Pamela: Christy, you have to hit refresh to see the new posts. Dr. Sable will be here at 8pm. We will handle the questions as quickly as possible. Please wait until he comes in to post your questions.
Rebecca: Anyone in midst of a inj. cycle?
StacyD: I have never been in this chat are there RE here
Pamela: Hi Dr. Sable! I am so glad that you made it! Are you ready to answer some questions?
dsable: hi all
Pamela: Yes, Stacy, Dr. Sable is an RE.
dsable: my refresh is quite slow
Rebecca: Welcome Dr. Sable, thank you for your time.
Pamela: Do you have a question Rebecca?
christy: hi Dr. Sable, It is my first time here, I apprciate your time
dsable: thank you-- its an honor to have been asked
William: **waving**...give me a second, kids melting down here *smile*
Pamela: Bill enters to the usual thunderous applause!
Sharon: Has anyone seen a DR Wakim in Pittsburgh???
dsable: now we have a choice-- speed or good typing--what do you all prefer?
wynn: welcome dr sable can you help my prog levels are 5.4 2.1 and 3.4 for the past three month re said i did O but me on clomid why? also, she said she will only do three cycled of clomid is this enough? i started clomid today cycle day 5 when should we have intercourse thanks for your response
Tracey: Dr. Sable, thank you for your time! I feel so fortunate to be coming to St Barnabus in a few months. I saw Dr. Garrisi, she was wonderful! My question is about coculture...can the decision be made to do it after seeing the embryo quality on day 1 or 2?
Sunita: hi everybody
StacyD: are we just to ask questions is there any order?
dsable: wynn-- I agree that clomid tends to run out of its usefulness after ~ 3 cycles-- time to move on usually at that point
Pamela: just ask Stacy D
dsable: hi tracey--we need to decide on co-culture from the beginning
wynn: dsable thansk for your time and response
Pamela: what is co-culture?
William: Dr Sable, thanks for joining us. Speed is always appreciated but you be the judge. We can always edit out typos before reposting the chat transcript. Also, we're working on a system that orders the Q&A better, hopefully that will be in place next month.
Tracey: I have had many pregnancies, then losses, always fragmented embryos. Is it a given that I don't need coculture because I've had so many pregnancies?
dsable: co-culture is the addition of cells from human endometrium or animal repro tracts to help embryos develop-- we have been doing it for ~5 years
sunita: hi dr sable , this is the first time i have come here
StacyD: Dr Sable we have done 6 IUI and 4 IVF and ICSI due to male factor retrograde ejaculation I used 6 amps of stims a day each time. My question is is it safe to continue with this many stims. I am worried about what this may do to my body
wynn: dsable with my prog levels 5.4 2.1 and 3.4 do you agree that i ovulated? also will clomid help to improve these numbers?
dsable: tracey alot depends on the specifics of the enmbryos-- the lab where they were "made" the neature of the pregnancies and the losses-- too complex a q to give a quickie answer
juliecre: hi dr. sable we have male factor if with 3 SA's with low motility (less than 20%) low kruger (2%, 2%. 7%) and normal count my dr. suggested 2 trials of iui with clomid and if no success move to ivf with icsi due to his low fertilization potential. i had 1 failed iui last month. does this sound reasonable to move on after two with his values or do you suggest more trials of iui?
Pamela: Bill, will you post the helpful hints for everybody???
sunita: i have been trying to get pregnant for past 7 nmths ,but have been unscuccesul
dsable: hi sunita and stacey-- stacey-- you definitely ov's with the 5.4 -- probably w/ the 2.1 and 3.4-- differenct labs have diff cut-offs at the low end of the progesterone scale--a technical thing
Tracey: Thanks Dr. my losses all tests are normal, just seem to have bad luck. 2 were trisomys at 8 and 9 weeks, a 6.5 week normal male due to a retroplacental bleed and normal boy/girl twins due to amnio at 19 weeks.
dsable: hi julie-- many factors-- your age being most important. I hate to give too specific a recommend. but 1-3 IUI's then I would rec. IVF/ICS
wynn: dr sable that was me wynn with the prog numbers so why clomid then for me?? if i O and all
Pamela: Sunita,  Have you seen a doctor yet?
William: yup, gimme just a sec, gonna edit them up on the side here so I can repost them
dsable: tracey-- I would probably not go w/ co-culture then
christy: Dr. sable what are the risks of irregular periods and provera and how can I get my periods back naturally so I can try to get pregnant
dsable: wynn-- good question-- some people ovulate more effficiently w/ clomid ie the egg gets better matured
Tracey: Thank you Dr Sable!
Pamela: Lovely group tonight, Bill. It must be Dr. Sable's soft bed side manner!
lucky: Dr. Sable, my infertility specialist stated that I might have symptoms of Polycystic Ovarian Syndrome. Could you describe what this is.
Rebecca: Dr. Sable- Is the only solution for a low Kruger IVF/ICSI or can IUI work with no female factor?
wynn: dsable thank you i hope so i heard anything under 10 means you didn't Ovulate but i guess not thanks for your time
Lori: Dr. Sable, why aren't pof patients good candidates for cytoplasmic transfer? Couldn't you use donor eggs and replace DNA with the pof patients? Are you doing this research? Thanks.
dsable: good q tracey-- many possible reasons-- thyroid off, PCO, not enough stim from brain to ovaries. No "risk" to regular provera use (as long as it is every 1-2 months) except infertility
sunita: i am lupus patient ,and was on paquniel for a yr , my doctor stopped paquneil in oct'99, and since then i have been trying to get pregnant.does lupus affect to get pregnant.we have'nt done any test gyanec wants to me to go for a test only after 1 yr of trying.can u help me advice about , what i am doing wrong.
juliecre: dr sable is baby asprin good to take even if you don't have an immune prob. if you are doing iui or could this be harmful?
StacyD: Dr Sable how long should I continue treatments without risk to my ovaries. I have done 6 IUI and 4 IVF and ICSI cycles max dosage of stims each time
christy: since I am trying to get prgnant, can I use provera and clomid together
dsable: hi Lori-- For cyto transfer we still need a group of matured eggs ie the ability to be stimulated. Nuclear transfer is being addressed in many ways-- none succcessful yet unfortunately-- good question-- I could tajke the whole hour answering
cheris97: How do I go about making an appointment for donor egg at St.B's
Which one of your clinics handle that?
Tracey: Dr. Sable, any thoughts on L-Arginine to improve follicular growth and lining?
sunita: dr sable , is it becos that i am only 7 mths in trying for preganancy , u are not ansering my questions.
afsk: dsable, you are popular here. Here's my question. Any latest research on pros and cons of blastocyst transfer?
Ali: Hi Dr. Sable, what is your opinion of a motility of 10% we have had several iui with stims. I have endo, no success. We are now about to do ivf . Motility is average, count is good. Do you think we will need icsi?
William: Chat Hints:
1. Increase the number in the "Messages:" box so you can read more messages with each "Refresh"
2. Type your message and use a "CTRL+C" to copy it to your computer clipboard, so you can re-post the question if it is not answered the first time.
3. Please be patient; Dr. Sable is volunteering his time and will not have time to answer all questions (we often have more than 50 people online during these chats).
