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Saturday, November 14, 2009

Low Ferritin Levels and Infertility
Could this be the hidden key to my problem conceiving?

I had a wild hair to follow up on a bunch of blood tests that were done by the hematologist who did my IVIG infusion. This was about a month ago - precisely the day prior to my embryo transfer. So on Friday I made the trip to his office to see if anything interesting turned up.

It did. And how.

It seems that even though I am just slightly anemic (hematocrit is about 31 or 32, I forget the precise number) my ferritin levels are at 14, which is VERY low.

The doctor asked if I bled a lot with menstruation (I do) or if I had a compulsion to eat ice or other odd things (condition: pica) to which I said "no". He asked if I'd tried iron supplements and I told him that I had and didn't like to take them because of the issue that it causes with my bowels moving slowly (that is to put it politely). He suggested that I do intravenous iron infusions - 5 treatments, each of 200mg, that would restore my iron levels rather immediately.

He said that if I was feeling tired or without energy that it would help me tremendously. I said I definitely wanted to do the treatments and signed up with the front desk to do a benefits check (I'm sure it's covered as they covered my IVIG infusion fee).

So upon arriving home, I check with Dr. Google on the ferritin issue to see if it causes problems with infertility and lo and behold....it does.

Apparently there was an anecdotal study done (think it was published in Lancet) where a number of women with low ferritin and infertilty were given iron in one form or another. A large number of them became pregnant within a short period of time (some sources say one month, others say 28 weeks). I hate to give anything too specific as I cannot find the original study - if I do I'll edit this post and include it and/or a link to it.

I am not hugely knowledgeable about the pathway of iron, ferritin, and hemoglobin - it's been way too many years, but apparently the iron that is transfused is converted in the body into a form that can be taken up by ferriton (storage) and hemoglobin (on RBCs). It takes anywhere from 2 to 4 weeks for the conversion from iron to ferritin/hemoglobin to become complete. So it's quite crucial that I do an infusion as soon as I possibly can in order to be prepared for the IVF cycle that I am just about to embark upon.

While the girl at the front desk said she'd do a benefits check on me and get back to me by Wednesday, I think I will take the risk and infuse on Monday so that I am one step closer to being in good shape for my IVF cycle.

I am stunned that something this huge has eluded my doctors and me. I've been borderline anemic all of my life and no one ever did a blood test to figure out WHY until now. We still don't know the cause of the low ferritin but there are three main reasons for that: heavy menses or internal bleeding; poor diet; or, celiac/Chron's disease.

I've had intestinal biopsies for celiac spruae years ago and that turned up negative...

While I don't eat much meat, I do eat a very varied (mostly organic) diet, take vitamins supplements, etc. I would say my diet is pretty darned good when compared to many. Maybe I'm still lacking? I guess I need to really pay attention and make some changes just in case.

I do have very heavy periods - so maybe this is it? I also donated blood a lot years ago....never thought it would cause harm but apparently you can deplete your iron reserves (ferritin) and then it winds up showing up in you hematocrit or hemoglobin numbers (resulting in anemia). So you can deplete your reserves of (in your ferritin) but still show a quasi-normal hematocrit/hemoglobin. That's why my numbers slipped by for god knows how many years.

So I am going to get my iron infusion on Monday with all due haste. No matter what it takes. I can't believe that something so common as iron could be the reason for my infertility.

It gives me a strange sense of hope that maybe I have a chance of effecting a change that can turn the tables at last.

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Comments on "Low Ferritin Levels and Infertility
Could this be the hidden key to my problem conceiving?
"

 

Anonymous amanda said ... (9:16 PM) : 

It's nice when you find a piece of the puzzle, isn't it? I remember when I got my MTHFR homozygous diagnosis. It felt good to know something and to be able to do something about it, especially given all that we had gone through at that point.

I hope this piece helps bring you closer to the ultimate goal.

 

Anonymous Anonymous said ... (8:24 AM) : 

Endometriosis and anemia go hand in hand, unfortunately. We've been bleeding from everywhere, for so long time.

 

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