Thanks lauren!
laurenca: Jasmine, Follicle stimulating hormone.
drscott: In regards to implantation problems. We know that the most critical component is still the embryo. If endometrial thickness, pattern, and blood flow are normal then the problem is more likely to be the embryos. Remember that the embryos from 25 year olds, 35 year olds, and 45 year olds all like the same under a microscope. Embryo morphology tells only part of the story
SussieG: Jasmine - FSH = Follicle Stimulating Hormone
mary: dr scott: i had my second ivf...the first didn't work. i am doing my transfer tommorrow. is it common fo rit not to work the first time but the second or third...i go to north shore in manhasset. they don't prescribe baby aspirin..do you?
also the retrieved 19 eggs. 11 were ready monday. 9 out of 11 fertilized with icsi...they said 7 more wwere ready about tuesday. do they use later maturation eggs to freeze?
Lynn28: Thank you Dr. Scott for that in depth answer!!!
bebe: To sam,
Dis you get pregnant from your 1st ivf. My husband gave me a 65% chance of success. i guess that is very good.
JILLNC: Dr. Scott thanks for being here with us. What is Estrogen's role for pregnancy? If prescribed when should it be taken and how much?
Lindy: Dr. If my temps fall below the coverline a few days after Ovulation and then again a couple of days later, is this indicative of Progesterone levels not being high enough, or does it more relate to what yo said before, vise versa.
jean: my husband had test bx +sperm yeah! we will be doing ivf w/in couple months very scared.
susie: can you comment of spotting in a 5 wk pregnancy...i am spotting
after a successful ivf.
laurenca: Dr. Scott, How can we find out about the embryo quality before we bother to transfer? Preimplantation genetic diagnosis?
drscott: Krista: With only 1/3 ovary and one tube left with probable adhesive disease IVF is your best chance by far. The issue will be ovarian responsiveness but you are best taking a direct shot at IVF and hoping that you will respond well
bebe: Sam,
sorry for the error, my doctor gave me a 65% chance. My husband knows very little about ivf. haha
wynn: dr scott considering ivf soon my dh recently had a SA we aquired SA through withdrawal during intercouse re said we need to retest reults were low count motility low and morph low she said this is probably all accurate do we have any chances of conceiving naturallt with counts like that
sam: to bebe..no but age was a factor, and the lab wasn;t good.. I got pg on my 1st IVF w/ Dr. Scott!
Dagney: Dr. Scott- I take beta tomm and am wondering if there are any sure fire pg signs since I'm also on progestrone??
William: **William waves to Rochelle**
angie: thx Dr Scott; What type of implant rate does transferring a compacting morula have?
Krista: Jean- We will be starting IVF in May. Is that when you think you will be starting? There will be a lot of cycle buddies.
Deb: DR. SCOTT I'm a poor responder to meds. I've had 3 IVF's cancelled because I've on'y produced 1 or 2 follicles each time. I have a persistent cysts that have been aspirated several times. My new protocol will be, 100mg clomid & 300iu of Puregon from cd2. Do you think this will increase my chances of more follicles, Or is it really just trial & error?
kjersti: Dr. We are doing icsi, medrol, baby aspirin and I'm on enbrel for RA..is there anything else that helps with implantation?
Pamela: William, how many people are here?
Krista: Dr. Scott- Thank you for your response
DebOH: Dr Scott I staretd my first cycle
and found out my FSH was 22 on day 10 is that too high too
conceive is there anything
that can be done for it ?
ginca: Krista i have the same dx as you and 1st IVF worked for me email me anytime
Jasmine: Dr. Scott,Had 1st IVF in Jan. It didn't work. We are now waiting to do FET but my period is 5 days late. Dr. wanted us to wait one cycle. Also, never rec'd answer why IVF did not work. 3 Grade 1 embryos were put in but did not take. What questions should I be asking RE? ttc for 5 years, 11 IUI's, 1IVF!!!
laurenca: Dr. Scott, Do you perform endometrial biopsy to test for presence of beta 3 integrin?
kj1: Dr. Scott - just received fertilization results from 1st IVF, 8 mature eggs - 3 out of 4 fertilized with IcSI, 0 out of 4 fertilized naturally. Dr. said sperm couldn't penetrate egg. Why? What can be done to remedy that problem (besides ICSI)? Thanks
sam: any way to counteract the IM Progesterone side effect of SEVERE Constipation???I drank h2o altered diet, Stool softner and citricil???
Stacey: Dr scott- I will be 29 next month just started synarel for first ivf. My fsh is 7.5 is that high for my age, could that mean that my egg quality is not that good? We are not doing icsi , my dh is fine, would it be a better idea to do icsi with my fsh level?? thanks
drscott: Laurenca: Evaluation of embryo quality is complex. There are 2 factors. The first is structural and can be assessed by a skilled embyrologist through light microscopy. The second is genetic and it can only be assessed by PGD. Some day we will assess all embryos for normality before transfer. AT the current time, the embryo biopsies are quite detrimental. At Saint Barnabas, we actually had lower initial pregnancy rates when doing preimplantation genetics in spite of the selection advantage. NO good method for pgd without hurting the embryos (a little) is avaiable at this time.
mary: dr scott: my first ivf failed. we had great embies...is it possible it sometimes takes two or three tries. if it doens't workt he first time is that an indication you will have problems.
justine: hello Dr. Scott. My dh and I have completed 6 iui (3 natural & 3 w/clomid 50MG) SA is excellent. Just unexplained. Do you recommend shots followed by iui or straight to ivf? thank you in advance for your answer.
jean: krista, not sure exact start date. we are waiting for a study-neither of our insurances cover it. possible may/june/july.
Lindy: Dr. Scott...
My temps drop twice during the luteal phase of my cycle. 1st a day or 2 after O, then again 2 to 3 days later. What do you think of this pattern in temps.
drscott: Justine: How old are you and how long have you been trying to become pregnant?
Rochelle: I'm about to start my 3rd IVF; have gotten pg. both times, but 1st was chemical and 2nd was possibly ectopic; my RE pretty much predicted it would happen based on my low estrogen level. I'm so scared of miscarrying again; (I mc at 7 wks after an IUI in the past)There's nothing one can do to prepare the endometrium???
JILLNC: Dr. Scott Thanks for being with us here today. What is Estrogen's role for pregnancy? If prescribed when should it be taken and what is the usual dosage?
William: 53, floor joists are creaking hehehe...
SussieG: Dr. Scott ~ I am currently on my 5th attempt with IVF,(fresh), I have excellent grade embryo's and they have been successful establishing a viable full term pregnancy (in my recipient - shared cycle). I have read that Estrogen Levels drop significantly on days 6-9 post retrieval. I have tried PIO & Crinone 8% for progesterone Support, but I am curious if I would benefit from Estrace or some kind of Estrogen therapy. I took Estrace and EV for an FET which resulted in a ++ beta test, but I miscarried early on. What are your thoughts? I am 29, para2 gravida2 2ndary bilat. tubal block
drscott: Lindy: BBT's are notoriously inaccurate - even when consistent. I would not base any evaluation or treatment on subtle BBT changes alone.
Sunny: Hello Dr Scott. I had retrieval today -- 6 of 12 were mature eggs. Any chance the others can catch up? We will have to use ICSI. Thanks.
mary: kjl: that happened to me the first time. did 1/2 icsi. i go to north shore in manhasset. this time did all ICSI and more meds and had much more fertilization. many times sperm isn't entering egg...icsi is the solution. where do you go for treatment
Jill: Dr. Scott, I had a normal pg from a previous marriage. My current DH and I have tried 3 IVF/ICSI cycles w/ 2 m/c. I am overweight, 60 lbs, does this effect anything?
bebe: To dr. Scott,
Do you recommend variococele surgery for husbands with less than 1 million to 2 million sperm count and 40 % motility, or would you recommend going straight to IVF. What are the success rates for a 29 year old with male factor. thank You
jodi: hi dr scott, in dec i had ivf w/ic
they retreived 8 embryos all fertilized 3 were triploid theother
5 multinucleated could you please tell me if i should try agian
or just go on to egg donation
also can you explain multinucleation for me thank you
laurenca: Thank you, Dr. Scott. This is what I was afraid of (regarding harm done from PGD). It makes sense that the more you mess with them, the less viable they will be.
