Egg reserve test

becky · Post by **becky** » Thu Jul 17, 2003 7:06 pm

Can anyone help me?? Mr Dr has agreed to help arrange for me an egg reserve test..if I can find the details..I hope that I haven't dreamt the whole thing up.. Any ideas?? I am sure that there is a blood test that you can have - very expensive and very few clinics offer it and it can give you a true egg reserve reading rather than a guess one from you FSH levels. fingers crossed someone knows what I am going on about. love Becky B

Traci · Post by **Traci** » Fri Jul 18, 2003 7:24 am

I would be interested too Keep me posted . Thanks Trace x

Helen GB · Post by **Helen GB** » Fri Jul 18, 2003 9:06 am

Hi girls...I think you are refering to the Day 3 Inhibin B test...details as follows: Day 3 Inhibin B: A new ELISA-based hormonal test, measuring the levels of Inhibin B in serum on day 3 of the menstrual cycle. Since only the Follicular Granulosa cells secrete this hormone, its level reflects on the potential of the ovary to grow follicles, which physicians refer to as 'ovarian reserve'. Women with low levels of the hormone were found to have more impaired ovulation in the course of the IVF cycle, lower pregnancy rates, higher cancellation rates and higher abortion rates. Inhibin B is secreted by the granulosa cells while estradiol is secreted by several other cell types in the ovary. Thus the Day 3 Inhibin B test provides the physician with a more direct and appropriate measure of 'ovarian reserve', compared to the currently used indirect FSH measurement (FSH is secreted by the pituitary gland). It may provide the couple some qualitative estimate of success in future cycles of artificial reproductive techniques. This information may also be used by couples to decide whether to try IUI, ART or to resort to another solution such as donor egg or adoption. Treatments - If Day 3 Inhibin B is abnormally low with a positive Anti-Ovarian Antibody test; then treat for Anti-Ovarian Antibodies with Dexamethasone or Prednisone. Consult a reproductive immunologist before treatment for Premature Ovarian Failure. Treatment should start on day one of the cycle. For low responders to induction of ovulation, treatment is also to start on day one of the cycle. If Day 3 Inhibin B is abnormally low with a negative Anti-Ovarian Antibody test; then increase Hmg dosage. If this is not successful, an egg donor is indicated. I think the Midland Fertility Centre offers this test by post. There is also the Clomid Challenge Test that can be done...I will post details of this when I find them...my Reference notes are all muddled up!! Bye for now Helen

Helen GB · Post by **Helen GB** » Fri Jul 18, 2003 9:16 am

And here's the other one: Clomiphene Citrate Challenge Test Q - What is the clomiphene citrate challenge test (CCCT)? A - The CCCT is a test that we use to help to predict a woman's reproductive or fertility potential. The tests consists of determination of blood follicle stimulating hormone (FSH) and estradiol levels on cycle day 3 and cycle day 10 (cycle day 1 is defined as the start of a period). Part of the test includes administration of an oral medication, known as clomiphene citrate (clomid, serophene) at a dose of 100 mg (two tablets) daily from cycle day 5 through cycle day 9. Thus, the first set of laboratory testing is drawn just before beginning the clomiphene and the second set just after finishing the medication. Q - Who needs the CCCT? A - We recommend the CCCT for all infertile women older than 35 and to younger women whose histories are suggestive of poor ovarian function. This test is also useful for patients of any age with unexplained infertility. Q - How are the results of the CCCT interpreted? A - Generally, an FSH level less than 10 mIU/ml is considered to be in the normal range. If the baseline (day 3) FSH is greater than 10 and/or the baseline estradiol level is elevated (greater than 70 pg/ml), the results are predictive of a significantly reduced fertility potential. The second set of lab testing (on day 10) is also important since approximately 50% of patients will have abnormal levels on day 10 only. FSH levels between 10 and 15 mIU/ml (on day 3 or on day 10) are in the "gray zone" in which pregnancy is still possible but is associated with a higher rate of miscarriage. An FSH level greater than 15 mIU/ml is indicative of a very low likelihood of pregnancy. Q - If my results are abnormal, what does that mean? A - Studies have shown us that, in association with fertility treatment, greater than 90% of patients with an abnormal CCCT will be unable to conceive and deliver a baby with their own eggs. Though a small number of patients will be successful, this information helps us to identify patients who should probably forego ovulation induction and/or IVF in favor of egg donation or adoption. Q - Are there situations in which the CCCT is not as predictive of fertility potential? A - Yes. Women with only one ovary tend to have slightly higher FSH levels. In addition, women who have had recent treatment with cancer chemotherapy often have a temporary ovarian dysfunction with fluctuating FSH levels. Many of these patients will recover normal ovarian function and fertility potential as time passes. Hope these help Love Helen

