LH level prior to starting IVF

Given my recurrent miscarriages, I am now considering giving IVF a try.


1) On day 1, 2, 3 and 4 of my cycle, I took an LH test (the test you would use to check on your LH surge prior to ovulation). It showed a faint line (compared to the dark reference line). One doctor I spoke to indicated that this is a poor sign as my LH should have dropped to a level where the test shows no line at all when compared to the reference line. This seemingly higher LH at the beginning of the cycle means that my egg quality would not be good. He therefore suggested not to go ahead with the IVF as it would unlikely be successful. Has anyone had a similar experience? Should I be very concerned about my LH level and does it change from cycle to cycle?


2) I also had my FSH tested on day 3 and it was about 5 which I understand is good. The day 3 scan also showed that I had 4 possibly 5 follicles. Does this mean that with stimulation, I would at most get 5 mature follicles, or is it possible that the scan does not pick up everything in which case if I am lucky I may get one or two more in the end?

As for question number 2 - yes, your FSH level sounds very good. I wouldn't pay too much attention to the day three scan, especially if you've not had any stimulation. It sounds way too early. Even after stimulation and a few days before egg collection my scans did not show up all the follicles. I think about 11-13 were picked up on the scans and the week prior to this the Doc only counted 8 (the main thing was looking at the size of the follicles, how well they'd matured etc). I actually ended up with 21 eggs collected. 17 of them were mature enough for IVF. Also, I can't quite remember if this is right or not but I think that sometimes not every follicle contains an egg and sometimes a follicle contains more than one egg.


I've no idea about question number 1 - it was never suggested to me that I do an LH test at the beginning of a cycle and I've never heard of this before. I'd be interested to know if this is standard practice. Also, if you're using Clearblue ovulation tests there's ALWAYS a faint blue line which is supposed to get darker when you're near ovulation. Another brand I got from my doctor only showed a line immediately prior to ovulation.

Hi Keepontrying


The LH test sounds interesting - particularly if the Dr thinks this is linked to egg quality. I am interested to know about this as we have had egg quality issues this 3rd Cycle of IVF and I have always wondered how we improve this when we are both very fit and healthy.


With eggs - it doesn't matter how many you get - its the quality that counts. Some Drs feel less is better as they don't have to compete so much against each other and the quality would be better in the end. So I wouldn't worry too much about how many eggs you get. Worry more about the quality - as it seems to be the most important thing - as we have found.....


Which Dr are you using?


Trying!

Yeah, 'Trying!' makes a really good point on the quality vs. quantity issue. I should have said that my first IVF cycle failed and I was told that it was, at least in part, due to my responding so well to the drugs and producing so many follicles. My hormones then weren't at the right levels to sustain a pregnancy. Good luck!

Kikidee,


Yes, I've used Clearblue before but do not remember if I've always gotten a faint line or no line when I tested negative. I do not know the ovulation test kit the doctor used. It was a strip (versus a stick). One half of it is green and the other half white (the white portion is the part you dip into your urine for just a second. You wait then 3-5 minutes for the results. For me, from day 1 to day 4, my LH level was coming down as each test I took the line became fainter on each subsequent day. It's good that the level was coming down but the doctor said it should have been a lot lower to start. I did a search on google and found two studies. One study concluded that high LH levels at the beginning of a cycle can prevent your eggs from developing properly (thus resulting in poor quality eggs). However another study showed that there was no conclusive evidence of this.


Trying!


I am new to IVF and have only started my research on this. I consulted a few doctors (the ones that have been highly recommended in this forum). We liked two of the ones we consulted but particularly liked Derek Lo because he spoke from the heart. He was probably the most negative of them all saying that I have so little chance of succeeding given my age. It made me feel so terrible, but all I can say is that if I have any chance at this, I have to just keep on trying regardless of my chances. I think Derek primarily focuses on IVFs and IUIs so he has a lot of experience in this area. It has been his experience that women who have high LH at the beginning of a cycle do not get pregnant (whether through natural means or IVF). That is the reason why he recommended that I wait a cycle for IVF. He did not want me to fail. I am therefore going with a natural cycle this time around.


What other tests do you generally take prior to an IVF cycle? What is generally the normal dose of FSH that one gets for IVF?

Hi Keepontrying


There are a lot of Drs out there and it sounds like you did some research, which is a great way to start out. We stayed with one Dr for too long and now have changed to a Dr who has a lot more experience and is really invested in our cause.


The LH study sounds interesting. I will ask my Dr about it. I just can't seem to understand why after 3 Cycles of IVF we haven't gotten pregnant. Its been a long road, and quite frustrating as we have tried absolutely everything.


With regards to tests - generally that all depends on the Dr. I had a full blood analysis on day 2 of my period and a scan - which showed lots of eggs. I then came back on day 21 to get Buserelin and start sniffing for 2 weeks, then I was put on puregon and had blood tests everyday to monitor estrogen and other hormones. I also had scans every day as the Dr only wanted to get up to 8 eggs as opposed to 20 (which I usually get) as he believes that quality is compromised if there are too many eggs. I also had an LH test and that showed normal - sometimes this lets the Dr determine which type of Stim drugs to give you as some (like Menopur contain LH, whereas others like Gonal and Puregon don't). Its also important not to get hyperstimulation - as that causes medical complications. Estrogen level monitoring can tell the Dr how much stimulation to give you each day to make sure that there are no complications. Its a bit of a science, but its well worth it as this third cycle was the only one so far that I didn't get hyperstimulated. Sadly I didn't get great eggs, but at least it was a relatively pain free and pleasant cycle (relatively speaking to the other 2).


Good luck with your IVF. If you have any other questions, feel free to PM me.


Trying!

Trying!


Yes, it's been a long road. What does your doctor say as to the reason why the IVFs have not been successful for you? Has it been an eqq quality issue each time? It seems that you are taking a lot of medication and tests throughout your entire cycle of IVF. I did not realize there was so much involved.


I did have a few other questions for you. I have sent you a PM.


Keepontrying