Lindy: Thank you Doctor, that makes me very optimistic!
Jill: Dr. Scott, I had a normal pg from a previous marriage. My current DH and I have tried 3 IVF/ICSI cycles w/ 2 m/c. I am overweight, 60 lbs, does this effect anything?
kj1: mary - Rush in Chicago
JILLNC: Dr. Scott What is estrogen's role? If lacking and was prescribed when during the cycle would you take it?
drscott: Sunny: with 6 of 12 mature for ICSI then you have 6 that give you a real chance. In vitro maturation of oocytes almost never leads to embryos which can implant. They will fertilize and look normal but virtually never implant. The other 6 are still fine so hopefully that will be enough.
redsonya: Dr Scott. I have unexplained infertility, conceived one child without any "help" and have been trying to conceive for 2 years now. I was on Clomid for 6 months and had a mc in the 6th cycle. My question to you is...My Re now wants to try 3 IUI'S with Gonal-F, I had one done that failed but I respondes well and the RE was optimistic, he would like to do 2 more IUI's but I think 15% is a small percentage to achieve pregnancy with IUI...I do have progesterone troubles where my beta levels were fine and I had to take Crinone for both pregnancies. Should I move right onto IVF?? Remember I am 38 years old...
Lynn28: Dr. Scott--- I was exposed to DES and a t-shaped uterus, cocks-comb cervix, --and from other causes, one good and one partially blocked tube. I had one early mc (low progest)-- What are my chances that IVF will work for me-- will my mc rate be very high??
Lindy: Dr. Scott.......
Regarding a tipped uterus, soes it play a part in the sperms ability to find its way.
Liz: Dr Scott, I've been on stims 10 days my E2 was only 317. I have pcos and my RE is being careful so I don't hyperstim. He increased my stims to 3 amps gonal f from 2 amps. I'm also on .10 lupron. I'm worried about E2 level. I had about 3-4 follicles at 17, 18 and another 5 or so a bit smaller. Is that ok?
jean: krista, is may going to be your first ivf cycle?
wynn: dr scott how acccurate is a SA through withdrwal durong intercourse
Sunny: Dr.Scott, thanks for your answer. --Sunnhy
JILLNC: Dr. Scott what is estrogen's role for pregnancy> If lacking and prescribed what days of your cylce do you take it usually
Lindy: Dr. Scott,
Regarding a tipped uterus. Does it interfere with the sperms ability to finds it way?
drscott: JillNC: Estrogen supplemenation depends on the kind of cycle. In natural cycles it may be used to help cervical mucus. It may also be used to help endometrial thickness in some settings but remember that it alters the pituitary and thus your bodies mechanism for timing your surge etc and may mess up your cycle. During stimulated cycles, the higher estrogen should be enough. Estrogen is needed to make the endometrium proliferate and may have some small role in the second half of the cycle.
susie: dr scott..there have been several estorgen and progesteron sideffects
questions...
Lindy: Dr. Scott,
Regarding a tipped uterus. Does it interfere with the sperms ability to finds it way?
SussieG: Dr. Scott ~ I am currently on my 5th attempt with IVF,(fresh), I have excellent grade embryo's and they have been successful establishing a viable full term pregnancy (in my recipient - shared cycle). I have read that Estrogen Levels drop significantly on days 6-9 post retrieval. I have tried PIO & Crinone 8% for progesterone Support, but I am curious if I would benefit from Estrace or some kind of Estrogen therapy. I took Estrace and EV for an FET which resulted in a ++ beta test, but I miscarried early on. What are your thoughts? I am 29, para2 gravida2 2ndary bilat. tubal block
Carmendmun: Dr. Scott I am 35 yrs old planning to start IVF after ectopic ruptures (9years ago). My husband and Idid not have a problem conceiving before ectopics. I Have one (18yo child). What are the chances if I can only afford 1 IVF cycle???
drscott: Lindy
a tipped uterus does not inhibit the ability of the sperm to find the tubes and the oocytes
Jill: Dr. Scott, I had a normal pg from a previous marriage. My current HB and I have tried 3 IVF/ICSI cycles w/ 2 m/c. I am overweight, 60 lbs, does this effect anything?
Tracey: Dr. Scott,
Thank you for your time. I've had 2 ectopics naturally, then 4 out of 5 IVFs were successful but I lost each pregnancy. At 36 8weeks extra chrom, at 37 6.5 weeks normal male retroplacental bleed, at 38 normal boy/girl twins at 19 weeks amnio related, and at 38 9 weeks trisomy 22. I was planning to go to St. Barnabus for PGD to reduce my miscarriage risk. Will PGD lower my chances considerably? What do you recommend, I just turned 39.
Rochelle: Dr. Scott:Is estrogen given during an IVF cycle?? I know I took it during IUI.
mary: dr scott: I HAD 9 OUT OF 19 eggs fertilize...i had 7 left fo rthe next day to mature...can those be used too? also...do you prescribe baby aspirin and is it common for the fisrt ivf not to work?
JILLNC: Dr. Scott thank you My RE has suggested me taking it with clomid next cycle. What days will have to take it. I take the clomid days 3 - 7
wynn: dr scott are success rate the same for women under 30
KF: I'm 34 with history of low progesterone, is it true that Prog in oil has better initial absorption rate than Crinone? Also how much stock do you put in immune tx and beta 3 integrin treatment????? thx Dr. Scott
William: For those of you new here, hit the "refresh" button whenever you want to update the screen to follow the discussion. When you want to ask questions or make a comment, type your comment into the box and hit "send". If you "log out" by accident, hit your "back" button on your browser to get back in.
Also, if Dr. Scott doesn't answer your question the first time, just repost it a few minutes later. Use your "copy" and "paste" features to save time rather than typing the whole question back in.
55 people here now, biggest chat we've had so far :o)
kj1: Dr. Scott - got fertilization results from 1st ivf - none of the 4 given chance to fertilize naturally did. Re said the sperm couldn't penetrate the egg. Why? what can be done to correct this problem (besides ICSI-did that and got 3 fertilized)
Betty: Dr. Scott,
Does a short LP matter in an IVF cycle?
drscott: Carmendum: At age 35 in good program the ongoing pregnancy rates are around 60% per retrieval. These numbers vary dramatically between programs - but also vary dramatically from patient to patient within a given program. Good ovarian reserve with good eggs is still the most important factor
CL: I have just completed 3 cycles of clomid, should I ask my RE to start a 4th cycle or should I move on to something else?
mary: DR SCOTT: I AM TAKING PIO THIS TIME instead of crinone. is pio better than crinone
Lindy: thank you Doctor.
SussieG: Dr. Scott ~ I am currently on my 5th attempt with IVF,(fresh), I have excellent grade embryo's and they have been successful establishing a viable full term pregnancy (in my recipient - shared cycle). I have read that Estrogen Levels drop significantly on days 6-9 post retrieval. I have tried PIO & Crinone 8% for progesterone Support, but I am curious if I would benefit from Estrace or some kind of Estrogen therapy. I took Estrace and EV for an FET which resulted in a ++ beta test, but I miscarried early on. What are your thoughts? I am 29, para2 gravida2 2ndary bilat. tubal block
angie: thx Dr Scott; What type of implant rate does transferring a compacting morula have?
laurenca: Dr. Scott, Do you routinely test for missing beta 3?
bebe: Dr. SCott. Do you recommend Varicocele surgery for very low sperm count and moderately low motility, or would you recommend going straight to IVF. I am 29 and have a polyps in uterus which is being removed soon. What are my chances of success with icsi? thanks
Jill: Dr. Scott, I had a normal pg from a previous marriage. My current HB and I have tried 3 IVF/ICSI cycles w/ 2 m/c. I am overweight, 60 lbs, does this effect anything?
Liz: Dr. Scott, Have you heard of Rep. Partners in Redondo Beach?