4. The chat transcript will be posted at the AIA website later this week, so look there to find anything you missed the first time through tonight!
dsable: in no real order: lupus does not seem to affect fertility in ovulating women, although the age ranges for infertuility and lupus intersect a lot. Aspirin data is not all that strong, but sinceit is so low risk ( a long as you have no bleeding problems) that it is widely used and recommended on the slight data that is there. As for the number of cycles of treatment, thankfully the data is not pointing to rincreased risks from the meds themselves.
juliecre: what is st. barnabas' success rate at for under 30 group for ivf with icsi for live births per 100 cycles?
Rebecca: Dr. Sable- is there any use in doing IUI for low Kruger or should we just move to IVF/ICSI-no female factor?
William: 23 people already...a little more managable than last time but we'll see who shows up, it's still early :o)
lanessa: my dr. gives me provera first before I take the clomid is this a good start
Tim: Hello Doctor Sable, my wife has stopped taking birth control pills after 10 years. We would like to become pregnant, but after 8 months she has had only 2 periods. According to her doctor, she cannot get pregnant until her periods are regulated. Should we turn to medications to help get her cycles regulated? If so, what would you recommend?
dsable: re blast transfer: I write a long article on this on my little web site you may find that helpful. 10% motile + endo --- I would go straight to IVF (+ICSI). Sunita I believe I did adfdress your question.
Elena: Dr. Sable-I'm a 28 yr old female trying to get pregnant  Who is a good canidate for Progesterone and or Clomid.  My cycles run about 28 to 30 days and As far as I know I do ovulate.
sunita: dr sabel , i am 28 yrs old.have controlled lupus , and controlled thyroid .i take 0.1 mg of thyroid medicine.and have been tring since 7 mths .can u suggest anything , that can be done to get pregnant
StacyD: Dr Sable my husband sperm motility was 0% our last cycle and we do do ICSI as he has retrograde ejaculation due to diabetes we did get pregnant but that was 2 years ago do you think having him do a biposy next time would increase our chances for motility or is the sperm not mature from the tubes
dsable: St Barnabas pregnancy rate first cycle under 30 is 68%. Low Kruger? depends on how low and your age. Typically 1-3 IUI then IVF unless there is another issue involved.
afsk: Thank you, Dr. Sable. Good luck to you all.
lucky: Dr. Sable, my infertility specialist stated that I may have symptoms of Ploycystic Ovarian Syndrome. Could you describe what this is?
wynn: dsable WOW those numbers are great!!
ConnieB: Dr. Sable, good luck in keeping up with all these questions!! After 3 years I got pg and had m/c on 2nd cycle of follistim (I also had m/c on clomid). The dr. is running test right now for antibodies and stuff. Lap in June 99 removed a little lap but tubes are fine, I used progesterone suppliments, and lining was at 16. I am 37 and worried my eggs are bad and that I am running out of time. 5 months ago my fsh was 9.8. I just don't know if I am wasting my time. How many more rounds of follistim would you reccomend before giving up? Thank you so much and God bless dr. that help us like you.
Rebecca: Dr. Sable- IUI work for low Kruger's or should we go straight to IVF/ICSI-no female factor?
Lori: Is there any experimental research or other options you recommend for pof patients to have genetically related child other than donor eggs?
LeslieC: Dr. Sable
I have PCOS and concieved on my third Gonalf F IUI cycle last summer. Unfortunately I lost the baby at 9.5 weeks. I tried another Gonal F cycle in Feb but it was cancelled. I have just started Lupron to be followed by Gonal F and IUI. I was wondering how many cyles I should do before moving on? I want to add that I have been doing weight watchers for 6 weeks and have lost 19.2lbs. Do you think this will help with the PCOS?
William: Chat Hints:
1. Increase the number in the "Messages:" box so you can read more messages with each "Refresh"
2. Type your message and use a "CTRL+C" to copy it to your computer clipboard, so you can re-post the question if it is not answered the first time.
3. Please be patient; Dr. Sable is volunteering his time and will not have time to answer all questions (we often have more than 50 people online during these chats).
4. The chat transcript will be posted at the AIA website later this week, so look there to find anything you missed the first time through tonight!
Rebecca: Thank you Dr. Sable-sorry for posting my ? so many times.
sunita: dr sabel , i am 28 yrs old.have controlled lupus , and controlled thyroid .i take 0.1 mg of thyroid medicine.and have been tring since 7 mths .can u suggest anything , that can be done to get pregnant
wynn: leslie sorry to hear of your m/c so sad
dsable: provera before clomid is important if you normally do not ovulate. If you ovulate clomid is reasonable if you are younger and have a lot of follicles on USS or a high LH:FSH ratio and your lining does not thin out from it. Sunita-- it might be reasonalbe to have a basic workup (semen analysis, HSG, basic labs and history/physical) in the next month or so depending on your age.
lucky: Dr. Sable, my infertility specialist stated that I may have symptoms of Polycystic Ovarian Syndrome. Could you describe what this is?
wynn: good bye all DR SABLE thank you so much for answering my questions and for your precious time we all appreciate it
LeslieC: Thank you Wyn! :-)
juliecre: what is the most important thing to ask to RE on an IVF consult?
sunita: dr sable , what are possiblities of preganancy when it is a problem with women , and when it is a problem witha man
Tracey: Dr. Sable, any thoughts on L-Argine to improve follicular growth and lining?
lisaC: Dr. Sable. I have irregular periods and don`t ovulate, even when I took chlomid. I have a narrow cervix, does this make it more difficult to conceive?
Elena: Dr. Sable-I have been told by other doctors
that if you ovulate you should not use Clomid. is this true?
dsable: pco is a condition where the ovulatory process is very inefficient-- too many small follicles and no one mature one. Result: no ovualtion, infertility, too much testosterone, not enough estrogen. Treatment: clomid first, metformin in many cases, injectables next (carefully!-- high risk for hyperstim and multiples) and IVF in many cases.
dsable: elena-- in general yes, although some women who ovulate can benefit from it-- depends on what other factors may contribute, Certainly for a short time only if you do use it.
William: sunita, just in case you missed Dr Sable's response re: lupus from earlier:
04-05-2000 08:08:18pm   dsable (IP address-
in no real order: lupus does not seem to affect fertility in ovulating women, although the age ranges for
infertuility and lupus intersect a lot. Aspirin data is not all that strong, but sinceit is so low risk ( a long as you
have no bleeding problems) that it is widely used and recommended on the slight data that is there. As for the
number of cycles of treatment, thankfully the data is not pointing to rincreased risks from the meds themselves.
sunita: dr sable , what are possiblities of preganancy when it is a problem with women , and when it is a problem witha man
dsable: lisa c-- on to injectibles unless you might benefit from metformin (severe-er PCO in some caes.) narrow cervix only important for IUI or IVF-- sperm don't need much room!
Joann: I have a question, I have had two m/c in the past year, I found out three weeks ago I have PCOS, went in for a glucose tolerance test today and it came back normal, with the last pg I used clomid to get pg also took prometrium, estrace and baby asprin. What should be the next step and how can I stay pg?
StacyD: Dr Sable my husband has retrograde ejaculation due to diabetes we have to do IVF and ICSI our last cycle two years ago his motility was 0% we did get pregnant with a one embryo transfer five day with assisted hatching. We are thinking of trying again if motility is still 0% will we have to do a biopsy to remove his sperm or can we still get it from his bladder
dsable: sunita-- infertility is always a couple issue-- one cannot generalize that way. There are effective treatments for most factors.
