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I Had 5 Failed IUI Procedures Inspite Of Having Endometrium Thickness Issue

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Posted on Thu, 27 Mar 2014
Question: Hi Doctor, I am on TTC since 2 years but have not been succeeded. I had 5 IUI procedures in 2013 for every alternate months. During the IUI procedure - took the FSH injections like Gonal-F,Menopur,Menogon . According to doctor, failure could be because of endometrium thickness issue. Usually , my endo thickness by Day 12 would be 8 mm with a dosage of 4 progynova 25mg per day for 7 days. Now , my doctor suggested me to go for IVF treatment. TSH : As on 1st Feb 2014 - 6.17 - under medication - Thyronorm 50 mcg, came down to 2.53 by 19th feb 2014. AMH is 5.3 , LMP is 20th Feb 2014. IVF doctor suggested me to take Ovral for 21 days. Injection Busag - 20 units every day from Day 15 (i.e., from 7th March) on thiegh. My husband sperm has been frozen as he has to go to US for urgent work. Volume frozen = 0.5 ml , Sperm concentration = 20 millis/ml , Motility = 89%
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Answered by Dr. Dattaprasad (5 hours later)
Brief Answer: IVF is next logical step. Detailed Answer: Hi, Welcome to HCM. IVF/ICSI is the next logical step for you after 5 failed IUIs after laparoscopy. Even if endometrium would have been fine during IUI cycle, IVF/ICSI is required after 5 failed IUIs. Kindly take Thyronorm regularly & try to keep TSH under control, as high TSH can affect baby. As you are going to do IVF with frozen sperm, ICSI would be better option which of course your doctor will offer. (In ICSI individual sperms are picked & directly injected into eggs, while in IVF, eggs & sperms are kept in a dish to allow natural fertilization). One thing regarding endometrium to be kept in mind: If endometrium remains low even during IVF procedure & if good quality embryos are available in adequate number, you can opt for cancellation of embryo transfer, freezing of embryos & transfer in next cycle after building endometrium after oral medicines (Progynova). In frozen embryo transfer cycle, you have XXXXXXX to wait for as many days as required to build endometrium. Your AMH report is fine if it is 5.3ng/mL (If it is 5.3pmol/L, it a low AMH value). Hope this helps you. Let me know if you have other concerns. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Dattaprasad

Infertility Specialist

Practicing since :2002

Answered : 673 Questions

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I Had 5 Failed IUI Procedures Inspite Of Having Endometrium Thickness Issue

Brief Answer: IVF is next logical step. Detailed Answer: Hi, Welcome to HCM. IVF/ICSI is the next logical step for you after 5 failed IUIs after laparoscopy. Even if endometrium would have been fine during IUI cycle, IVF/ICSI is required after 5 failed IUIs. Kindly take Thyronorm regularly & try to keep TSH under control, as high TSH can affect baby. As you are going to do IVF with frozen sperm, ICSI would be better option which of course your doctor will offer. (In ICSI individual sperms are picked & directly injected into eggs, while in IVF, eggs & sperms are kept in a dish to allow natural fertilization). One thing regarding endometrium to be kept in mind: If endometrium remains low even during IVF procedure & if good quality embryos are available in adequate number, you can opt for cancellation of embryo transfer, freezing of embryos & transfer in next cycle after building endometrium after oral medicines (Progynova). In frozen embryo transfer cycle, you have XXXXXXX to wait for as many days as required to build endometrium. Your AMH report is fine if it is 5.3ng/mL (If it is 5.3pmol/L, it a low AMH value). Hope this helps you. Let me know if you have other concerns. Regards.