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Woman With High FSH & Fibroids Trying To Conceive

Question:

Hello Dr. Ramirez,

I am 37 years old with multiple fibroids. My gynecologist gave me Clomid and asked me to test FSH simultaneously and my result came out  22.9, I did ultrasound today and to his surprise there was an egg. He said that I have 3 factors that hinder pregnancy, age, high FSH and the fibroids, the biggest one is 4 cm.  He suggested considering removing my fibroids. I am worried I dont know what to do.

Regards, M. from Jordan

Answer:

Hello M. from Jordan,

Removing a 4 cm fibroid is not indicated unless it is impinging into the uterine cavity.  I would think that to be a needless surgery.

I presume that he did what is called a “Clomid challenge test”, in which case the FSH level is taken on cycle day # 3 and then day #11.  If that was the case, then your FSH is almost menopausal levels, but since you created a follicle, you are probably “peri-menopausal”.  At 37 years old, IVF is the treatment of choice, and more ideally would be to use donor eggs.  IVF is more effective than trying naturally, but your chances may still not be great.  The only way to overcome the age factor, which causes eggs to deteriorate in quality, it to be able to get lots of eggs.  An elevated FSH means that your ovaries probably will not respond much.  But, it is worth a try.

After all, it only takes one perfect egg to have a baby.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG

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