Elena: Dr. Sable-IF I'm usually regular with my periods and I only menstrate for about 3 to 4 days. Is it possible all I might require is progesterone suppositories?
penny: can someone tell me how this works?
tarasue: hi.  what's the scoop~ what are we talking about?
lucky: Dr. Sable, my infertility specialist stated that I may have symptoms of Ploycystic Ovarian Syndrome. Could you describe what this is? Thanks
juliecre: dr. sable please comment on the use of baby asprin in women without autoimmune probs
dsable: most important thing to do first visit with an RE is to listen. ask yourself: does this person understand my case? does he/she know what is in my history? Why is he/she recommending what he./she is recommending? Do I have options/ alternatives?
Teresa: I have been diagnosed as having PCOS. My doctor has prescribed a progestin. Is there a difference in progesterone and progestin? Is this a good treatment for this condition?
Taren: Dr. Sable my husband has a varicole problem. He had corrective surgery but did not help much. We have had 7 unsuccessful IUIs any suggestions?
William: sunita, I'll give your Q a shot and Dr. Sable can also follow up.
The question about pregnancy possibilities when it is a problem with the woman or the man is very general. The specifics of the problems is what's important. For example, a man with a low sperm count could benefit from clomid, but if it is very very low then perhaps nothing short of ICSI will do.
ConnieB: Dr. Sable, did you see my post about m/c on 2nd round of follistim. How many more times do thing I should do injectables with any realistic hope of carrying the pg. I am 37 and feel my eggs are have run out of time. (fsh was 9.8 though 5 months ago. Also I have a tilted uterus with a slit instead of a whole for an opening to my cervix. do you think they is why I have only gotten pg off IUI's? thanks
Pamela: Tarasue, this is a general infertility questions and answer with Dr. David Sable who is the director of the reknown St. Barnabas program in NJ.
dsable: it's rare that we can "cure" infertility just by giving progesterone. 3-4 days of bleeding is pretty much the middle of the bell curve
lanessa: I have pcos and do not ovulate at all I do have periods there just not regular.Last mo.I tryed my first set of clomid I could feel my ovaries doing things I've never felt before,but I've started my period.So taking the provera first is good?
tarasue: Dr. Sable, my husband has bilateral varicoceles, but although his motility and morphology are a little low, my RE thinks that corrective surgery is unnecessary. Is that a fair assessment, or should we get another opinion? (my husband's urologist said to try to get pregnant without surgery first)
lawteddy: does clomid decrease the risk of miscarriage...if i have only been trying to concieve for a month but need to take progesterone to bring on my it bad to take clomid so i don't have to keep trying and risk waiting a year or more before getting pregnant?
Elena: I know this is a really stupid question.  How dangerous is taking Clomid without a  prescription? (black market)
StacyD: Sorry my computer keeps going down wondered if my questions about retrograde problem was answered?
sunita: thanks william.i am able to ask only general questions.cos i am just a beginner in this ,and i feel i have yet to go a long way , to understand the diiferent medical terms that are used in this chat
penny: Dr. Sable I have diminished ovarian reserve. This month my levels were fsh=1.5 lh=1.8 and estrogen=314. Can you please explain what might be going on this cycle. I only had my period for one day.
dsable: Hi taren-- after 7 IUI's for male factor it may be appropriate to move to IVF/ICSI. Re miscarriage after follisti/IUI-- unfortunately there is a 15% risk of loss in any pregnancy. I would not give up despite this incredibly frustrating experience. A 9 FSH is not so high that an aggressive stim cannot usually help. And at 37 yo you're still quite young.
William: StacyD, you can post your question again and if Dr. Sable has already answered it, you'll be able to find the answer when the chat transcript is reposted at
Pamela: Elena--I WOULD NEVER TAKE FERTILITY MEDICATION without the supervision of a doctor!!! Also, I would never purchase black market product. It is NOT worth it. You could hurt yourself!!
Tracey: Dr. Sable, any thoughts on L-Arginine to improve follicular growth and lining?
ConnieB: Thank you dr. Sable, I guess I am just feeling old!!!!
lisaC: I`ve never heard of PCOS before. Since I don`t ovulate and have very irregular bleeding, does this mean I have PCOS? What are the symptoms and how do the doctors check for it?
dsable: I'm going to defer on the varicocele q because I do not repair them myself-- in general I am not a huge fan of varicocele surgery-- the results are too all overthe place. Penny-- The high E2 level is pushing down the FSH and LH artificially. Perhaps you did not ovulate and this is only breakthrouhg bleeding and not a real period.
Sharon: Dr.sable, How effective is the use of aspirin and heparin in autoimmune women with recurrent pg loss?
sunita: what are different ways , to get pregnant . i mean right now , i am doing the Basal
Body temperature , are they any other methods to know which day i ovulate
lucky: Dr. Sable, my infertility specialist stated that I may have symptoms of Ploycystic Ovarian Syndrome. Could you describe what this is? If you are not familiar with this syndrome, I would appreciate that input as well. Thanks
Taren: Dr. Sable I am 26 yrs old. We have been ttc for four years. My husband is on clomid and some improvements but each time we do a SA they counts change month to month any reasons for this?
William: well sunita you've come to the right place, I suggest that you check out our online book by Dr. Malpani, it's a very good guide to the basics of infertility from A to Z. If you don't see the FertileThoughts menu to the side of your browser, just go to after the chat and look at the menu to find "Online Book"
Pamela: Sunita,  You can try timing intercourse using an ovulation predictor kit. You can buy them at any drug store. Ovu Quick is a good one.
StacyD: my husband has retrograde ejaculation due to diabetes and motility was 0% our last IVF and ICSI cycle but we did get pregnant and we would like to try again should we do a biposy to remove the sperm which is not mature or should we remove it from his bladder again even though it was 0% last time two years ago
dsable: Amen Pamela. The data on L-arginine is very new and unverified. Similar to the very brief Proxceed excitement of a few months ago.
Janice: Dr. Sable,  I recently read an article regarding couples doing ivf and the treatment fails due to an infection caused bybacterium ureaplasma. what do you think about this study. Thanks in advance Janice
dsable: I would probably go with the bladder retrieval. If there immotile sperm is viable (your pregnancy suggests it was) you may spare your husband a procedure.
lawteddy: do i have to keep pressing refresh to see the new messages
Pamela: Dr. Sable...could you address the PCOS question? I think that the asker want to know a little about the disorder.
Elena: I wish I knew what my levels were to determine what my E2,P4, and Lh are? But I don't have the money right now. The panel is very expensive. I just want to know what I can do to help the process along. :(
penny: Dr. Sable, with a fluctuating fsh level is it still possible to get pregnant. I am only 28 years old.
Pamela: Yes, lawteddy, you have to keep pressing refresh to keep up with the chat.