Helen GB · Post by **Helen GB** » Fri Jul 18, 2003 9:27 am

And some more food for thought....... Researchers seek tick of women's biological clock By John Wolfson ~ The Seattle Times SEATTLE (Nov 2002) Theresa Naluai-Cecchini's lab coat fluttered as she strode down the hallway of the University of Washington Medical Center. Her left hand clutched a plastic container that looked very much like a toolbox, except for the orange "Biohazard" sticker affixed to it. As Naluai-Cecchini pushed the elevator button, her attention seemed fixed on her mission rather than the social significance of her team's project, which could revolutionize the lives of women everywhere. Soon their work could solve a riddle that even the most sophisticated science cannot unravel today: how many years a woman has left to get pregnant. Researchers at the UW's Fertility and Endocrine Center, working with a $400,000 federal grant, are closing in on a solution to the fertility frustration. They may not be able to extend childbearing years, but within three years they may be able to give a woman information that right now cannot be found anywhere in the world: how much longer she can reasonably expect to remain fertile. No one had ever bothered to figure out how long women remain fertile because it had never been much of a concern. Most infertility problems in the past have been related to anatomical abnormalities. "When I started 40 years ago in this business, you never saw a 40-year-old infertility patient," said Dr. Michael Soules, head of the fertility clinic and one of three doctors in charge of the project. "They started showing up about 10 years ago. They were delaying childbirth like no other generation." For all the significance of the work, for all its breakthrough scientific potential, the core of the project's methods couldn't be simpler. In the end, it comes down to counting. Find a way to accurately count the eggs in enough ovaries and patterns begin to emerge. "This is not rocket science," said Soules. The counting is significant because of the possible relationship that exists among the different types of eggs in the ovaries. The researchers believe a typical baby girl is born with about 1 million eggs, 500,000 in each ovary. The eggs sit in small clusters just under the surface of the ovary and are known in this state as primordial follicles. After puberty, some of these eggs begin to grow and move toward the center of the ovary. The layers of cells that surround these eggs also grow, secreting a liquid as they do. And in that liquid lies the hopes of the project. The growing egg and surrounding cells are known as antral follicles, and the UW researchers believe there is a correlation between the number of them at any given time and the total number of eggs in the ovary. The more antral follicles, the more eggs remaining. What makes this so important is that the liquid in antral follicles shows up on sonograms. Soon, doctors may be able to tell a woman how many eggs she has with a simple ultrasound. The team wants to count another 100 or so ovaries before it draws any conclusions, but the researchers believe that a normal, fertile woman has between 20 and 25 antral follicles at any time. Women with 10 or fewer will have a hard time conceiving. Though the researchers are confident of their findings so far, plenty of work remains. It may be that women are born with vastly different numbers of eggs, or that they lose them at different rates. And it may be that both of those possibilities are true. If that's the case, the researchers may never be able to predict how long a woman will remain fertile because they won't know whether her eggs are diminishing quickly or slowly. But even then, the sonogram would provide a useful snapshot of a woman's fertility. If it showed she had, say, 15 antral follicles, and she wanted children, she would know to start thinking about getting pregnant fairly soon. "Maybe you're planting a seed," said Dr. Nancy Klein, who heads the team along with Soules and Dr. Angela Thyer. "You can say, 'Hey, you're looking a little low.' Maybe she'll think about having children at 30 instead of waiting."

NicolaUp · Post by **NicolaUp** » Fri Jul 18, 2003 11:14 am

Wow what an amazing wealth of information this site provides. Thank you. I't sounds a bit doom and gloom though, I'm hoping that my last day 1 (long story) FSH level at 17.5 was a blip and that it will all be back to normal next month. Spk soon, Nicola.

Helen GB · Post by **Helen GB** » Fri Jul 18, 2003 11:38 am

Here is the link to Midland Ferility Services site...they charge £75 for the ovarian reserve testing www.midlandfertility.com/index1.htm

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