Q. Can a 35-year-old female with a surgical history of unilateral salpingectomy and PCOD undergo IVF treatment?

Hello,

Welcome back to icliniq.com.

I read your query and understand your concern.

Hope you are doing fine. Now if age is a factor that is making you ask for an IVF (in vitro fertilization) procedure, you can go for it directly. The best age for a lady to get pregnant is 19 to 35 yrs. You have reached the upper limit and it would not be advisable to try your luck with normal methods for long. Once the eggs in your ovaries get over, there is no treatment to get them back and even the IVF (in vitro fertilization) procedure may not be possible after a particular age. There is no such fixed age after which pregnancy's chance is low, as the oldest mother in the world is 45 years old. My own patient had a triplet pregnancy at the age of 41 years after a few hormonal injections. If you want to try otherwise, that can be done for a few more months. Since you have one tube and could have a pregnancy through that, then there is a good chance for you to conceive through the same tube again. For the diagnosis of PCOD (polycystic ovary disease), your weight has to be corrected.

PCOD (Polycystic ovary syndrome): This is a congenital condition, I mean it is a genetically programmed condition, you get it from your parents. When you suddenly put on weight, this cholesterol is converted into estrogen hormone (if I may simulate-have not you seen obese men developing breasts and in young obese girls, who develop periods at a younger age - they all have high levels of estrogen hormone or female hormone). In your body too when fat, which is stored for tomorrow, is more than normal, then it is converted into a hormone that tips the balance between FSH (follicle stimulating hormone) from the brain and the ovarian hormone. FSH (follicle stimulating hormone) as the name suggests stimulates follicles from the ovary, but once the follicle is big enough to ovulate, the FSH (follicle stimulating hormone) is suppressed by the same estrogen hormone from the ovary. But when the same estrogen hormone is coming from fat, the brain is confused and follicle growth stops early at a smaller follicle size and will not rupture, next scan you will see all these follicles as polycystic ovaries. This is usually associated with obesity, irregular menstrual cycles, no periods for a few months, and later heavy periods with clots and fleshy masses, spotting on and off, thyroid abnormality, and prolactin problem indirectly. You develop that extra pad of fat around the mid-segment of the body, especially the waist, thighs, and breasts, with no fat beyond the elbow and knees. Excessive body hair growth, hair fall, a dark shade over the lower half of the face, acne, oily face skin, black skin over the back of the neck, inner thighs, and under the surface of the breast. May have a family history of diabetes, especially father or his family. This will not allow ovulation to occur at any time and so you cannot get pregnant, till it is treated. It also increases your chances of early pregnancy abortions. But this has a solution.

Your weight has to be:

Weight (in kg)= Height (in cm) - 100

Your expected weight is 52 to 57 kg (121 to 126 lbs). Once you reduce weight to the normal range, you would not need any medicine to get periods or to get pregnant and pregnancy will be healthy.

To reduce weight follow the following tips:

1. No junk food or fast food or red meat, reduce snacks in between meals.

2. Have low calories food and high proteins.

3. Regular exercise (especially for the waist and hip area), aerobics, yoga, brisk walking (swing your hands well), try to reduce five to eight pounds per month.

Do not hurry on weight reduction, it will be difficult to maintain. As soon as you reduce at least 10 pounds of weight, you will see changes.

Kindly see if the following checklist of investigations is done:

1. Husband- Semen analysis at least to be done four weeks apart preferably in an infertility center (examination done by an andrologist), blood sugar level.

2. Wife - Blood sugar levels, thyroid profile.

3. Ultrasound scans evaluate the uterus, ovaries, and adnexa (adnexa is the group of ovaries, fallopian tubes, and ligaments that secure the female reproductive organs.)

4. Confirm tubal patency- It is the most important (Tube is the connection between the uterus and ovaries, the bridge where sperm meets the egg and forms a baby). It is the size of the hair follicle and cannot be seen on scans. It is such a small opening tube that it can get blocked easily.

5. Check with HSG (hysterosalpingography), which is an x-ray taken with a dye, or SSG (sonosalpingography) which is a scan with a dye, or laparoscopy (only one tube is left, once you had gotten pregnant, does not mean the tube is still open, it may be blocked by small mucous plug or adhesions, so on).

If all this is done and found normal, nothing can stop a pregnancy with God's will. So I would advise, reducing weight by a few pounds (this will improve the egg's response be it normal or hormonal injections or IVF-in vitro fertilization, once weight starts reducing, have your fallopian tube tested. If the remaining tube is also blocked, go directly for IVF (in vitro fertilization), but if the tube is still open, give it four to six months. Try with normal methods or better with hormonal injections with or without IUI-intrauterine insemination (a simpler method with four times the pregnancy chances, cheaper, and it is not IVF-in vitro fertilization).

Hope I have cleared your query, do write back if any more queries.

All the best.

Regards.

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Dr. Balakrishnan R

Experience: 23 + Yrs

Obstetrics And Gynecology

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