William: **William crosses his legs and nods to Dr Sable at the mention of varicocele surgery** I agree, I'm not a fan of it either!
sunita, Roger Hunt has edited a very good "low tech ways to get pregnant" FAQ that can be found at the website. It's a good read also. I think many doctors would agree that basal body temperature has only limited accuracy, but BBT combined with examination of your mucus and use of an ovulation predictor kit can give you a lot of information when all are used together.
dsable: Janice-- mycoplasma data has been kinking around forever and has never been too convincing. We always test for it and treat it when it is there, but my suspicion is that it is a regular non-pathogenic inhabitant of some women's vaginal tracts.
pigletoscar: Hi all!!
StacyD: Thank you Dr Sable would the sperm be more healthy and more motile if removed from his tubes?
juliecre: dr.sable once one comes into st barnabas for ivf consult, as long as all of the pretests are done and iui's completed, how long before they can start a cycle and what kind of time frame is it from when you begin meds like lupron etc before harvest and transfer?
Lori: Dr. Sable, Is there any experimental research/other options you could recommend for pof patient who wants gentically linked child without using donor eggs.
Pamela: For you New York Area folks, AIA will be having meeting on low tech ways to pregnant on April 13th. You can find out more later by going to and visiting the monthly meetings section.
lawteddy: what does it mean if progesterone doesn't bring on withdrawal bleeding...i've tried for the past 7 months with no success and my estrogen level is over 230...all my other levels are normal
Joann: Dr.Sable- do you feel that stress has anything to do with miscarriages. ANd also how does caffeine affect fertility?
dsable: Pamela-- I actually did addressthe PCO question about 10 posts ago. If time permits I'll repeat it. Regarding the fluctuating FSH-- at 28 it would have tyo fluctuate pretty darn high for this RE to give up on you.
StacyD: William or Pamela how often do you have Re online and how can I find former chats with REs
William: Chat Hints:
1. Increase the number in the "Messages:" box so you can read more messages with each "Refresh"
2. Type your message and use a "CTRL+C" to copy it to your computer clipboard, so you can re-post the question if it is not answered the first time.
3. Please be patient; Dr. Sable is volunteering his time and will not have time to answer all questions (we often have more than 50 people online during these chats).
4. The chat transcript will be posted at the AIA website later this week, so look there to find anything you missed the first time through tonight!
tarasue: Dr. Sable, in your opinion how many hours after hcg injection should IUI take place?
sunita: william - would i find the book on low tech ways to get pregnant, on the website ,.and how do i examine my mucus
penny: Dr. Sable thank you for your help. My fsh level has only went up to 16.1 and I was told I only have a 1% chance. The doctors office I was going to has a cut off of 12%. Is it still possible to get pregnant on my own?
dsable: julie-- almostright away and ~3 weeks. Joann-- I believe-- big time-- that the worst thing to do is to convinve yourself taht stress will play a role in outcome. Fastest route to uncontrolled stress: tell yourself that you are not allowed to be stressed. Caffeine: in moderation (one cup a day tops--based on no great data.)
ali: Dr. Sable, I have mild- moderate endo and have had surgery. My husband has good count average morph and motility 10%. I have done 2 iui with stims(gonal F) no success and a few natural or clomid. Do you think 10% is a male factor issue. will we require icsi? TY for giving your time!!
William: We're having these chats on a 2-4x a month basis, but we are getting so many people attending them that we'd like to set up a standard rotation of experts and do 20-25 chats a month. The transcripts are at the site, plus we're going to place the transcripts into a searchable database here at FertileThoughts.
lucky: I must have missed information about PCO. If you could post it again I would appreciate it.
Pamela: We have two to three meetings a month. And shortly we will be moving up to weekly meetings. The topics vary. You can find this months schedule at under meetings. The next on line meeting this month is on May 18th. Patricia Mendell, CSW will be talking about ovum donation, finding a donor, emotional issues etc..
dsable: lawteddy-- you need an exam and an USS. We need to know how thick your lining is-- with E2 230 it should respond to provera unless you are pregnant, the lining is damaged or there is a blockage.
taylor: Dr. Sable  I am 28 years old and have been diagnosed with PCOS Im alittle confused my periods are very regular the only real sign is that I have noticed acne in my chin. We have done 4IUI's with clomid and have not gotten pregnant. I am moving on to Follistum and IUI next month. How many cycles of this should I do. I am getting anxious and really want to start IVF soon. What do you advise. By the way my husband has low sperm count but had varicocele surgery 7 months ago and numbers are improving. (Last time they were 30 million 50% motility.)
William: sunita, your gynecologist should be able to tell you about examining mucus, I'm not an expert on the subject but from what I understand, if/when your mucus is clear, sticky, and has the consistency of uncooked egg white, you're very close to ovulation and it is time to get your DH (Devoted Husband) in the mood :o)
StacyD: William or Pamela has the Doodys in Ft Worth ever been a guest at these chats?
Elena: Dr. Sable-My husband and I have been having unprotected sex for 3 yrs now, but we just actively started trying. Being that in that 3 yrs I was not taking any birth control you think I would have gotten pregant. Does that say that I have a infertility issue or maybe a minor problem that needs corrected?
dsable: hi ali-- I would definitely think about IVF, probably with ICSI with 10% motility. Absolutely.
Pamela: What is your head count Bill?
dsable: Elena-- depending on your age I would have the workup done sooner rather than later 0--0 3 years is a long time.
lisaC: Dr. Sable. I have had a workup for my infertility, however, I think that further tests should have been done before I start tx. I often wonder if I have endo. or PCOS because of my irregular bleeding. Can I push for them to do the necessary tests to confirm this?
lawteddy: i had an ultra sound of my ovaries before the the first time i started the progesterone...and everything was a uss an ultrasound
Tracey: With PGD what percentage of embryos are damaged during the procedure?
Pamela: If there are non members of AIA here, and you would like to receive a complimentary newsletter and information packet about AIA, after the chat, email me your snail mail address including your full name!
And I will put a information packet and newsletter in the mail to you.
alane: Dr. Sable  How long is the average time for a 41 yr. old to conceive naturally?
Janice: William, Love your illustration of our mucus at ovulation time :)
Elena: Dr. Sable-I'm 28. Are you saying that during those 3 yrs-even though we were using the withdraw method that the odds for my getting pregnant
should have been significant?
dsable: lisa c-- you should always be comfortable w/ your treatment. Know: risks, benefits, alternatives before starting anything. Lawteddy-- USS is ultrasound. What I would want ot know is: how thick is the non-responding uterine lining?
Pamela: Janice, I bet you didn't know that Bill was such a romantic?
dtredd: Hi
penny: Dr. Sable with my day 3 fsh level being around 16.1 do you think there is a chance for me to get pregnant on my own. How can I tell what my real fsh level is if my estrogen is so high?
dsable: tracey-- 0.6% pf PGD embryos are damaged by the procedure (ie 6 out of one thousand)
Elena: I want to thank Pamela and Dr. Sable for answering my questions this evening. :)
Joann: Dr Sable- is there any way to avoid a miscarriage, I have had two in the past year, and am so scarred to have another one. Is there anything I can do to lessen the risk?
lisaC: I need to know the symptoms of PCOS!!
dtredd: I have a question about the endo med lupron...
Pooh: Dr. Sable, I will be seeing a new RE tomorrow. I've been ttc for 19 months and the last 4 months on Clomid which isn't working. My dx is unexplained, what would the normal next step be in my tx?
bessie530: are there any books out just on pcos?
Carlene: Dr.Sable, Dh and I will be undergoing ivf sometime late summer. I have one blocked tube, and one tube the RE describes as "seedy". I have asked my RE about hydrosalpinx, but she said there didn't appear to be any when they did the ultrasound. That was 2 years ago. Should I be checked again, and, can an ultrasound in fact detect hydros? I'm a little dubious of spending all that money, to have embryos destroyed by toxic fluid.
Janice: Pamela,  No I did not. I am going to email you after, i am a CT lady helping Lauren S get a meeting together. Look forward to meeting you.
William: StacyD, not that I know, but if you'd like for them to come and do a chat for us please let them know they can contact or to discuss this.
Janice, thanks!    Pam, last I checked it was about 35.
dsable: hi elena-- I'm sorry I missed the withdrawal part of it. You need to ask DH just how good he was at withdrawing-- kidding aside; at 28 you have the luxury of giving it some more time or going right for an evaluation.
StacyD: which is better three day transfer or five day?
Lori: Dear Dr. Sable, Is there any experimental research/options you could recommend for pof patient (34) who wants genetically linked child w/out using donor eggs. Thanks.
lisaC: What hormone is responsible for ovulation? What is the normal range when you do ovulate?
Pooh: Hi Penny, {{Hugs}}
Becky: Good evening!
Pamela: LisaC--I am sure that Dr. Sable will get to you, but after the chat, visit AIA's PCOS Center. There are many articles on PCOS there as well as a moderated message board. You will find it very helpful.   All the symptoms and information about PCOS and treatment options are there as well.
ali: Dr. Sable, My docs use crinone after IVF and my friends Dr. in CO does not use any progesterone. what are your feelings on the subject? Thanks again
juliecre: dr.sable in your opinion, if one has insurance to cover ivf at a clinic with average results (brooklyn ivf) with the much better success rates out there esp. in the NY/NJ area do you think it is worth it to just bite the bullet and pay for the whole thing to go to a place like st.barn.(we are not rich by anymeans but do have enough available to cover it) or do you think one should try it 1 cycle with the clinic covered?
dtredd: Dr Sable, I am taking lupron for 6mos for stage 2 endo, is that too long to take it?? We have been ttc for 9 1/2 yrs, what are my chances of getting pg after I get done taking the drug??
Liz: Dr.Sable. I am 40.9 my 3 day FSH was 6.9 E2 <20. Just had my 4th DIUI(Follistim/HCG) 5 good size follicles 3 smaller. Sperm sample for 2 days was 50mil grade 3+/4 and 52mil grade 3+. Do these numbers look as if I have a chance this cycle
How soon can I test?  Thanks,  Liz
penny: Hey Pooh sweety I read your post earlier thank you!
dsable: pooh- need to complete the evaluation: tubes (HSG) Sperm (SA) day 3 hormones. If done, next steps are either injectables, laparoscopy or IVF depending on the results of all tests, your age and other history factors. Carlene-- I am probably the world's most paranoid RE about hydros (article: "Trouble with hydros" at I would think about another HSG.
Katie: hello
Ally: Dr. Sable, Is it possible to ovulate right up until the day before menstration?e
Pamela: Bessie,  Dr. Thatcher is coming out with a book soon. I don't think that there are any books out right now that are completely dedicated to PCOS.
lanessa: say my temp. is 97.0 when you ovulate what % does it go up.
Becky: Dr. Sable...I am thinking about asking my RE to put me on Viagra for my next FET,,can never develop a lining past 6mm even on 10 mg's estrace. Im afraid enough studies havent been done on birth defects though or have there? Thanks!
taylor: Dr. sable What should a sperm count at least be for a successful IUI. As well as motility etc. Thanks
Pooh: You're welcome, Penny. I just hate to see you so upset :(
William: "how good was he at withdrawing"    Indeed...hehehehe... :o)
dsable: Lori-- I'm afraid for true POF we are still powerless. We'll need 5 or so more years.
Teresa: Is it true that progestin is the synthetic hormone for progesterone? I have heard that there are more side effects with taking progestin; is this true?
Becky: hey tarasue, its me Becky from stepparents BB.
penny: Dr. Sable with my day 3 fsh level being around 16.1 do you think there is a chance for me to get pregnant on my own. How can I tell what my real fsh level is if my estrogen is so high?
alane: Is there anything that can help the implantation of an embryo?
Elena: Dr. Sable-I heard that to at least have a chance at conceiving your E2 has to be a least 150?
bessie530: pamela thank you for answering my question.
tarasue: hi becky!!!
William: Chat Hints:
1. Increase the number in the "Messages:" box so you can read more messages with each "Refresh"
2. Type your message and use a "CTRL+C" to copy it to your computer clipboard, so you can re-post the question if it is not answered the first time.
3. Please be patient; Dr. Sable is volunteering his time and will not have time to answer all questions (we often have more than 50 people online during these chats).
4. The chat transcript will be posted at the AIA website later this week, so look there to find anything you missed the first time through tonight!
lisaC: Which hormone is responsible for ovulation? What is the normal range?
tarasue: dr. sable, in your opinion how many hours after hcg is the right time for IUI???????
dsable: Becky-- my preference in these cases is acupuncture. Viagra is still just an anecdote. Taylor-- at least 1-2 million motile post wash to give it a shot. My preference: 3 IUI's max, then IVF.
Becky: tarasue..wanna chat after this in friendship?
Iral: What does it mean if there are WBCs in the semen???
dsable: lisa C: a complex interpay between FSH, LH, estradiol and "little" hormones like inhibin and activin. The LH surge directly causes preceds ovulation by ~36 hours.
tarasue: sure! that would be great, becky!
Tracey: Dr. Sable, any specifics on acupuncture? I go once a month for a general treatment, should it be specific points?
Becky: Thank you Dr. Sable....
Janice: Hi Becky,  I have never been to friendship , where would I find it??
dtredd: Dr Sable, I have endo and am taking lupron for 6mos, is that too long to be on it and what are my chances of getting pg once I am done taking it?? We have been ttc for 9 1/2 yrs...
StacyD: Dr Sable how long before ret should HCG be given I think I have lost eggs before they were removed my first Re did 32 hours and I always had the same number of eggs that I had on last sono but last Re does 36 hours after HCG and I never have half the eggs as on sono?
Iral: what does it mean if there are wbcs in the semen?
dsable: tarasue-- no agreement on this simple issue. Sperm needs to wait for egg and needs to get comfortable ("capacitate"). After IUI some sperm are all gone within a few hours; some cases they stick around for quite a while. Just like men themselves: very unreliable and unopredictable!
Becky: Janice, it should be listed with all the other chatrooms...Im headed there now...see ya there Tarasue
taylor: Dr. Sable   Do you automatically test a PCOS patient for Insulin resistance/ Thankyou
dtredd: Hi lorih...
ivy: Dr. Sable-my dh has a sperm count on 8 million with 25% motility for 4 hours, would it be better to try iui or ivf? We have had one unsuccessful iui already.
tarasue: Thank you, Dr. Sable.
dsable: stacey d-- we do ours 35 hr pre-retrieval. dtredd-- 6 months is usually the max. Prognosis? tough call depending on your age, how bad endo was (I assume bad)-- I would lean towards being very aggressive.
lorih: hi dtredd
lisaC: Dr. Sable. My RE says I`m not ovulating but tells me he`s not sure what the cause of my infertility is. I don`t get it...If I`m not ovulating what else could it be?
