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Done With Semen Analysis. Planned Relations But Failed. Misdiagnosed As Ovarian. Advise?
Question: hello sir,tis s dr XXXXXXX 29yr old,from hubli,karnataka,OBG consultant,SDM HOSPITAL,Dharwad,,husband 33yr,Associate Prof -Medicine,have been married fr 6yrs,hormone profile N,semen analysis N,HSG Normal,tried 3 cycles OI cc 100mg,HCG trigger,2-3df.avg 22-24mm,12mm et,planned relations,failed,2nd cycle of IUI(cc+GT-HP-FSH & HMG)ovitrell trigger,IUI on 15th day,ectopic lt tube,lap salphingectomy done after 2 doses of methotrexate,misdiagnosed as ovarian earlier in may 2013,now after 3 months tried IUI (r-FSH+Gonapeptyl)37.5 & 50 resp,ovulated on d17,failedLPS wit inj gestone 100mg im fr 15 daysprev cycles gel/micr prog used,shd i R/o end TB & advise me what next?Eagerly awaiting ur reply
Brief Answer:
Look for solutions - not for problems !
Detailed Answer:
I agree this is frustrating !
Testing for endometrial TB is very unreliable. You can read more about this at WWW.WWWW.WW
Do a complete workup before starting treatment haphazardly.
You need the following simple medical tests:
Blood tests for you for the following reproductive hormones – FSH ( follicle-stimulating hormone),LH ( luteinizing hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.
HSG ( hysterosalpingogram, X-ray of the uterus and tubes, WWW.WWWW.WW on Day 8 of your cycle ( to confirm
Your right fallopian tube is open);
The vaginal ultrasound scan on Day 10-11 should check for the following. A. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture
Please send me the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me.
If there is a problem, then we can treat it !
The fact you have conceived once ( even though it was an ectopic ) means your chances
Of having a healthy baby are excellent, so please don’t get disheartened !
Taking treatment at a world-class clinic will maximize your chances of success and give you peace of mind you did your best !
We look forward to helping you to have a baby !
Regards,
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, XXXXXXX XXXXXXX SBS Road, Colaba
Bombay 400 005. India
Tel: 91-22-0000, 0000, 2218 3270
FAX ( India) 91-22-0000.
Helping couples build families !
PS Read our book, How to Have a Baby – A Guide for the Infertile Couple,
Online at WWW.WWWW.WW !
Look for solutions - not for problems !
Detailed Answer:
I agree this is frustrating !
Testing for endometrial TB is very unreliable. You can read more about this at WWW.WWWW.WW
Do a complete workup before starting treatment haphazardly.
You need the following simple medical tests:
Blood tests for you for the following reproductive hormones – FSH ( follicle-stimulating hormone),LH ( luteinizing hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( www.srl.in). Day 1 = Day the period starts.
HSG ( hysterosalpingogram, X-ray of the uterus and tubes, WWW.WWWW.WW on Day 8 of your cycle ( to confirm
Your right fallopian tube is open);
The vaginal ultrasound scan on Day 10-11 should check for the following. A. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture
Please send me the detailed test results and medical reports . You can scan them in as a single doc or pdf file and email them to me.
If there is a problem, then we can treat it !
The fact you have conceived once ( even though it was an ectopic ) means your chances
Of having a healthy baby are excellent, so please don’t get disheartened !
Taking treatment at a world-class clinic will maximize your chances of success and give you peace of mind you did your best !
We look forward to helping you to have a baby !
Regards,
Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, XXXXXXX XXXXXXX SBS Road, Colaba
Bombay 400 005. India
Tel: 91-22-0000, 0000, 2218 3270
FAX ( India) 91-22-0000.
Helping couples build families !
PS Read our book, How to Have a Baby – A Guide for the Infertile Couple,
Online at WWW.WWWW.WW !
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
hello sir,its 2 inform that,i have got all my D3 hormonal profile done at Thyrocare,
FSH 6.3,LH 6.1,PRL 20.9,TSH 1.97,AMH 2.5ng/dl,rest thyroid profile N,
TPO- negative,
DHEAS-143.7mcg/dl,17-OHP -1.2ng/ml ,Androstenedione -2ng/ml
Testosterone free & total 0.19 &10.9 ng/dl,SHBG N,
Antral follicular count 6-7/ovary,ut ET 10mm,uniform,normal morphology,endometrial flow -good,I am consulting one of the leading infertility specialist at Bangalore,when asked about need fr HSG,the doc went through the CD of lap during salphingectomy,opined that my rt tube appears normal & since HSG was done just 9months back,cat 2A,so no need to repeat the test,i was asked 2 try 2-3 cycles of IUI & then IVF if i dont conceive.I am really in a dilemma.
Sir,at what stage does testing for TB-endometrium(RNA-PCR) becomes neccesary?
FSH 6.3,LH 6.1,PRL 20.9,TSH 1.97,AMH 2.5ng/dl,rest thyroid profile N,
TPO- negative,
DHEAS-143.7mcg/dl,17-OHP -1.2ng/ml ,Androstenedione -2ng/ml
Testosterone free & total 0.19 &10.9 ng/dl,SHBG N,
Antral follicular count 6-7/ovary,ut ET 10mm,uniform,normal morphology,endometrial flow -good,I am consulting one of the leading infertility specialist at Bangalore,when asked about need fr HSG,the doc went through the CD of lap during salphingectomy,opined that my rt tube appears normal & since HSG was done just 9months back,cat 2A,so no need to repeat the test,i was asked 2 try 2-3 cycles of IUI & then IVF if i dont conceive.I am really in a dilemma.
Sir,at what stage does testing for TB-endometrium(RNA-PCR) becomes neccesary?
Brief Answer:
Secondary infertility
Detailed Answer:
Hi again,
These PCR tests for TB are very unreliable, please do not do them. Lots of false positives which waste time and money . You can read more about this at
WWW.WWWW.WW
A laproscopy only allows the doctor to see the outside of the tubes. The fact you had an ectopic means there is some tubal damage - which could affect the other tube as well.
Regards,
Secondary infertility
Detailed Answer:
Hi again,
These PCR tests for TB are very unreliable, please do not do them. Lots of false positives which waste time and money . You can read more about this at
WWW.WWWW.WW
A laproscopy only allows the doctor to see the outside of the tubes. The fact you had an ectopic means there is some tubal damage - which could affect the other tube as well.
Regards,
Above answer was peer-reviewed by :
Dr. Raju A.T
Hello sir,thank you for your advice.
Can i undergo HSG on d8 of this cycle combining with OI+IUI?Is it safe? I am really in a dilemma & don't wish to waste a cycle.
Regards,
XXXX
Can i undergo HSG on d8 of this cycle combining with OI+IUI?Is it safe? I am really in a dilemma & don't wish to waste a cycle.
Regards,
XXXX
Brief Answer:
HSG in the IUI cycle
Detailed Answer:
Yes, you can , since the HSG is done on Day 8 and the IUI is usually done on Day 12- Day 14, by which time the HSG XXXXXXX has been excreted
Dr Malpani
HSG in the IUI cycle
Detailed Answer:
Yes, you can , since the HSG is done on Day 8 and the IUI is usually done on Day 12- Day 14, by which time the HSG XXXXXXX has been excreted
Dr Malpani
Above answer was peer-reviewed by :
Dr. Shanthi.E
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