Lynn28: William, how do I cut/copy/paste my message??
wynn: dr scott how accurate is a sa through withdrawal during intercourse
drscott: Betty: A short luteal phase should not occur in IVF if progesterone is being replaced. Otherwise it does matter. An ovary whose follicles have been aspirated may not function normally and if progesterone drops too fast you may lose a viable pregnancy. That is why we ask our patients to put up with all the progesterone which we know is no fun.
JILLNC: Dr. Scott Thanks for your answer. My re has discuss me taking the estrogen next cycle. What days will I take it> I do clomid days 3 - 7>
laurenca: Dr. Scott, What's the highest E2 level you like to see on day of HCG (for IVF)?
Chaya: Dr. Scott - I have two questions for you.
1.) Are there any disadvantages to using ICSI during an IVF cycle?
2,) I have done several cycles with injectables and IUI, and the problem is that the eggs mature before my uterus becomes thick enough. (The thickness is something like 5.8 max). Would this hurt my chances for a successful IVF cycle, and is there anything that can be done to help this situation?
jodi: hi dr scott, in dec i had ivf w/ic
they retreived 8 embryos all fertilized 3 were triploid theother
5 multinucleated could you please tell me if i should try agian
or just go on to egg donation
also can you explain multinucleation for me thank you
khein: What can be done to lower high FSH levels?
wynn: dr scott how accurate is Sa through withdrawal during intercourse
drscott: Wynn: A semen analysis through withdrawal during intercourse is OK if the numbers are great and everything is normal. If the result is suboptimal then you really do not know and a specimen collected through masturbation is still needed.
susie: what are the downsides and side effects of lots and lots of progest?
wynn: dr scott how accurate is Sa through withdrawal during intercourse
JILLNC: Dr. Scott Regarding Betty's question. I thought you said earlier it was better not to take progestrone until 10 days after ovulation????????????????????????????????????????????????????????????????
Jill: Dr. Scott, I had a normal pg from a previous marriage. My current HB and I have tried 3 IVF/ICSI cycles w/ 2 m/c. I am overweight, 60 lbs, does this effect anything?
Rochelle: Dr. Scott: Do you recommend taking estrogen supplements, like we take progesterone shots?after IVF; can it decrease chances of mc??
drscott: khein: A high FSH is only a symptom. It is easy to make an FSH go or up or down. That does not change the underlying problem of poor egg quality.
Janice: Dr Scott,
I have had high and normal FSH readings (ranges 5.5 to 12.4), have tubal disease (thickening), LUFS, and am 34. My RE says I have a 5-10% chance with IUI and a 1-4% chance with IVF. Other REs I have spoken to but am unable to see regularly due to location of my hometown in upstate NY have encouraged us to try IVF - what do you think?
wynn: dr scott can a women get preg naturally with low sperm count
Jasmine: how do you use the IP address
JILLNC: Rochelle where are you from?
drscott: Rochelle: We do not routinely supplement estrogen after IVF. We tried it years ago and it made no difference.
jean: is dr scott there anymore?
Lynn28: Dr. Scott- I am DES exposed and have a t-shaped uterus, cocks comb cervix, and from other reasons I have 1 good tube, 1 partially blocked. I had an early mc (low progesterone) following IUI. What are my chances of success with IVF?? Considering the DES -- is the mc rate high?
laurenca: Dr. Scott, Do you test for beta 3? And how high do you want E2 to be on day of HCG for IVF cycle?
cindy: Hi Dr. Scott - it's Cindy, your old patient. You performed my transfer on 9/5 and thanks to you, I am 7 months pregnant
Rochelle: JILLNC: I'm from NY
kj1: Learned today that DH's sperm cannot fertilize my eggs - can't penetrate the outside. Why? What can be done to remedy that (besides ICSI -- did that and got 3 fertilized)
wynn: cindy CONGRATULATIONS
Carmendmun: What should I be doing now to prepare my body for IVF?? Vitamins, excersise? Should my DH be doing anything??
drscott: Wynn: A woman can get pregnant with a partner who has a low count. It is just a matter of how low. When counts are below 1 million conception is rare (there are a few exceptions). In general counts below 5 million have a poor prognosis in vivo.
Didi: Dr Scott, I am taking 10,00 unit of Profasi this time, this is my first IVF. I usually have low progesterone after every IUI, do you think that this will help with a result in the end?
SussieG: Dr. Scott ~ I am currently on my 5th attempt with IVF,(fresh), I have excellent grade embryo's and they have been successful establishing a viable full term pregnancy (in my recipient - shared cycle). I have read that Estrogen Levels drop significantly on days 6-9 post retrieval. I have tried PIO & Crinone 8% for progesterone Support, but I am curious if I would benefit from Estrace or some kind of Estrogen therapy. I took Estrace and EV for an FET which resulted in a ++ beta test, but I miscarried early on. What are your thoughts? I am 29, para2 gravida2 2ndary bilat. tubal block
Jill: Dr. Scott, I had a normal pg from a previous marriage. My current HB and I have tried 3 IVF/ICSI cycles w/ 2 m/c. I am overweight, 60 lbs, does this effect anything?
JILLNC: Rochelle I thought you might be a Rochelle from NC. Sorry. You were asking about progestrone - have you had mc's
jean: kjl, i have heard something about assisted hatching.
jean: kjl, i have heard something about assisted hatching.
Pamela: Yes, Jean, Dr. Scott is there. People are asking complicatedd questions and there are over 50 people here! He is typing as fast as he can! I imagine that this is a little stressful for him!!
Tracey: Dr my fsh was 9 and e2 less than 25. I just turned 39, have had 4 successful IVFs (but lost all pregnancies)What are my chances?
KF: I'm 34 with history of low progesterone, is it true that Prog in oil has better initial absorption rate than Crinone? Also how much stock do you put in immune tx and beta 3 integrin treatment????? thx Dr. Scott
cindy: BEST OF LUCK TO EVERYONE HERE :) :) :)
redsonya: Dr Scott, is there a way to determine egg quality if you don't have IVF??
bebe: Dr. Scott,
do you recommend bilateral varicocele surgery for male with <1 -2million sperm and 40% motilty, ot IVF/ICSI. What are success rates for 29 year old woman with male factor. Thanks
angie: thx Dr Scott; What type of implant rate does transferring a compacting morula have?
justine: Hello Dr. Scott. We have unexplained dx. next choices are shots w/ iui or straight to ivf. we had 6 iui (3natural and 3 clomid 50MG).
Tracey: Dr my fsh was 9 and e2 less than 25. I just turned 39, have had 4 successful IVFs (but lost all pregnancies)What are my chances?
susie: how normal is spotting after a successful beta test???
Lindy: and to you Cindy!
drscott: Cindy: Congratulations on your pregnancy. I hope you are doing well. Please let me know whey you deliver. Hearing about the babies is the best part of being an RE.
sam: drScott,
any suggestions on how to counteract the side effect of severe constipation when taking Progesterone IM?
SussieG: Dr. Scott ~ I am currently on my 5th attempt with IVF,(fresh), I have excellent grade embryo's and they have been successful establishing a viable full term pregnancy (in my recipient - shared cycle). I have read that Estrogen Levels drop significantly on days 6-9 post retrieval. I have tried PIO & Crinone 8% for progesterone Support, but I am curious if I would benefit from Estrace or some kind of Estrogen therapy. I took Estrace and EV for an FET which resulted in a ++ beta test, but I miscarried early on. What are your thoughts? I am 29, para2 gravida2 2ndary bilat. tubal block
Jasmine: I don't know how to retrieve my answers...can someone please help me by typing the directions in the message space.
laurenca: Dr. Scott, I'm a court reporter. For a nominal fee, I'll transcribe your answers at the speed of light :) Actually, you're doing great!
drscott: Susie: It is very common to have spotting after a positive pregnancy test. It occurs in approx 1/3 of all pregnancies. It scares our patients to death but as long as it is less than a menstrual cycle it ususally is perimplantation bleeding and is not a threat to the pregnancy
Tracey: Dr my fsh was 9 and e2 less than 25. I just turned 39, have had 4 successful IVFs (but lost all pregnancies)What are my chances?
jodi: hi dr scott, in dec i had ivf w/ic
they retreived 8 embryos all fertilized 3 were triploid theother
5 multinucleated could you please tell me if i should try agian
or just go on to egg donation
also can you explain multinucleation for me thank you so muchhi dr scott, in dec i had ivf w/ic
they retreived 8 embryos all fertilized 3 were triploid theother
5 multinucleated could you please tell me if i should try agian
or just go on to egg donation
also can you explain multinucleation for mesi
Sandy: If I don't get pregnant in the next two month my doctor wants to start IVF. I would like to know the lenth of the process. I am 39 years old and have been trying for 4 months. I should mention that I had surgery 8 months ago to remove fibroids, which was very successful.
