Suggest Treatment For Unexplained Infertility

Posted on Tue, 6 Oct 2015

Question: Hi doctor, i am suffering from unexplained infertility from last 4 yrs. my laprscopy and hysteroscopy all are normal. we undergo 2 cycles of IVF also 9 months back but was not fruitful because my endometerium was not growing more than 6.6. currently its in good position ranging 9-10 and i am advised FSH injections with follicular monitoring followed by duphaston. 3 cycles had passed still no answer with all normal reports , my menstrual cycle is of 27 days . please guide

Answered by Dr. Mahesh Koregol (1 hour later)

Brief Answer:
Endometrial thickness needs to be improved

Detailed Answer:
Hi,

I saw your attached reports and I understand your concerns.

Following is my reply:

1. You are suffering from unexplained infertility as all reports are normal.

2. As you say endometrial thickness is low, you need to get endometrial biopsy for PCR of tuberculosis bacteria which leads to decreased endometrial thickness.

3. Ask your fertility specialist to give you pentoxyphilline tablets which improve endometrial thickness.

Let me know if you need any more clarification.

Regards,
Dr. Mahesh Koregol.
IVF& Infertility Specialist

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Mahesh Koregol (24 minutes later)

hello sir , thanks for the prompt reply. my IVF cycle failure reason was said to be endometrial thickness not good enogh. it was done on dec 2014. currently its good ranging 8 -10 mm . for reference i have attached my ultarsound report on page 8 . nakesero hospital ,entebbe.
so now the ET problem is not there. follicular studies going on and i am advised FSH .last 3 cycles we are following this FSH , follicular monitoring and duphaston tablets twice daily. my last menstrual periods was 19-08-2015. current LMP is 13th september 2015, today is my 2nd day. tommorow i probably will have TVS , so i will send that too. please advice

Answered by Dr. Mahesh Koregol (15 minutes later)

Brief Answer:
Please send reports

Detailed Answer:
Hi,

Please send previous IVF Cycle summary details so that I can check details.

Also share tomorrow's ultrasound scan for further advice.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Mahesh Koregol (34 minutes later)

OK sir

Answered by Dr. Mahesh Koregol (10 hours later)

Brief Answer:
Let me know the details

Detailed Answer:
Hi,

You can scan and upload reports and summaries of previous IVF cycles as attachment to this query.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Mahesh Koregol (14 hours later)

Hi, I have provided some attachments. Please review them.
hi , at the time of IVF we were told the eggs and sperm are very good quality. total 6 embroys were there, out of which 4 were transferred in 1st cycle and the later frozen 2 in 2nd IVF. then we were out of embroys and due to professional commitments of my husband we didn't got for another cycle.
right now, as u know today is my DAY 3, no Trans vaginal scan was done today. i got my recent thyroid report which has been attached. prescrobed clomid 100 for5 days. and review at day 12 by folliculgram through TVS.
looking forward to ur guidance.
regards XXXXXXX

Answered by Dr. Mahesh Koregol (7 hours later)

Brief Answer:
Take gonadotropin ( HMG ) injections.

Detailed Answer:
Hi,

I saw the attachments. Everything seems fine.

You can also get some HMG hormone injections this cycle to improve endometrium as clomid reduces endometrial thickness in some women.

If you are still in entebe, you can consider transferring back those 2 frozen embryos.

Let me know if you need anymore help.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar