Q: My 28 years old wife is unable to conceive for the last 4 years. Her test report shows that follicle-stimulating hormone (FSH) is 22.5 (folliclar phase 1.1 to 9.6; midcycle peak 2.3 to 20.9 luteal phase 0.8 to 7.5; menopausal females 34.4 to 95.8; pregnant females 0.0 to 0.99 (CLIA method). Her follicle size is 18 x 16 in right ovary and 12 x 12 in left ovary on 16th day and ER is 15.1 mm. Now the doctor has told us that in-vitro fertilisation (IVF) is the only way to get a child? What to do if FSH is more? Is there any way to reduce the FSH level? Or, do we have to go straightaway to IVF?

A:I doubt you need to go for IVF straight away. You may repeat the test, and establish the egg formation by ultrasound scanning first. There are medicines to help form eggs like clomiphene citrate, and also injectable preparations if clomiphene does not work It usually is effective in over 80% of cases. Along with the medicine, scanning to time egg formation and then coitus at the time of egg rupture, or just before it, can be tried for 3-6 cycles.