Teresa: Is there a difference between progestin and progesterone?
penny: Dr. Sable with my day 3 fsh level being around 16.1 do you think there is a chance for me to get pregnant on my own. How can I tell what my real fsh level is if my estrogen is so high?
dtredd: Dr Sable, aggressive as in IVF?? I am 29, will be 30 in July.. thank you for answering my question... I had stage 2 endo on ovaries and some was scattered and I had some adhesions...
Victoria: ************ANYONE*************
Can someone please help me with a question? My dh and I want to go to a bed and breakfast for our anniversary. The problem is, the B&B has a hot-tub, and I know these are not good for a man's sperm. If we went to the B&B a week before I ov, would that be enough time for my dh's sperm to "recuperate" and be back to normal? Thank you so much!
dsable: ivy- IUI has almost no medical risk, but I would guess that you'll ultimately need IVF if those are the typical numbers. Taylor-- we do not routinely test for insulin resistance-- the normative data (ie where the bell curve lies) in thios population is not well defined.
StacyD: Thank you Dr Sable for your time and thank you William and Pamela for being here as well
lanessa: Dr. do you know just how many people become pregnant with the use of clomid? thank u
dsable: Hi Victoria-- Just use it as a warm tub instead.
juliecre: if i have a luteal phase of 10-11 days is progesterone necessary after iui?
Lori: Dr. Sable - Do you recommend natural ivf in diminshed reserve patient? w/ ins. coverage
Victoria: Dr. Sable - I didn't realize there was a dr. here!!! How lucky for me! Can you answer my question about hot-tubs and sperm quality?
ivy: Thanks Dr. Sable.
dsable: There is no good data on how many people get pregnant on clomid who already ovulate. For those who do not ovulate and then ovulate with clomid about 60% conceive.
ahs: Dr. Sable-my story, age 41 ist IVFw/ ICSI in Jan, successful, but m/c at 7weeks. Had D&E-waiting for my period to try another cycle. What are my chances of a successful pregnancy?
Janice: Dr. Sable
I just wanted to say Thank you for your time this evening, and for answering all of our questions :)
Victoria: dsable - I don't think we can. Usually the temp in those things is pre-set.
Carlene: Gotta run, thank-you Dr. Sable for your time. Very much appreciated.
William: 2 doctors actually, William does claim doctoral status (PhD hehehe)
You're welcome StacyD!
Iral: Dr Sable, can you please tell me what it means when you have WBCs in your semen???????????
Pamela: you also have a weight problem, or trouble with too much hair in places you don't want too much hair? Or too little hair in places you don't want too little hair? These symptoms along with the lack of ovulation could point to PCOS.Do you have any of these symptoms? Has your doctor mentioned this? Are you seeing an RE?
Elena: Dr. Sable-Do you know how long sperm can live outside of the body?
dsable: ahs-- tough call. Miscarriage risk w/ IVF > 40 is upwards of 20%.
lanessa: Thank u do u know if there's more of a chance of miscarriage?
Ally: Dr Sable, Can one ovulate from the day after bleeding stops up until the day before bleeding starts again?
ahs: thanks for answering Dr. Sable-but you don't sound too encouraging!
lorih: Hi Dr Sable, could you tell me what cause a women to have an high estradiol level on day 3.
Pooh: Dr. Sable, in a typical average unexplained dx, I'm 28, SA and HSG were both ok along with Post Coital(sp). Prog. level was great on 50 mg of Clomid, just didn't work. Would just an injectable medicated cycle have high odds or should I ask to discuss the IUI? Thanks for your help.
Janice: Victoria,  Dr. Sable did answer your ques, he said he would rather see a warm tub used instead. Hope that helps :)
dsable: elena-- depends on "where" outside the body-- incubator in an IVF lab? >24 hours. Dixie cup in subway? considerably less (don't mean to be disgusting-- keyboard taking on a life of its own)
Pamela: Dixie cup in a subway??? LOL
Victoria: janice - thanks! I didn't see his answer!
Tracey: Dr. Sable you are really funny!
penny: lorih, I am not the dr but I too had a high estrogen level on day 3. Mine was 314. Do you mind if I ask what yours was?
lisaC: Dr. Sable. I`ve always had irregular periods but not really any PMS. Now, I get really bad acne and I always feel PMS`y. I`m always bloated, cranky (to be polite) and my periods drag on for no reason. My flow is very unpredictable and it is driving me crazy. Why all these problems now and not in my teenage years? I feel like I`m in menopause!!!!!!!
dsable: ally-- bleeding and ovulation can be completely independent (ie some bleeding does not come from shedding of the lining)-- not a reliable indicator
dtredd: Dr Sable, I am 29, so what would you consider "aggressive"?? IVF?? I had one IVF about 3 mos ago and it didn't work, my re thinks I had an implantation prob due to the endo, and that is why she recommended the lupron... I had a lap in July and had stage 2 endo and had it on my ovaries and some was scattered and I had some adhesions too...
dsable: hi lisa c-- not menopause but maybe irregular ovulation
William: *LOL* RE with a sense of humor...Dr Sable, did you have women folding their "unmentionables" into a neat stack on TOP of their clothes a few years ago? Ever hear about that joke that women were pulling on their REs?
Janice: Dr. Sable  It is so great to see you have such a wonderful sense of humor
lorih: Jenny it was 120.
penny: Dr. Sable, do you have faith that a woman with a fsh level below 20 can get pregnant on her own. Age 28
taren: Dr. Sable  My husband's doctor suggested that he go to the clinic once a week and give a sample and them freeze it and when I get ready for IUI combine all of them. What do you think?
Bdbooh: can anyone tell me how much does one IVF cycle usually cost? Im in California.
penny: lorih, my estrogen was 314 but it is so high due to my fsh problem. do you also have a high fsh? Or have you?
Victoria: Dr. Sable - what should the max temp of the hot-tub be? Would this temp be OK for right AT ov, too? If we did get in the hot tub (warm) during time of ov, would that hurt me at all as far as chlorinated water entering the vagina and uterus and killing the sperm?
Staci: Dr. Sable, I am 36 diagnosed w/PCOS. Have tried IUI 3X, also participated in Rezulin study. Any new advances in treatment?
lisaC: How can I predict ovulation when it is irregular?
Joann: Dr Sable- I had ovarian drilling three weeks ago and now have noticed alot more cm is this normal and how long does the ovarian drilling last?
Pamela: IVF cycles range in cost from $5,000 to $15,000. It depends on what you need and where you go.
ali: Dr. S do you believe in crinone or any progesterone after IVF?
Elena: Dr. Sable-Thanks for the laughs :0
I just wondered if all those times that  my husband and I had unprotected sex and right after he ejaculated I inserted some into my vagina-or if the sperm had died already.   Oh my-I'm getting pretty personal now. Maybe I should just cut my questions short this evening. Thanks for answering all my  silly questions. Just worried about my chances of conceiving.
William: Linda, if this is your first drug+IUI cycle, that's pretty good, if you're on your last IVF cycle and are maxed out in terms of drug dosage, that's not so good. My wife was a pergonal junkie, needed 5 amps a night for more nights than usually, and the first 2 cycles yielded very few eggs, but the last one she had 24 follicles and they harvested 12 eggs that fertilized.
dtredd: Pamela, what is your last name??
