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Q: Does anyone have a good protocol for infertility for a 40 year old female with one good tube and hx of one miscarriage? Thyroid and saliva workup..vitamin /mineral/fatty acid levels/yeast/food allergies??
TIM CALLAGHAN md dc

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A1: Get a hormone profile with progesterone, estradiol and testosterone by saliva or radioimmunoassay. If the estradiol is high, and progesterone and testosterone level is low there have been 100% successful pregnancies using 2 capsules of DeAromatase twice daily in more than 100 women. This restores hormone levels to normal. One body builder had been on steroids for 20 years with his wife unable to get pregnant. She was pregnant within 30 days when he started De Aromatase. 5 capsules daily.
Dr. Jim Howenstine

A2: I would recommend using the current protocols on http://www.uptodate.com. In June 2007 they have a new revised protocol for female infertility that is very good.

At age 40 you must quickly assess "ovarian reserve" as that is key in this age group. Get a day 3 FSH and Inhibin B. An elevated FSH or a low Inhibin B should signal that a "high tech" approach should be considered sooner rather than later. If available, also obtain AMH (Anti-Mullerian hormone) Its presence indicates a depleted ovarian follicle pool.

Of course you cannot forget the male factor and evaluation of tubal function. Newer studies show that Chlamydia antibodies are very helpful in determining patients with a "tubal factor" and are now more predictive of infertility than abnormal HSG and historical factors. What is meant by "one good tube"? Did she have an ectopic removed, or does she have evidence of a hydo-salpinx?

Elton Kerr, MD, FACOG
YAKIMA, WA

A3: Dr. Callaghan,

I have had good results with three tests: Vaginal Culture & Sensitivity through http://www.DoctorsData.com, Female Hormone Panel through Genova Diagnostics and a serum anti-sperm antibody test. Clear up ANY abnormal bacteria, balance the hormones and make sure that she doesn't have the antibody.

Frank Strehl, D.C., D.A.B.C.I.
Wheaton, IL
http://www.DrStrehlOnCall.com

A4: You might have the patient review the Conception Kit (conceptionkit.com) which received FDA approval in March 2007. A free informational DVD is available that explains how the product works. It is the only complete home artificial insemination kit which is a completely natural alternative for couples struggling with fertility problems. It will treat many male side and some female side fertility problems. It has had great success with sperm counts as low as 1.28 million (almost clinically sterile) and with women as old as 42 who failed with multiple IUI's and IVF's.

Dennis Stepanovich,DC

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