Lynn28: Dr. Scott- what are my chances of success with IVF-- I am DES exposed- t-uterus, c.c. cervix, 3 IUI's, last resulted in early mc, chem pg, low progest. Is my mc rate higher in general due to DES, and with IVF??
Stacey: Dr scott- worried about my fsh i am only 28 fsh is 7.5 e2 less then 10,
William: If your answer scrolled away, type a larger number into the "Messages:" box and hit "refresh". if you type in 99 it will let you go back quite a ways
Lindy: sam, try a stool softner, not a laxative.
SussieG: Jasmine ~ Hit Refresh, and you will get all the replies
Jill: Dr. Scott, I had a normal pg from a previous marriage. My current HB and I have tried 3 IVF/ICSI cycles w/ 2 m/c. I am overweight, 60 lbs, does this effect anything?
sam: to Lindy I took that also..no luck anything else
drscott: Tracey: Interpreting your fsh depends on the lab doing the test - there are many different measuring systems and they do not mean the same thing. Chances go down pretty severely after 4 cycles without a delivery. The prognosis depends on how far those pregnancies developed and the remainder of your recurrent miscarriage evaluation
SussieG: Dr. Scott ~ I am currently on my 5th attempt with IVF,(fresh), I have excellent grade embryo's and they have been successful establishing a viable full term pregnancy (in my recipient - shared cycle). I have read that Estrogen Levels drop significantly on days 6-9 post retrieval. I have tried PIO & Crinone 8% for progesterone Support, but I am curious if I would benefit from Estrace or some kind of Estrogen therapy. I took Estrace and EV for an FET which resulted in a ++ beta test, but I miscarried early on. What are your thoughts? I am 29, para2 gravida2 2ndary bilat. tubal block
wynn: dr scott did you say sperm counts under 5 mil have low success rate in IVF with ICSI
Lindy: Prune Juice? Soft diet. solids. Soups that sorta stuff. Gosh you must feel terrible!
redsonya: Dr Scott, where do you practice?
William: Jasmine, the IP address simply identifies your computer, it isn't used for anything else.
sam: to carmen
penatals for sure
Tracey: I had 2 ectopics naturally, then 4 out of 5 IVFs were successful but I lost the pregnancies. At 36 8week extra chrom, at 37 6.5 week normal male retroplacental bleed, at 38 lost normal boy/girl twins at 19 weeks amnio related, at 38 a 9 week loss trisomy 22. All miscarriage tests are normal, should we do PGD?
Jill: Dr. Scott, I had a normal pg from a previous marriage. My current HB and I have tried 3 IVF/ICSI cycles w/ 2 m/c. I am overweight, 60 lbs, does this effect anything?
angie: thx Dr Scott; What type of implant rate does transferring a compacting morula have?
JILLNC: Dr. Scott I'm on clomid days 3 - 7 what days would I take the estrogen
drscott: Jill:
Weight is not particularly important if you stil have regular cycles on your own. In those women with irregular cycles and increased weight there is a decrease in egg quality which can be a problem. More fragmentation is a problem for some but not all of these women.
Kathy2: Dr.Scott: I am 31, have stage 4 endo, 8 cm endometrioma on right ovary, cul de sac is obliterated, ovaries adherrent to each other, and bowel, and uterus. Should I go straight to IVF? Or do another lap, and then IVF?
Lindy: Dr.Scott............
What are the dangers of being unmonitored while on Clomid?
drscott: JillNC: The use of estrogen would be if your endometrium was thin or your mucus is too scant. You would begin the estrogn on day 11 and continue it through ovulation.
SussieG: Dr. Scott ~ I am currently on my 5th attempt with IVF,(fresh), I have excellent grade embryo's and they have been successful establishing a viable full term pregnancy (in my recipient - shared cycle). I have read that Estrogen Levels drop significantly on days 6-9 post retrieval. I have tried PIO & Crinone 8% for progesterone Support, but I am curious if I would benefit from Estrace or some kind of Estrogen therapy. I took Estrace and EV for an FET which resulted in a ++ beta test, but I miscarried early on. What are your thoughts? I am 29, para2 gravida2 2ndary bilat. tubal block
Deb: Dr. Scott. I've been told that it's rare to be over supressed with Synarel, but I'm a poor responder ( 1 or 2 Follicles each ivf) Next cycle I'll not be using the Synarel, but clomid & Puregon. Will this increase my chances of producing more follicles?
JILLNC: Dr. Scott I'm on Clomid days 3 - 7 what days would RE have me take the estrogen
KF: Is it true that Prog in oil has better initial absorption rate than Crinone? Also how much stock do you put in immune tx and beta 3 integrin treatment????? thx Dr. Scott
Pamela: Dr. Scott practices in Morristown NJ.
Betty: Dr. Scott - thanks for your time & answers!
I know that exercise is supposed to be kept to a minimum after transfer... how about swimming?
Carmendmun: Yes how do you use the IP address??
justine: dr. scott, We have unexplained dx. our next choices are shots w/ iui or ivf. what do you recommend. we had 6 iui--3 natural & 3 w/ clomid 50mg. i am 35.
wynn: dr scott did you say ivf rates were low with sperm counts under 5 mil
laurenca: Dr. Scott, I am 8 weeks pg from IVF. I was given estradial valerate shots every 3 days after transfer, and just stopped the shots last week. Is there any danger of my lining breaking down and causing miscarriage now?
Jasmine: Dr Scott, I think you answered but we missed it. 31 yrs old. 1st IVF failed in Jan. Waiting to do FET but period is 5 days late. Unexplained infertility. No answers given why IVF didn't work. 3 grade 1 embryos put in. ttc for 5 years. What kind of questions should I be asking my RE.
drscott: Kathy2: Defintely go straight to IVF. Surgery for stage IV endometriosis produces pregnancy rates in the best of hands of only 20%. Second procedures are no where near as succesful. A single IVF at age 31 is a far superior choice and is less invasive and less risky
Lindy: Pamela, How are we doing?
angie: thx Dr Scott; What type of implant rate does transferring a compacting morula have?
Lynn28: Dr. Scott- What are my chances of success with IVF with my DES exposure. Higher mc rate?? Had one mc due to low progest after IUI (early)
SussieG: Carmendmun ** the IP address identifies your server** it has no other function, to get your replies, hit the refresh button
JILLNC: THANK YOU VERY MUCH DR. SCOTT, PAMELA, AND FERTILE THOUGHTS.
Pamela: The IP Address are just there, we don't use them for anything
Mdavis: Dr. Scott, how do your pregnancy rates compare with St. Barnabas' IVF practice?
jodi: hi dr scott, in dec i had ivf w/ic
they retreived 8 embryos all fertilized 3 were triploid theother
5 multinucleated could you please tell me if i should try agian
or just go on to egg donation
also can you explain multinucleation for me thank you very much
Liz: Dr. Scott, I'm a little worried about my E2 level 317 after 10 days of stims. I have pcos and RE doesn't want me to hyperstim. My stims were increased from 2 amps gonal-f to 3 amps. and I'm still on Lupron .10. Isn't my E2 level too low?? This will be my 1st IVF.
wynn: dr scott did you say ivf rates were low with sperm counts under 5 mil
Pamela: Lindy, I think that we are doing great. I do think that this must be stressful for Dr. Scott! But I think that he is working through the questions!
Lindy: Dr.Scott...What are the dangers of being unmonitored while on Clomid?
