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Q. I had ovulatory dysfunction. Can you suggest a way for me to start a family?

Answered by
Dr. Balakrishnan. R
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 17, 2018 and last reviewed on: Nov 28, 2022

Hi doctor,

I have had ovulatory dysfunction for about seven years. About a year ago, my husband and I decided to try starting a family. Not seeing any success, we visited a fertility doctor about two weeks ago, and she prescribed hormone blood tests. My test results are estradiol serum: 13 pg/ml, prolactin: 4.16 ng/ml, AMH: 1.97 ng/ml, FSH: 7.41 mIU/ml, and LH: 1.93 mIU/ml. Can you please suggest a way to start a family? Do I need to take a treatment considering my numbers? I have had irregular menstrual cycles for ten years. Now the frequency is 27 - 41 days. I was on Metformin for four years since I was initially misdiagnosed with PCOD. It has now been confirmed that I do not have polycystic ovaries. Laboratory tests were performed last week and are attached herewith.

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Hi,

Welcome to icliniq.com.

I understand your concern.

Let me get a few facts straight in relation to the hormones and ovulation, thereby, pregnancy. Twenty-eight years is a very good age to get pregnant. Your weight is within the normal range. So, anovulatory possibilities are low. Prolactin and luteinizing hormones are normal.

Usually, a lady is born with a fixed number of eggs. Every month, she keeps ovulating and expelling the best eggs. So, by 35 years of age, she loses most of the good eggs, and by 40 years, the good leftover eggs are minimal. So, the chance of a healthy pregnancy is very low. As the number of eggs from the ovary keeps depleting, the brain has to repeatedly order the ovaries to release the best of the leftover eggs. So, initially, FSH (follicle-stimulating hormone), which is under 4 mIU/ml, is not enough to get good eggs. The overflow of eggs from the ovary is blocked by AMH (anti-Mullerian hormone).

So, as the number of eggs reduces, the FSH is needed in higher doses for effect, and AMH has to bow lower to release the eggs. So, in your results, FSH is more than 4 mIU/ml, and AMH is down to 1.93 mIU/ml. So, all this indicates that the eggs are at a lower number. So, you may need a good ovulation induction with hormone injections.

With good stimulations, you should get two to five good eggs, and the doctor can control the trigger to ovulate it. Then you can either have normal contact or ask for IUI (intrauterine insemination). If the eggs are very low or enough eggs are not produced, you can have a pregnancy by IVF (in-vitro fertilization) with donor eggs. So, go ahead with stimulation and hope for the best.


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