hi,
Thanks for the query.

according to your description,

your ultrasound features are indicating blighted ovum, may be the growth stopped at 4 weeks of gestational age,
subserosal fibroid usually will not affect the pregnancy as that lies outside the uterine cavity, due to hormonal effect size of the fibroid increases during pregnancy after abortion properly the size can decrease to some extent, if not better to take treatment before next pregnancy, as subserosal fibroid can undergo torsion or red degeneration etc complications in pregnancy.

your hormonal levels and anovulation indicating the possibility of poly cystic ovarian disease, with treatment for PCOD your hormonal levels can come to normal.
though your estradiol level is elevated as your FSH level is within normal level there may not be poor ovarian reserve.

so you consult your gynecologist and decide regarding treatment,
-if you are having any symptoms due to fibroid like menorrhagea, pain abdomen etc, you can go for treatment, if no symptoms are there you can go for conservative management with your doctor's advice.
-you can start treatment for PCOD with your doctor's advice which can control your hormonal level.


Hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please rate the answer after closing the discussion.
Take care.

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hi,

the factors against poor ovarian reserve in your case are,
- you are at young age and poor ovarian reserve is usually seen in perimenopausal age group.
-normal FSH levels.

positive factors for poor ovarian reserve are,
-sometimes it can affect younger age group also as in idiopathic cases,
-high estradiol levels sometimes can mask elevated FSH levels.

poor ovarian reserve can lead to infertility by poor ovarian reserve and impaired oocyte development.

so to diagnose this condition, if your doctor recommends, you can go for tests like,
FSH estimation by clomid challenge test,
-antral follicle count by transvaginal ultrasonography,
-detection of serum levels of anti-mullerian hormone,
-blood levels of Inhibin B,
-ultrasound measurement of ovarian volume and follicular density etc.

treatment for poor ovarian reserve is cyclical ovarian disease which is characterized by menstrual irregularities, anovulation, with elevated LH, estrogen and insulin levels,
though you are having only few symptoms and signs of it as it is a common disorder better to rule out, if you are not having PCOD features in recent scan then the possibility is less.

as you conceived once with fertomid and as poor ovarian reserve is not yet proved in you you can go for it again with your doctor's advice.

Wish you Good Health, If you are satisfied with my response please rate the answer after closing the discussion.
Take care.

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