Can immature follicle size affect conception?

Question

Hello doctor,

I am 32 years old, female and my husband is 39 years old. We have been married for two and a half years. We did not control taking any type of birth control from the beginning since we needed a baby. We did all the required tests. My scan report showed only one immature follicle size of 10.9 mm in my right. My progesterone level was a little low, 10.9. This month I had a scan which showed again an immature follicle size 13.8 mm on the left side which according to the doctor, is not in good shape either. I need advice on this.

Answer 1

Hello,

Welcome to icliniq.com

I read your query and understand your concern. I do not think you need to worry, 19 to 35 years is the right age to get pregnant. No one can decide the follicular growth and health by just a scan. Progesterone level is just indicative of whether the ovulation has occurred or not and if on time. It has to be done on the 21st day, but there are much better methods to know if ovulation is occurring. If you want to know if good follicles exist in the ovary, then you need to do serum AMH (anti-müllerian hormone). You need to have AMH done in the first 14 days of the period. Please do not decide on fertility chances based on Progesterone. Follicle number and quality can be improved using HMG (Human menopausal gonadotropins) injection. Kindly see if the following checklist of investigations is done

1. For the husband, semen analysis at least two- done four weeks apart preferably in an infertility center (examination done by an andrologist), blood sugars.

2. For the wife, blood sugars, thyroid profile(T3, T4, thyroid stimulating hormone).

3. Ultrasound scans to evaluate the uterus, ovaries, and adnexa.

4. Confirm tubal patency- most important- a tube is a connection between the uterus and ovaries (the bridge where sperm meets the egg and forms a baby) this is the size of a hair follicle and cannot be seen on scans. Being such a small opening tube can get blocked easily, so check with HSG (X-ray with dye), SSG (scan with dye), or laparoscopy. If all this is done and found normal, nothing can stop a pregnancy. I hope I have cleared your query, do write back if any more queries.

Thank you.