SussieG: Dr. Scott ~ I am currently on my 5th attempt with IVF,(fresh), I have excellent grade embryo's and they have been successful establishing a viable full term pregnancy (in my recipient - shared cycle). I have read that Estrogen Levels drop significantly on days 6-9 post retrieval. I have tried PIO & Crinone 8% for progesterone Support, but I am curious if I would benefit from Estrace or some kind of Estrogen therapy. I took Estrace and EV for an FET which resulted in a ++ beta test, but I miscarried early on. What are your thoughts? I am 29, para2 gravida2 2ndary bilat. tubal block
sam: to Pamela
thanks for arranging this chat
drscott: Jasmine: Sorry about the failed cycle. 3 grade 1 embryos is great but there are other factors. Was your transfer easy, did they do it under ultrasound guidance, was your endometrium thick enough (8 mm or more), how did the rest of your embryos develop? There are alot of questions and your doctor will probably want to review your cycle with you from beginning to end. FET's are doing great today, almost as good as fresh cycles so your chances should be good. Good luck
jean: pamela, i can not believe there are so many questions. good job to dr scott. pamela are there more of these chats coming up?
Lindy: pamela, yes very stressful. But he is making his answers very easy to understand and that is most likely causing the majority of the stress <g> I like him.
Pamela: I just want to remind people that is we don't get to your questions, but I am sure that we will, we do have doctor moderated message boards on the AIA site. Just go to https://americaninfertility.org
Tracey: I had 2 ectopics naturally then 4 of 5 IVFs were positive but I lost them - at 36 8 weeks extra chromosome, at 37 normal male retroplacental bleed, at 38 normal boy/girl twins at 19 weeks amnio related, at 38 9 weeks trisomy 22. Karotyping, antibodies, HSG, cultures, doppler all normal. Should we do PGD with next cycle?
Stacey: dr scott- On day 4 of synarel for 1st ivf, do you think it is as effective as lupron?
Lynn28: Dr. Scott- what are the chances of success for IVF with DES?? Had 1 early mc post IUI - low progest. Are my mc rates higher-- with IVF and on own?
susie: i think this chat is great...can we continue without dr scott and share our expereicnes??
KF: Dr. Scott, is it true that Prog in oil has better initial absorption rate than Crinone? Also how much stock do you put in immune tx and beta 3 integrin treatment????? thx
ChristinaB: Dr Scott- I know that doctors do not know why endometriosis is linked with fertilty so I don't expect you to know either. However can you share some of the theories? Thanks!
angie: thx Dr Scott; What type of implant rate does transferring a compacting morula have?
Pamela: We like him too Lindy! He is on AIA's board of directors. He is very busy, in high demand, and trys to be generous with his time!
Betty: Dr. Scott - thanks for your time & answers!
I know that exercise is supposed to be kept to a minimum after transfer... how about swimming?
wynn: dr scott did you say that ivf rates are low with sperm count under 5 mil
Jasmine: Thanks Dr. Scott for the kind words. We really thought the fresh would work but hopefully you are right about FET's. Positive and sticky thoughts to everyone!!!!!!
laurenca: Thank you for your time, Dr. Scott! Bye everybody.
jean: dr scott, my hb and i have opportunity to participate in ivf study or pay for one cycle-do you feel the study will decrease our chances of success.
SussieG: Dr. Scott ~ I am currently on my 5th attempt with IVF,(fresh), I have excellent grade embryo's and they have been successful establishing a viable full term pregnancy (in my recipient - shared cycle). I have read that Estrogen Levels drop significantly on days 6-9 post retrieval. I have tried PIO & Crinone 8% for progesterone Support, but I am curious if I would benefit from Estrace or some kind of Estrogen therapy. I took Estrace and EV for an FET which resulted in a ++ beta test, but I miscarried early on. What are your thoughts? I am 29, para2 gravida2 2ndary bilat. tubal block
Pamela: Yes, you can also share your experiences with each other, and after the official chat is over, you will be able to stay in this room and continue on with each other.
khein: Dr. Scott: What increases success rates of preg. using good donor eggs?
justine: hello dr. scott, we have unexplained dx. have had 3 natural iui and 3 iui with clomid 50mg. do you recommend shots w iui or ivf? i am 35. thx
bebe: dr. scott.
do u recommend varicocele surgery for men with very low counts, or is ivf the best way to go. what are success rates for 29 year old with male factor
ChristinaB: I don't see where dr scott is posstingm am I missing something?
redsonya: Dr Scott, do you think thyroid function plays a part in infertility? I have regular cycles and am on synthroid .15 for a total thyroidectomy
drscott: SussieG: The drop in estrogen in 6 to 9 days in the luteal phase suggests that you may need more support. The estrogen is not the critical component - progesterone is. Remember that when estrogen production from the ovary goes down so does progesterone. I would really suggest you think about IM progesterone (no fun). The other issue is your tubes. Do you have distal tubal disease? If you have any hydrosalpinx or blocked distal tubes you may need to think about dealing with them before going on. Is your endometrium normal in development and appearance?
Pamela: Christina, are you hitting reload?
wynn: dr scott did you say ivf rate swere low with sperm counts under 5 mil
KF: Dr. Scott, is it true that Prog in oil has better initial absorption rate than Crinone? Also how much stock do you put in immune tx and beta 3 integrin treatment????? thx
Carmendmun: I think I missed the answer to my question 35 y0 two ectopics 9 years ago, one 18yo child
Lindy: Pamela, I am sure it is like bread upon the water. He is generous to be here and his skills are so valuable. I hope he knows how much it means to all of us to have this chance.
Mdavis: Dr. Scott, do you do blastocyst transfer? How successful is that process?
ChristinaB: I see his responses...thanks.
Betty: Dr. Scott - thanks for your time & answers!
I know that exercise is supposed to be kept to a minimum after transfer... how about swimming?
drscott: redsonya: thyroid is important in reproduction. If your levels are normal (ie a normal sensitive TSH and free T4), your body will be happy. It does not care where it comes from. There are some rare syndromes where thyroid problems are associated with ovarian and other endocrine hormonal problems. MOst people are just fine on their synthroid.
angie: thx Dr Scott; What type of implant rate does transferring a compacting morula have in the uterus?
sam: to Carmendmun
he answered it...
SussieG: Dr. Scott, Yes, my lining is great, 12.9, I have done Progesterone IM, and Crinone 8% as a combination. I do not have DTD, HSG detected bilateral blockage, - hydros
Pamela: Dr. Scott just told me that he is doing a lot of blastocyst transfer and it is going great! Can you tell us more about it Dr. Scott???
KF: Dr. Scott, is it true that Prog in oil has better initial absorption rate than Crinone? Also how much stock do you put in immune tx and beta 3 integrin treatment????? thx
drscott: Betty: The main problem with exercise is heat so swimming is great. It dissapates the heat as you go. Just reminder to "cool off" slowly after your laps
Melissainpa: HELLO EVERYBODY
Carmendmun: I MISSED IT?? How do I get it??
Haiki: Dr.Scott
Is it common for obgyn's to give patients clomid and have them do only bbt charts and no scans? Also, can you tell if the egg has dropped by the bbt only? Thank you for your time.
lisah: Dr. Scott, what do you like to see progestrone levels at before IVF retrieval?
redsonya: Dr Scott, if you have low progesterone when you should start supplementation? I had an IUI and my progesterone level was 6 a week later..
ChristinaB: Dr Scott- can you please share with me some of theories of why endometriosis and infertility are linked...I have stage 2. Are my chances gonna be significantly decreased if I put off getting pg for 2-3 years?
Pamela: Bill, can you help out Carmendmun???
Lynn28: Dr. Scott-- Please say a few words about DES-- Are my chances with IVF as good? I have the typical DES traights-- t-shape uterus, cc cervix, and h/o 1mc post IUI- 2nd to low progest. How will I fare with IVF? MC???
Tracey: Re my losses- 2 ectopics naturally. 4 of 5 IVFs successful. first loss at 36 8weeks extra chrom, 37 6.5 weeks normal male retroplacental bleed, 38 normal boy girl twins at 19 weeks amnio related, at 38 9weeks trisomy 22. What are my chances, should we do PGD? aal miscarriage tests normal
SussieG: Hi Missa... :o)
CL: Dr. Scott - I don't seem to ovulate on anything my RE puts me on- any suggestions?
wynn: dr scott did you say ivf rates were low with sperm counts under 5 mil
angie: thx Dr Scott; What is the implant rate for transferring a compacting morula in the uterus?
justine: hi dr. scott. we have unexplained dx. so far we have done 3 iui natural and 3 iui w/ clomid 50 mg. do you suggest shots w/ iui or ivf? i am 35. thx.