Pamela: LisaC,  Have you tried an ovulation predictor kit?
lorih: jenny my fsh was normal according to my re's office.
dsable: William-- we request that our patients hang their clothes on the door knob so we know when to politely enter. My patients have me quite well trained.
Pamela: dtredd-Pamela Madsen...I am the executive director of AIA.
LINDA: I'm in Tn. and mine is 12,500,meds and all
dtredd: Pamela, AIA??
William: Yes, IVF can be expensive, especially if the RE's other job as a stand-up comic isn't panning out very well :o)
(Keyboard taking a life of it's own sorry!!)
dsable: I hope no one mistakes my feeble attempts at humor for a lack of sensitivity. Just the opposite!
Iral: DR SABLE, Can you please tell me what it means when there are WBCs in the semen?
penny: lorih, a day 3 estrogen level usually means you have a fsh problem. I was told due to this problem that I have diminished ovarian reserve. Have you heard about that?
Pamela: The American Infertility Association or AIA.
we are the co-sponsors of this chat. Come visit us later.
lisaC: Pamela, no I have not tried opk. I don`t really believe they work, or am I wrong!
Tracey: Your humor is much appreciated!
Pooh: I had no idea what I was walking into when I came in here tonight, but this is great! Cheap entertainment in which I'm learning a lot from :) lol
Liz: Dr.Sabel  My 3 day FSH was 6.9 E2<20. I am 10 days past 4th DIUI(Follistim/HCG. Had 5 good size follicles 3 smaller. 2 day sperm sample was 50mil 3+/4 52mil 3+. Do these numbers look as if I have a chance this time. How soon can I test?
Thank You, Liz
penny: Sorry to be a pest. Dr. Sable with my day 3 fsh level being around 16.1 do you think there is a chance for me to get pregnant on my own. How can I tell what my real fsh level is if my estrogen is so high?
dsable: ali-- we found what we felt were unacceptably high levels of bleeding and a slightly less implantation rate with Crinone-- we went back to IM prog for our IVF patients
Pamela: No Doctor Sable!! We love it!!!! That is what makes you so good. We need to laugh. It might even make us ovulate!
Victoria: Dr Sable - what temp should a warm hot-tub be?
dtredd: Dr Sable, I am having some back pain... is this because of the lupron?? And, what can I take with alot of calcium in it?? I am allergic to milk and my re said to take Tums but it doesn't seem to be adequate and I am also drinking Sunny D with calcium...
ali: We can tell you are very sensitive, humor is always nice in a differcult situation. thanks for being here!!!
lorih: jenny mine was 6.4 on my last re's visist.
Lori: Pamela, what is ovarian drilling? Yikes.
dsable: hi penny-- not a pest at all. Tough to give a straight answer. In our data the only patients who broke the FSH rules were the under 32 yo's. A provera withdrawal might helpo sort out the FSH/E2 relationship.
William: Dr Sable, there was a running joke in the infertility newsgroups about 5 years ago. Some woman realized she was folding her underclothes into a pile and then stacking the rest of her clothes on top...she then decided to wear her Victoria's Secret best, and fold them into a pile "ON TOP" of the other clothes. Well, the RE was a bit flabbergasted and the patient and the nurse had a good laugh. This got posted to the online newsgroups and suddenly dozens of women were doing the same thing, sometimes keeping the joke to themselves and later hearing that the same RE was getting this from 2 or 3 women who were then laughing about it in the newsgroup.
A riot, especially for us men who like to shop for their wives at VS :o)
dtredd: Pamela, thank you... :)
Pamela: LisaC--try ovu quick...but they sure do work...just read the directions!!! Many of the programs use them.Much better in my opinion then the basal.
lorih: penny sorry i cought see the (P) so I thought it was a (J)>
dsable: Victoria-- warm enough that it does not become a natural contraceptive.
penny: lorih, was that the same blood as your estrogen level? This last time my fsh was only 1.5 but estrogen was 314. Which means the estrogen being so high is making the fsh look better than it really is.
William: Dr Sable, just don't tell us to "scoot down a little more" *LOL*
Tara: My husband and i started infertility testing one year ago.The testing showed that my progesterone levels where low... the following October I had a pregnancy that i lost @ 5-6wks. I was under the assumption that i could not ovulate with levels this low... also could these levels cause spontaneous ab's?
dtredd: William, LOL
Victoria: Dr. Sable - like body temp? (98.6*)
dsable: dtredd-- tough call. Internet rule number 1: don't diagnose pain online. For calcium: broccoli, other green leafy veg's, tums are actually quite good.
lisaC: Pamela, could you briefly explain how opk works? Does it have to do with temperature?
lorih: penny yes it was the same time.
April: How many times should I try IUI with pergonal and Hcg before going to IVF
Pamela: Let Dr. Sable explain ovarian drilling. It is not what you think. They are not getting the power tools out!
dtredd: Dr Sable, maybe that is why I have been craving broccoli??? :)
dsable: don't worry William I will never tell you to scoot one way or the other.
Janice: William--- You crack me up :) THANKS JUST WHAT I NEEDED TONIGHT
ali: Dr. Sable Are you connected with Drs. Sandler and grunfeld or just same hosp? And where is your office located? tx
penny: Dr. Sable thank you for all your help!!
Pamela: April,  it depends on your age, but some say three or four attempts.
dtredd: William, you are the one that I talked to on the phone awhile back, am I right??
Iral: Please help me Dr Sable. I am really worried about the WBC in the semen. What if there is something really wrong?
Ally: Dr Sable, I'm 39 and 2 yrs ago a tried to donate eggs to my sister. They told me I was not a good candidate because my FSH was recorded at 22.5 , estradiol was 92 (tested on 3rd day of cycle). Does this mean I have no hope of becoming pregnant again?
April: My Dh sperm count is 120 MCC should we try just the pergonal and HCG what is the % if we go for the IUI
dsable: atack of the broccoli cravers! Linda-- unless you ahve PCO I am completely comfortable with a 6 mp IVF stim in most cases.
ovarian drilling is a way of decreasing the amount of androgen making tissue (eg testosterone) in the ovaries to tip them in a more efficient direction in their hormone production, In some cases it makes people more sensitive to stim, in others it permits ovulation.
Pooh: Dr. Sable, we're typical unexplained. SA, HSG, PC, and excellent prog level on 50 mg of Clomid. Just no pg. I'm 28 and dh is 31. I'm scared to death of the Endo biop due to the bad experience with HSG. Do you think just injectables would be worth a try or should I ask to be more aggressive and discuss IUI? Patience is getting a little low at ttc for 19 months and not even a nibble on conceiving..
penny: lorih, did your RE mention diminished ovarian reserve at all to you?
dtredd: Dr Sable, LOL :)
William: hehehe...I couldn't blame Dr. Sable for telling me to scoot to the corner and shaddup!
Yup, that was me dtredd! Something about your insurance, right?
lorih: penny no she didn't.
