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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had gastric bypass. Told as premature ovarian failure through blood work. Taking Estradiol and Progesterone

Hi Dr. Grief,

I am a 31 year old female. I had gastric bypass on October 24th 2012. I have lost a total of 160 lbs in the last year. My question is regarding premature ovarian failure.

In May I went to see my OBGYN because I had only had 2 periods since December 2012. At that time she did blood work and found the following levels:

DHEA - 388
LH - 22.9
FSh - 36.6
estradiol - 15

I was told then that I most likely had premature ovarian failure. I was sent to an endocrinologist who said the same thing. I started on Estradiol 1mg and Progesterone 5mg 12 days on and 12 days off. I have two healthy children. My husband and I want to have a baby and feel discouraged.

I have done a lot of research and it seems that hormone levels fluctuate throughout the cycle. How can I be told I have premature ovarian failure when my labs were randomly drawn and weren't drawn on any specific cycle day? My LH could have been normal if I was ovulating at that time, correct?

What are my options? I believe I ovulated on cycle day 15 as I had negative/positive/negative ovulation tests. I began charting my temps as well. Is it possible they are wrong as my blood work wasn't done on any specific day?

Thank You,

Jamie Gaudie
Mon, 25 Nov 2013
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OBGYN 's  Response
Hello Jamie
Thanks for writing to us with your health concern.
You have not mentioned on what cycle day specifically was the blood work done.
When the LH and FSH levels are high, that is when premature ovarian failure is suspected.
Also, a low estradiol level points to that.
ideally yes, the labs should be drawn on day 3 of your cycle, so please get them repeated.
Most specific for premature ovarian failure is AMH, which is independent of cycle day.
PLease insist on AMH measurement, as it perfectly reflects the ovarian reserve.
All the best.
Take care.
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Had gastric bypass. Told as premature ovarian failure through blood work. Taking Estradiol and Progesterone

Hello Jamie Thanks for writing to us with your health concern. You have not mentioned on what cycle day specifically was the blood work done. When the LH and FSH levels are high, that is when premature ovarian failure is suspected. Also, a low estradiol level points to that. ideally yes, the labs should be drawn on day 3 of your cycle, so please get them repeated. Most specific for premature ovarian failure is AMH, which is independent of cycle day. PLease insist on AMH measurement, as it perfectly reflects the ovarian reserve. All the best. Take care.