Melissainpa: sussie, is this my sussie??? from ny
KF: Dr. Scott, is it true that Prog in oil has better initial absorption rate than Crinone? Also how much stock do you put in immune tx and beta 3 integrin treatment????? thx
donna: Dr scott, I just failed my 5th IVF attempt (3rd to transfer). I had 11 eggs, of terrible quality, only 3 fertilized with ICSI, and only 2 made it to transfer. I'm 33 with normal FSH. Can you recommend any other treatment which might work other than DE? Thanks!
SussieG: Yes Missa, it is your Sussie :o)
toro91: I have stage 4 endometriosis and had a laproscopy in May, 1999. I have since gone through 3 superovulation cycles none of which were successful, I am thinking of doing IVF but was wondering if I should have another laproscopy before?
Lindy: Dr. Scott...........
What do you believe the dangers are of being on Clomid without monitoring?
Melissainpa: call me:)) I got news from re today
debbie: hello
Pamela: Bill, are the floor boards still creaking?
Liz: Dr. Scott, I my E2 level is only 317 after 10 days of stims. I'm worried I have been on 2 amps of gonalf and they increased it to 3 amps. I have pcos ans this is my 1st IVF and RE doesn't want me to hperstim. What do u think about my level? I have about 10 follicles, but only 3-4 are above 17mm.
susie: kf, i've had long conversations about
beta 3 with my re...we can chat
after the official chat if you want.
jean: dr scott, if i participate in ivf study will it decrease my success rate at all?
SussieG: ok, I can't find the number...LOL
Melissainpa: jean, where asi study being done????
KF: HEY DO I SMELL, LOL...Dr. Scott, is it true that Prog in oil has better initial absorption rate than Crinone? Also how much stock do you put in immune tx and beta 3 integrin treatment????? thx
redsonya: Dr Scott, thanks for the answer about the synthroid...would my progesterone level be affected also??
Melissainpa:
Lynn28: Dr. Scott- please comment about DES. What are my succes chances with IVF?? Higher mc rate?? I have typical DES traits-- small, t-uterus..etc.
Carmendmun: Can any one help me?? PAm saw you Lifetime spot very good Its great to put a face to a name it was nice "meeting " you
ChristinaB: Do we have to keep reposting our question?
Melissainpa: hi william, how r ya
Pamela: Dr. Scott....Can you help out KF??? : )
debbie: Dr. Scott, I was diagnosed with polycystic ovaries, but I have normal hormones and normal periods. What does that mean??
drscott: KF: three questions
1. progesterone in oil delivers the most consistent levels. Adequate studies are not available to say whether crinone is as good for implantation. Recent studies are mixed. I worry alot about the implantation so I think IM is best at least until the pregnancy test.
2. In the absence of recurrent pregnancy loss their is absolutely no credible data to support antiphospholipids, natural killer cells, etc in infertility. We studied over 2000 women over 4 years and found absolutely no relationship with pregnancy, implantation or delivery rates.
3. Beta 3 integrin is very interesting but should still be considered experimental. Our patients with abnormal results still did well in ivf. On the other hand maybe ivf corrects the problem and that was one of the reasons they needed IVF. Bruce Lessey is doing a multicenter study throughout the south and will have a good answer for us all soon. WE do not use this test routinely at this time.
Pamela: Thanks Carmendmun, I am glad that someone was watching today!
Tracey: Did I miss an answer? Sorry...
Chaya: Pamela - Thanks for arranging this on-line chat session. Would it be possible for us to view today's Q's and A's on the AIA website afterwards? Thanks.
Melissainpa: whoa dr scott, you are good at keeping up:)))
SussieG: Ok, I'll call you now....
Dr. Scott & Pamela, your time and help is most appreciated... Thank you so much
wynn: dr scott did you say success rates for ivf were low with sperm counts under 5 mil
William: Sorry, I think it scrolled away. Remember, Dave will forward this text to Pam and it will be posted on the AIA website, and then posted here later. Check Pam's website in the next few days and the chat transcript should be available online
Carmendmun: I was at work but taped it
angie: thx Dr Scott; What is the implant rate for transferring a compacting morula in the uterus?
Melissainpa: what was on lifetime, and jean are you doing a study????
ChristinaB: Sorry Dr Scott- just want to make sure my message doesn't get lost. Can you tell me of some of the "therories" of why endometriosis and infertility are linked? Thanks
KF: Thank you very much for answering my questions Dr. Scott, this is my first time on chat, very cool, very fast and overwhelming im sure. Thanks again...
Pamela: Chaya, I will have the Q and A up tomorrow on the message board.
Carmendmun: OK so I may still get the answwer to my question?? GREAT
Tracey: After 2 natural ectopics I've had 4 out of 5 IVFs work and 4 losses..at 36 8w extra chrom, at 37 norm male retroplacental bleed, at 38 normal boy/girl twins amnio related, at 38 9week trisomy 22. All miscarriage tests are normal..should we try PGD? any suggestions?
Tracey: After 2 natural ectopics I've had 4 out of 5 IVFs work and 4 losses..at 36 8w extra chrom, at 37 norm male retroplacental bleed, at 38 normal boy/girl twins amnio related, at 38 9week trisomy 22. All miscarriage tests are normal..should we try PGD? any suggestions?
wynn: pam do you have children
drscott: Debbie: Having ovaries which look like PCO on ultrasound when you have normal cycles and normal screening hormone levels is in fact a variant of PCO. You are unlikely to have insulin resistance and will not have an increased risk for some of the other problems that PCO patients have. You are likely to be a high responder with ovulation induction and your embryos are slightly more prone to fragmentation and early arrest. Dont let that make you nervous - women with this problem still have an excellent prognosis for delivery
angie: thx Dr Scott; What is the implant rate for transferring a compacting morula in the uterus?
Pamela: Yes, Carmendmun, you will get your answer! Sorry that you missed it scroll by!
Lynn28: Dr. Scott-- Please say a few words about DES and IVF-- what are the success chances-- mc rates?? I have typical DES features and 1 mc after IUI-early.
Carmendmun: DR Scott Thanks so much for your time and expertise!!!!!
Haiki: Do we have to post our question more than once?
Pamela: Yes, Wynn, I have two boys. I had my oldest through GIFT, he is now 11, my youngest is 7 and he is a cryo ivf baby.
wynn: dr scott do you know dr samnathan phiefffer at univ of penn if so is she s reputable re
angie: thx Dr Scott; What is the implant rate for transferring a compacting morula in the uterus?
cindy: DR. SCOTT - THANK YOU FOR YOUR TIME - I'M GLAD I WAS ABLE TO CHAT. CINDY :)
sam: to Debbie
What dr. Scott described sounds like me and we were lucky to get a baby through IVF
susie: is there a danger in too much progesterone?? thank you for your
time and amazing expertise,
Deb: Dr. Scott, PLEASE! Help for poor responders. I've seen no Q's or A's here!
wynn: thanks pam i needed some inspiration
debbie: dr. scott, my husband has had varicoele surgery, and the only reason i found out about the pco is b/c his doc wanted me to get checked out. Is this a form of infertility on my part??
angie: thx Dr Scott; What is the implant rate for transferring a compacting morula in the uterus?
wynn: dr scott did you say success rates for ivf were low with dh and low sperm count
William: Still time for a few more questions? :o)
ChristinaB: What are the theories of why endo and infertility are linked>
Pamela: Wynn, I truly believe that if you are looking, you will find!
wynn: pam what was your dx
debbie: sam, tell me more about your situation
Pamela: Wynn, I was a mystery!
drscott: Christina B: Endometriosis and infertility are linked in complex ways. IN the milder stages, the immune problems which allow the endometrial cells to implant and grow provide an abnormal environment for the oocyte. Eggs exposed to the peritoneal fluid (the stuff in the pelvis) are less likely to be found by tubes and are less likely to have sperm bind. There are likely other issues as well. As the stage of the disease advances, scarring and inflammation become bigger problems. You should probably ask your MD for an explanation for your specific findings.
