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Infertile patients cannot afford to wait for treatment while their eggs get older.

Dr. Sherman Silber, Infertility Center of St. Louis, is offering video consultations for patients who need to plan now for their treatment while stay-at-home orders are in place. He is talking to and evaluating patients in their home to comply with social distancing measures.

Dr. Silber is discovering that patients actually prefer this method of telemedicine consultation over the conventional office visit. Patients have conveyed that “it is so much more convenient and less stressful” to have a telemedicine personal consultation than to take a day off from work to travel to the doctor’s office and sit with other nervous patients in the waiting room.

The COVID-19 pandemic is thus changing much of the way we will do things in the future, and for the better. “Our patients are surprisingly much happier with this approach. Of course, at some point we need to perform hands on treatment. But with this new manner of seeing patients, we can come to the right diagnosis and treatment plan for most patients more efficiently, quickly, and painlessly, with no loss of personal one-on-one communication.” This is a very welcome new era of telemedicine that has been forced on us by the current difficult times.

Female Fertility – Avoid Ineffective Tests

To get feedback from patients who have undergone treatment at our Center, click here to go to the Patient Comments page.

If you have any questions, you may call us at  (314) 576-1400.

Let’s look briefly at three of the less effective methods for diagnosing infertility—“day three FSH and estradiol”, “day three inhibin B Level”, and “chlomid challenge test”—which are still used today in clinics around the world.

Day three FSH is a blood test which measures levels of FSH (follicle-stimulating hormone); a hormone which fluctuates in relation to a woman’s ovulation cycle. Originally, it was thought that these levels could be used to determine the existence of a high ovarian reserve (large number of eggs left in the ovaries), but studies have found that this is an incorrect correlation. FSH will only have very high levels at the very end of a woman’s egg supply. This, however, is certainly not helpful to a woman in life-planning, since it does not predict where she is on the biological clock.

Day three inhibin B level is another blood test which measures a hormone used to inhibit the pituitary’s release of FSH. Similar to measuring FSH, this test is ineffective in predicting ovarian reserve until it is already too late.

Chlomid challenge test is another test which measures FSH levels to determine a woman’s ovarian reserve, but it does so by measuring her FSH levels while taking Chlomid (an estrogen-like drug and popular medication for stimulating ovulation in infertile women). The FSH levels while one is on this drug vary widely and do not give an accurate interpretation of ovarian reserve. The chlomid challenge test is simply an indirect day three FSH and estradiol test, and it is not a good indicator of ovarian reserve until it is too late.

Fortunately, there is a new technique called Antral Follicle Count [video], developed by Dr. Silber, which solves the biological clock question with a precise, painless procedure that requires only a few minutes of ultrasound and a trained technician. Also see the Preserving Your Fertility section.

If you have any questions, you may call us at  (314) 576-1400.