Victoria: DR SABLE - So sorry to keep bugging you with the same old question, but I'm still pretty unsure! Should the temp of the hot-tub be about body temp (98.6*)?
dsable: ally-- maybe, maybe not. What FSH testing mainly tells us is how likely you are to respond to treatment. Some women who do not respond to stimulation still can get pregnant on their own.
taylor: Does prednisone help along with clomid for elevated testosterone levels. A friend of mine said she tried many many months of clomid then her RE added prednisone and she got pregnant. Never heard of this just though I'd ask. Thanks
dtredd: William, LOL, you're funny!! :) --Yes, it was about our ins, we still haven't gotten that worked out, dh is looking into getting a different job... the place that he is trying to get on at covers IF up to $15000, alot better than $3000 lifetime!! I also just wrote an article for our local paper, it is posted on the Gen IF bb...
lisaC: Dr. Sable. Does a woman feel a twinge when ovulation does occur?
penny: lorih, if you don't mind me asking what is your diagnosis?
loopylisa: hello
dsable: victoria-- there are no hard and fast rules here. 98.6 sounds ok; 90 sounds better (remember the testicles live outside for a reason; but then again people DID get pregnant in the summer before air conditioning!)
Marie: are the shots going?
dsable: lisa C-- most women do not; some who think they do are feeling last night's pot roast making its way through the GI tract
penny: Ally, I am in the same shoes as you are but I am 28. My re diagnosed me with diminished ovarian reserve 2 months ago. My fsh is all over the place.
cat: Dr. Sable,  Is it normal for bbt to drop prior to ovulation?
Iral: I guess the temperature of a hot tub is more important than a potential infection. Thanks for nothing!
juliecre: where can we look at this board after the chat?
William: Victoria, I have an even better answer than what temperature the water needs to be, and that answer is that DH doesn't get any tub time. After all, you'll need someone to fetch you your book, another glass of champaign, someone to wash your hair, get your robe, etc. :o)
Make him stay out of the tub, but make it worth his while (and those of you who get to assist your DHs during semen collections know what I mean here :o)
lorih: penny I'm secondary with a positive dx for lupus anticoagulant antibodies.
dsable: taylor-- actually a steroid (prednisone, dexamethasone) are important additions to clomid in some cases. Well studied.
dtredd: Marie, I just took my first one about 3 weeks ago and I won't have another one till about the end of May... my side effects are still awful... :( Thanks for asking...
Victoria: DR SABLE -haha!! Good one!! OK, ONE more question, and then I'll shut up!! heeheehee! Would a "hot" hot-tub be harmful to ME either during ov or, if I would HAPPEN to become pg, at 2weeks after conception?
lisaC: Are you sure you`re a doctor because you sure have a sense of humour!!!!!!!
penny: lorih, I am sorry to hear that. I just have the premature ovarian failure that my RE keeps rubbing in my face
William: kewl, did the article mention FT? (I'm such a pig for PR)
Rebecca: Dr. Sable- I'm very happy with my RE but a may consider switching to you since I appreciate a good sense of humor!!
dtredd: William, no, I didn't... :( Sorry!!
Victoria: LOL@ William!! Vroom! Vroom!! You've got it!! heehee
Marie: is a long time between shots...what are the side effects?? {{HUGS}}
Pamela: Dr. Sable, it is getting late. Why don't we finish up with one more question.
William: That's ok, Pam's helping me out in the PR area also *wink~let*
cat: Penny,  If you don't mind me asking, what's your age?
Janice: Wow William Before I read the last part of your response to the HOT TUB ques I thought you were one of these sentimental guys. i guess your a regular guy after all, always something in it for those men. got to love it. You are funny :)
dtredd: Marie, I have been having hot flashes, mood swings and headaches...
dsable: If I have missed anyone's question feel free to email me at some point:
ali: Dr. Sable, where is your office located and are you affiliated with Dr. Grunfeld or just same hosp?
William: William has a very dirty mind, but it is for all the right reasons :o)
dtredd: William, that's good, LOL
penny: cat, I am 28. How about you. do you have the same as me?
lisaC: Pamela, you didn`t explain how opk works!!! Please!!!!
Pamela: got to read the box!
ali: THANK YOU DR.SABLE!!!!!!!!!!!!!!!!!!!!!!!!!!!
Marie: Dtredd...except for the hot have the same things I do....:-)
Tracey: Dr. Sable, thank you for your time and humor! (You too William!) I want to compliment you on the way you treat your patients at St. Barnabus. I've been to two other clinics and was never made to feel comfortable. You do a great job!
dsable: I'm at Saint Barnabas. Dr. Grunfeld is one of our valued affiliates.
dtredd: William, how do I get my dh to initiate?? (if you know what I mean) I am always the one doing it and it gets frustrating!! :(
William: I'm sentimental in my own incredibly self-serving way, or so my wife tells me hehehe...maybe this is why she's going off with her friends this weekend and leaving me with the girls...
...and why she went off to San Francisco last month and left me with the girls... there a pattern here?
cat: Penny, I am 41 and am not sure exactly what my dx is. He thinks it's luteal phase defect.
Janice: Thanks again Dr Sable :)
Victoria: Thanks so much for your time and expertise, Dr. Sable.
dtredd: Marie, what are you taking??
juliecre: dr sable thank you very much for you time!!!
dsable: I hope this was helpful. If anyone runs into the young lady whose question I missed please have her email it to me-- tough to keep up with all of them.
dtredd: William, LOL, poor you!! :) LOL
cheryl: i have a question regarding surrogacy.
lisaC: Ciao Dr. Sable! Merci beaucoup!
penny: Cat, do you have your period the same time every month? Are they short?
Marie: Dtredd...nothing know me and "bump"...
Lori: Dr. Sable, Thank you for your time and humor in a not always humorous situation. It is appreciated.
Janice: Dtredd,  YOU GO GIRL
cat: Thanks Dr. Sable!
Pooh: Thank you Dr. Sable for your time and showing us that drs can have great personalities.
penny: Thanks for all your help Dr. Sable!!!
dtredd: Janice, LOL, thanks!! :)
Pamela: Thanks Dr. Sable!!! Good night!!
dsable: best wishes to you all-- Mrs. Dr. Sable is waiting at home.
cat: Penny,  My cycles range from 24-27 days.
Toni: thank you Dr Sable
Debbie: What is the term "ovary waxing & waning mean"?
William: oh geez, dtredd, don't get me started I love to give hints on that, but I know what I like and I don't know if your DH thinks the same way...but we can take that discussion offline, you can e- me at and I'll pass along some ideas, but the most important thing is probably being understanding with DH and talking to him about what excites him in bed, and then being willing to try some new things...main thing is to get him talking about what his desires are.
Ally: Penny, interesting to hear that someone is experiencing the same as I. I always think I am the only one. I have used OPK and can not get consistant readings on the LH. Never jives with my cm.
Janice: Pamella and William,  Thank you both very much too!!!
penny: Cat, I only had my period for one day I guess the POF is finally kicking in.UGH!
Pamela: Good night everyone!!!
taylor: Dr. Sable  What reasons would (prednisone) be important along with clomid. Thanks
dtredd: William, LOL, okay, thanks!!
William: g'nite Pam, I'll give you a call in a few !
cat: Penny,  Mine are about 3-4 days.
cheryl: thanks for nothing
William: taylor, dr sable left his e-mail address, if you scroll back right now (change the number in the message box to 99 and hit "refresh") you'll be able to find his e-mail address.