Haiki: Dr.Scott
I am on 3rd cycle of clomid. I had normal lap in Janurary and my husband has normal s/a. My obgyn doesn't do any scans with clomid, only does bbt? Can you tell if the egg has dropped with that only?
ChristinaB: Is there any system to this or is it just random answering of questions?
angie: thx Dr Scott; What is the implant rate for transferring a compacting morula in the uterus?
Lindy: Dr.Scott............
What are some of the down falls of being on Clomid without monitoring?
Pamela: Dr. Scott, Do you want to give this another 15 minutes and try to answer the "waiters" questions??
donna: Dr scott, I just failed my 5th IVF attempt (3rd to transfer). I had 11 eggs, of terrible quality, only 3 fertilized with ICSI, and only 2 made it to transfer. I'm 33 with normal FSH. Can you recommend any other treatment which might work other than DE? Thanks!
wynn: dr scott did you say success rates with ivf were low with men of sperm counts under 5 mil
William: hehehe...Pam is a mystery shrouded in confusion all wrapped up in an enigma.
Pamela: Christina B, this is random, Dr. Scott is dancing as quickly as he can.
sam: to debbie:
what is your email address?
Pamela: Gee, Thanks Bill. That was very nice.
angie: thx Dr Scott; What is the implant rate for transferring a compacting morula in the uterus?
wynn: thanks for you answers pam im ok my dh has low sperm count he wants to keep trying im so frustrated
Carmendmun: And Dr Scott is doing a great job dancing around
Tracey: i had 2 natural ectopics. then 4 of 5 IVFs worked but lost them all. decent responder FSH 9, E2 less than 25. At 36 lost extra chrom at 8weeks, 37 norm male at 6.5 weeks bleed, normal boy/girl twins at 19 weeks amnip related, 38 9week loss trisomy 22. Just tuened 39, all tests for mc are normal, inculding doppler, karotypes, antibodies. What next should we do PGD?
Tracey: i had 2 natural ectopics. then 4 of 5 IVFs worked but lost them all. decent responder FSH 9, E2 less than 25. At 36 lost extra chrom at 8weeks, 37 norm male at 6.5 weeks bleed, normal boy/girl twins at 19 weeks amnip related, 38 9week loss trisomy 22. Just tuened 39, all tests for mc are normal, inculding doppler, karotypes, antibodies. What next should we do PGD?
Lynn28: Dr. Scott -- Please comment on DES and IVF-- what are the success chances?? WHat about higher mc rates? I had one mc early post IUI, low progest, and typical DES features, small t-uterus, etc.
sam: yea Dr. Scott seems to be a great dancer! thanks dr. Scott
angie: thx Dr Scott; What is the implant rate for transferring a compacting morula in the uterus?
KF: Pam, arent we all EN"EGG"MAs
debbie: sam: where can i post it other than here
Pamela: Wynn, are you doing IVF?
drscott: Still trying to catch up:
Angie: The pregnancy rates for transferring a morula to the uterus depends on how many days it took to get there. Morula are normal on day 4 but are a little behind in their development if still their on day 5. Pregnancies do occur with morula transfers on day 5 but are half of those with expanded blastocyst. As regards to rates, ask specific questions to your doc about your program. Blasts in women under 35 are about 90% in our program, 75% for women 36-39 and 45% for over 40 - BUT remember that these our best patients who have the best embryos!!!!
William: :o)
jean: tracey, i am so sorry for your losses as a first time to be ivf can i ask you how do you keep doing it?
wynn: pam we are thinking about it im not sure dh wants to try old fashioned way still im 29 hes 38
justine: Dr. Scott, hhhhheeeellloooo! i have unexplained dx. Have had 6 iui (3 natural & 3 w/ Clomid 50 mg.) Do you suggest shots and iui or ivf?
thank you for your answer. i am 35.
sam: to debbie how about on AIA Msg B..Ask a PCO-like question..
Deb: Dr. Scott, Poor responders!!!!!
donna: Dr scott, I just failed my 5th IVF attempt (3rd to transfer). I had 11 eggs, of terrible quality, only 3 fertilized with ICSI, and only 2 made it to transfer. I'm 33 with normal FSH. Can you recommend any other treatment which might work other than DE? Thanks!
Tracey: Jean, stubborn or crazy...seriously our twins were born alive and I knew it was worth it.
lisah: Dr. Scott, Progestrone level before retrieval?
Pamela: If it is male factor, I would go high tech. You have youth on your side, don't wait.
khein: What increases success rates in egg donation with good eggs & sperm?
angie: OH THANK YOU DR SCOTT: my morula was a day 4!!They said it was growing well!! I am 37 and you are helping me stay postive. Thank you!! :)
drscott: Lynn28. As regards DES and IVF. The best study shows that if the endometrium developms normally - ie 8 mm or more at mid cycle with a trilaminar appearance, that the pregnancy rates and outcome are fine. Outcomes defintely go down if those milestones are not achieved. You need to see where you fit. If you are not normal then losses may be increased.
Lindy: Doctor, Thank you for sharing your time and energy with us.
drscott: Angie: Good luck. An embryo is supposed to be a morula on day 4 and you likely have a very good chance.
wynn: thanks pam now i have to convince him
Pamela: Can I ask that if you just walked in, that you hold your questions. I would like Dr. Scott to answer the questions that have been waiting. It is late, and some folks have been waiting long. So if you just walked in, I suggest posting your questions to our general message board that is moderated by doctors at http:/americaninfertility.org
Chaya: Hi. I missed whether the question was answered regarding whether there are any disadvantages to using ISCI? Would there potentially be damage to the embryo? Thanks.
Lindy: YEEEAAAHHHHHHHH Angie!!!! Keep us posted.
wynn: pam my re says my cycles are great and so are my hormone levels do you think my chances at success through ivf are pretty good
Tracey: Re my losses - 2 natural ectopics, 4 of 5 IVFs worked, lost all 4. at 36 rxtra chrom 8 weeks, at 37 normal male rertoplacental bleed 6,5 weeks, 38 norm boy/girl twins 19 weeks amnio related, 38 9 weeks trisomy 22. all tests normal. any suggestions, PGD? my peri says i draw the bad card
jean: dr scott-will ivf study decrease my success rate
ToniC: Hi. Today I had an ultrasound 6w3d and saw two heartbeats, but the sacs/yolks did not appear the same. One was pretty clear and the other one was smaller. My doctor doesn't seem to think the smaller one will survive. Note: I hyperstimulated and although I started out with high betas, they were not not quite doubling every two/three days. However the last beta did double. I'm scheduled for another ultrasound next week. Any thoughts? Any chance the smaller sac will catch up?
Pamela: What about poor responders Dr. Scott?
Deb: Thanks Pamela! re: poor responders
Pamela: Toni, if you actually saw two heart beats, that is pretty good. Some sacs are smaller. I think you have to wait and see.
angie: Thanks Lindy and Dr Scott- I will keep posting on bbs for sure.
Angie
3 dpt
ICSI
drscott: Deb: Poor responders!
This is a complex but really important topic. There are at least 2 types. There are those who follicles which can be seen on scan but are not maturing. Better stims help these people and many will conceive. The other group has very low basal follicle counts (before any stimulation) When that number is less than 4 then the follicles are not there and stimulation changes do not improve the number which mature. In any event, be careful to avoid post maturity. Sometimes thre is a tendency to stimulate longer hoping some other follicles come along or catch up. That is a mistke as it hurts the quality. Post maturity is a very big problem in this circumstance.
debbie: to sam, i just posted a message on the board, please post your situation there, i am really worried and would really love to here about it
kara: i would also like info on poor responders . I have had two ivf cycles one was cancelled due to poor response and the other only produced three follicules.
Pamela: Dr. Scott, what about participating in studies?? Will it decrease the participants success rates????
