Physician Uncovers Cause of Multiple Miscarriages Through Inhibin B Test;

Couple Conceives and Delivers Healthy Baby Through Egg Donation

Situation

When a Manhattan professional couple decided to have a child, they knew their age might present a problem. The husband was in his late 40s, the wife in her early 40s. After their first pregnancy ended in a miscarriage, the couple’s doctor assured them that this was common and not to worry. However, after a second miscarriage, the couple saw a fertility specialist who ordered several basic tests to assess the wife’s ovarian reserve (the quality and quantity of her eggs.) According to the specialist, the wife’s FSH level (FSH is a hormone involved in producing eggs) was consistent with someone in her 20s. However, to get the best embryos, in vitro fertilization (IVF) was recommended.

Against their doctor’s strong advice, the couple insisted on having a PGD (Preimplantation Genetic Diagnosis) test done on the fertilized eggs to determine if there were any genetic abnormalities. Of the seven eggs, five fertilized and all showed as having Down syndrome. The fertilized eggs were never transferred to the woman. The couple then went to another fertility specialist who found that the couple had traces of infection, which was treated with Tetracycline.

After numerous attempts with artificial insemination, the woman conceived, but suffered a miscarriage at 10 weeks. Desperate to uncover the reason for her multiple miscarriages, the wife began searching the Internet for information. Thinking that her problem may be “bad eggs,” she came upon the term Inhibin B, and discovered it was an advanced test that provides physicians with a more accurate measure of ovarian reserve than FSH measurement.

Following some additional Web surfing, she found a fertility specialist who regularly ordered the Inhibin B test for his patients. The couple contacted Dr. Scott Roseff and set up an appointment to meet with him at his New Jersey office.

Solution

Following an exhaustive examination of the couple, Dr. Roseff ordered several advanced diagnostic tests through Repromedix: the Inhibin B and another FSH test for the wife and the SDFA test for the husband. SDFA assesses the level of the sperm’s DNA fragmentation; previous doctors had only tested the sperm’s quantity and shape.

The FSH and SDFA test results were both normal. However, the woman’s Inhibin B level was 15; a normal level is 45 to 200. The Inhibin B test confirmed that the poor quality of the wife’s eggs meant the couple had virtually no chance of sustaining a pregnancy using her eggs, even with IVF. Dr. Roseff advised the couple to consider egg donation with in vitro fertilization, which they readily agreed to.

Result

The woman conceived after the first IVF cycle using a donor egg and, after an extremely easy pregnancy, gave birth to a healthy baby boy. The couple is, of course, elated. However, the new mother wishes her original physicians had ordered the Inhibin B test following her first miscarriage, which would have spared her and her husband the pain of two successive losses and thousands of dollars. “I think it’s important to have as much information as possible before undergoing treatment,” she explained. “IVF is so financially, emotionally, and physically draining. Why would a couple put themselves through that if they knew their chances of sustaining a pregnancy were so low? Thankfully, we ultimately knew what our choice was, and we made the best decision possible.”