Lynn28: Thank you for your time and answers Dr. Scott!
susie: what is the message board for this group??
jean: pamela, thankyou!
drscott: Chaya: As regards the risks of ICSI they are very minimal if at all. In over 1000 in our groups experience we have not had any increase in problems. I would not hesitate to do ICSI if you need to.
donna: Dr scott, I just failed my 5th IVF attempt (3rd to transfer). I had 11 eggs, of terrible quality, only 3 fertilized with ICSI, and only 2 made it to transfer. I'm 33 with normal FSH. Can you recommend any other treatment which might work other than DE? Thanks!
Pamela: Susie, go to http:americaninfertility.org
we have a doctor moderated board there.
Tracey: Could someone tell me if I missed the answer to my post? Thanks!
Susan: I've completed all blood work and am going for counseling and Hysterometry on Monday. Will I be able to start IVF Lupron and Stims this cycle (I'm due on March 29)
William: Pam, just so you know, I'm a little under the weather here and going to sign off.
Dr. Scott, thanks for joining us and supporting AIA and FertileThoughts!
Everyone, thanks also for showing up this was a great chat.
Bill
ToniC: Thanks Pam. It's been an emotional roller coaster for both my husband and myself. I guess that's all we can do .... wait and pray.
KF: DOCTOR SCOTT: In regards to DEB POOR RESP. What about situations when you have 2 mature eggs and 7 or 8 that are 15mm or less, should you try to stim longer and let them catch up
Chaya: Thanks Dr. Scott, and thanks Pamela for arranging this chatgroup. Goodnight to all.
Pamela: Dr. Scott, what about studies...does it decrease success rates for patients???
angie: thx everyone for organising this chat!
Lindy: Pamela. ICSI, is that a type of assisted hatching? Or is that the manual introduction of sperm into the egg?
Haiki: Did I miss the answer on clomid? I got booted off. I am on clomid and obgyn hasn't done any scans. Can you tell if the egg drops with just bbt?
Pamela: Lindy, ICSI is putting the single sperm into a single egg.
KF: DOCTOR SCOTT: In regards to DEB POOR RESP. What about situations when you have 2 mature eggs and 7 or 8 that are 15mm or less, should you try to stim longer and let them catch up
drscott: pamela: Participating in studies may or may not impact pregnancy rates. Most pharmaceutical studies are quite safe. Organon, Serono, and Ferring sponsor most of the studies and are very careful not to harm patients. On the other hand, studies regarding progesterone replacement are good examples where there really is no way of knowing if the alternate forms will do as well as IM. It is possible that success rates could go down. Ask your doctor very very carefull about ways in which the study could change the outcome. Also, remember that IVF success rates were in the low teens 15 years ago. The higher rates of today represent knowledge gained from the experiences of other patients who participated in studies. As long as it is safe and your doctor can reassure you about outcomes, I would strongly encourage everyone to participate so that we can get smarter and have more over our patients conceive and have families.
Susan: My FSH level and estrogen were high on cd3. I'm 42.5 years old. Is there anything I can do to increase my fertility chances?
Carmendmun: How can you participate in a program??
Pamela: Thanks Dr. Scott, could we finish we these last two question...KF has a poor responder questions and Haiki has a clomid question.
Tracey: after 2 natural ectopics 4 of 5 ivfs worked, lost all 4. 36 8w extra chrom, 37 6.5w norm male retroplacent bleed, 39 norm boy/girl twins 19 weeks amnio related, 38 9w trisomy 22. all tests normal, peri says bad luck. any recommendations, PGD?
Tracey: after 2 natural ectopics 4 of 5 ivfs worked, lost all 4. 36 8w extra chrom, 37 6.5w norm male retroplacent bleed, 39 norm boy/girl twins 19 weeks amnio related, 38 9w trisomy 22. all tests normal, peri says bad luck. any recommendations, PGD?
efierman: we did our last IVF cycle where we had 14 retrieved and only 6 fertilized. We don't have male factor, do you recommend ICSI? I think it can only help. What do you think?
wynn: dr scott i know its getting late but did you say ivf sucess rates were low with sperm counts under 5 mil
Carmendmun: THANK YOU DR. SCOTT AND PAM!!!!!!!
drscott: KF:
When you have 2 mature and 7 or 8 that or 15 are smaller - it depends. IF you are on the fifth or sixth day of meds you should probably go on for another day. If you are on the 10 th day of meds you should stop. It also depends on the rate of rise of E2, the rate of growth of the follicles, the exact distribution of the smaler ones' sizes, and your age and history. These are the really tough calls that you depend on the experience of your doctor to help make the right choice.
wynn: thanks dr scott and pam
jean: dr scott, thank you so much for answering my question.
Pamela: Again, I just want to remind people that it is getting very late and it is getting time to close this chat for tonight. If you did not get your question answered tonight, please post them on our doctor moderated message board at https://americaninfertility.org
Your questions will be answered there by tomorrow...Dr. Scott may even stop by.....
drscott: wynn: IVF rates are fine with less than 5 million sperm. but conception naturally are through insemination drop off dramatically. It also depends on the shape of the sperm and the percent that are motile with very good progression.
jean: thank you pamela. can you tell me are there more of these online md chats for future reference?
wynn: thanks doctor scott
Lindy: Gosh so many variables!
I am looking forward to talking with my RE next week. I feel like I have a little better understanding. Thank you Doctor Scott and Pamela. See you at www.amerianinfertility.com
susie: KF -- where is your re clinic?
Lindy: .org Got it thanks Pamela!!!!!!
KF: Thanks, Dr. Scott, I was on Gonal F for 13 days, and RE said my embie quality was excellent with pronuclear embies, 3 of which were at 8 cells...weird I know but I had 2 leads on day 10 and the others were at 17mm-15mm so we went 2 more days....Thanks for the info...very helpful.
Pamela: Jean, get to know us! We have lots of great things to offer! Check us out at https://americaninfertility.org
We have two chats this month and in April there will be three. We have a great national monthly newsletter for members! We also have a 800 number for peer support and more information...
drscott: efierman: with 6 of 14 in the prior cycle. I would ask how many of the 14 were mature - they should have a polar body if you are looking on a report or be called metaphase II or MII. if the 14 were mature then ICSI is needed. If only 8 were mature then 6 of 8 is normal. This is a great direct question for your MD to discuss with you. In general, when fertilziation rates are below 50% of mature eggs, then ICSI is consideration in any future cycles.
Pamela: Lindy,
we are a .org
jean: thanks pamela i will check it out. this has been a little overwhelming. thank you again pamela and dr scott. bye.
KF: Suzzie, I was at Highland Pk in Chicago, Now considering Cornell in NYC
Susan: My FSH level and estrogen were high on cd3. I'm 42.5 years old. Is there anything I can do to increase my fertility chances?
susie: KF, your situation sounds very similar to mine...do you have endo??
is that your concern with beta 3??
Lindy: Yes, thanks Pamela. I saw that and I will be visiting soon. You have been very helpful and friendly. Makes it easier to think and ask questions.
donna: Dr scott, I just failed my 5th IVF attempt (3rd to transfer). I had 11 eggs, of terrible quality, only 3 fertilized with ICSI, and only 2 made it to transfer. I'm 33 with normal FSH. Can you recommend any other treatment which might work other than DE? Thanks!
wynn: goodnight thank you dr scott and pam
Pamela: Okay Dr. Scott!!! You have been great!!! Your fingers must be tired!!! I know that your eyes are!! I truly thank you for coming by and I hope that you will do this again!
Susan: KF-Are you still in Chicago area or have you moved to NYC? I like my Chicago RE, if that helps you.
KF: Min endo Suzzie. Near Ureter. 4 dots and not compromising to me I would never have known....
drscott: Good luck to everyone. I hope that the information was helpful.
Haiki: Thank you.I am glad I found this site.
Lindy: YES!!! Thank you Dr. Good night.
susie: KF -- how long have you been trying and what
procedures....
Susan: Thanks, Dr. Scott.
Ang: Hello
Pamela: Everyone will be able to read this transcript tomorrow on the message board at https://americaninfertility.org
If you want to stay and visit with each other, this room will remain open for this evening!
Thanks again, Dr. Scott and Good Night!
susie: pamela...dr scott was great. thank you.