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Due to endometrium thickness the embryo didn't stuck. But scan showed no thickness. Suggest?

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Infertility Specialist
Practicing since : 2002
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My Sister got her ET done & result was negative . Doc said that due to endo wall thickness embryo dint stuck , else would have been ! So my question is that can't we diagnoise this before ET that wall is thick?? What are the remedies to overcome this issue ???
Posted Wed, 11 Sep 2013 in Infertility Problem
 
 
Answered by Dr. Dattaprasad 29 hours later
Hi,

You must know one IVF ET cycle doesn't give 100% success rate.

Regarding diagnosing endometrial thickness, answer is yes, it can be seen by scan before ET. But if you don't have enough good quality embryos that can be frozen, there is no option but to transfer embryos irrespective of endometrial thickness.

Solution is to go for another IVF/ICSI cycle, give higher dose of stimulation to produce surplus eggs which can make extra embryos. If embryos are of adequate quality, freeze all embryos & do ET in next cycle after making optimum endometrium.

From the details given by you I couldn't understand whether endometrium was thicker or thinner than normal. Kindly quote exact endometrial thickness, number & grade of embryos which were transferred for exact guidance.

Let me know if you have other concerns.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Due to endometrium thickness the embryo didn't stuck. But scan showed no thickness. Suggest? 28 minutes later
ET - 15 /embryos transferred -3 . How thickness is related to egg quality ? It was thick .
Also what is the difference - 3 days embryo transfer & 6 days embryo transfer ? In 6 days embryo transfer ..R the chances more ?
 
 
Answered by Dr. Dattaprasad 3 hours later
Hi,
Welcome back.

In 3 day embryo transfer embryos are grown in lab for 3 days & in 6 day embryo transfer for 6 days.
For 5/6 day embryo transfer you need at least 4-5 good quality embryos on 3rd day. If you don't have that, embryos might not grow further till 5/6 days(embryos stop growing) & you may have no embryo for transfer.

Growing embryos till 6th day depends on many factors including quality & quantity of embryos on 3rd day, quality control of lab & individual lab's experience about pregnancy rates after day 6 ET.

Generally speaking, day 5/6 embryo transfer gives better rates than day 3 embryo transfer if equal number of embryos are transferred.
Let me know if you have other concerns.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Due to endometrium thickness the embryo didn't stuck. But scan showed no thickness. Suggest? 15 hours later
So do you think that endothickness can be cured with medicnes & give positive result . Also what are other alternatives & remedies to lessen down the thickness ? Due you think that this could be the genuine reason for the failure of ET ? Chances are more with donor eggs ?
Also what exactly is endo thickness & what role does it play in giving positive or neg result ?
 
 
Answered by Dr. Dattaprasad 12 hours later
Brief Answer:
Endometrial thickness needs to be optimum.

Detailed Answer:
Hi,

Welcome back.

Endometrial thickness is not related to quality of embryos. I had asked that question to know the influence of embryo quality on result (Low quality embryos will give lower pregnancy rate irrespective of endometrial thickness).
Thickness of 15mm is on higher side of normal.
Regarding cure of endometrial thickness with medicines, there are some medicines which can prevent endometrium from growing abnormally. Those medicines(Progesterone) need to be given prior to actual cycle of IVF/ICSI.
Also endometrium could be thicker beccause of some polyp(extra growth). It can be diagnosed & treated by hysteroscopy (In hysteroscopy, a telescope is inserted in uterus & inner lining is directly visualised).

Thick endometrium may be one of the major reasons for failure of ET.

Regarding donor eggs, chances of pregnancy with donor eggs will definitely better as normally young (<30years) woman is selected for egg donation. Younger age gives better egg quality & quantity and hence better chance of pregnancy. But whether she needs donor eggs or not, depends on her ovarian reserve (capacity to respond to hormonal stimulation & produce eggs) & the quantity & quality of eggs she got in last cycle. Her doctor can better guide her further in this matter.

Endometrium is the inner lining of uterus. Optimum thickness of around 8-12mm has to be there for better chance of pregnancy. (Pregnancy can occur with as low as 4mm & as high as 18mm thickness, though chance becomes less).

Following is the summary of plan that can be followed:
1. Do hysteroscopy to rule out other significant pathology inside uterus & if found, treat it at the same time.
2. Depending on her ovarian reserve & previous response during IVF/ICSI go for own/donor egg IVF
3. If she goes for own egg IVF: Ask doctor to give higher dose of hormones so as to make many eggs; Freeze all embryos. Go for frozen embryo transfer next cycle.

I hope I have made the point clear.

Let me know if you have other concerns. if not you can close the discussion & rate the answer.

Awaiting reply,

Regards.
Above answer was peer-reviewed by
 
Follow-up: Due to endometrium thickness the embryo didn't stuck. But scan showed no thickness. Suggest? 36 hours later
Hi ! Hysteroscopy was done ...Uterus is normal & no polyp also . Any othr remedy to overcome this issue Endo thickness . Excersice & weight reduction would help? ny other remedie which can drastically help . she had 3 best quality embryo transfer - one with eight cells other with 6 cells .
what do you mean by frozen eggs ?
 
 
Answered by Dr. Dattaprasad 4 hours later
Brief Answer:
Repeat hysteroscopy necessary.

Detailed Answer:
Hi,
Welcome back.
If hysteroscopy was done before IVF, she needs to repeat it as polyps can form any time.
Remedy for endometrial thickness is to give progesterone tablets for one cycle prior to actual IVF.
Exercise & weight reduction is not direct treatment for endometrial problem, but it may improve chance of pregnancy by other mechanisms.
No other remedy which can drastically help can be given during actual IVF cycle.
I didn't say frozen eggs. I had commented about frozen embryos. In next cycle if again endometrium is thick, we can take out eggs & make embryos in IVF lab & transfer those frozen embryos in next cycle after optimizing endometrium.

Let me know if you have other concerns.

Awaiting reply,

Regards.
Above answer was peer-reviewed by
 
Follow-up: Due to endometrium thickness the embryo didn't stuck. But scan showed no thickness. Suggest? 1 hour later
In Hysteroscopy - anthesia will be given ...
 
 
Answered by Dr. Dattaprasad 23 minutes later
Brief Answer:
if required

Detailed Answer:
Hi,
Whether anaesthesia is to be given or not depends on two things:
1. Size & type of hysteroscope: If small 4mm flexible scope is used, anaesthesia is not required.
2. Pathology seen; if something like polyp is found which requires correction/removal, anaesthesia is usually needed.

Let me know if you have other concerns.

Regards
Above answer was peer-reviewed by
 
Follow-up: Due to endometrium thickness the embryo didn't stuck. But scan showed no thickness. Suggest? 14 minutes later
ok thank you
 
 
Answered by Dr. Dattaprasad 14 minutes later
Brief Answer:
You are Welcome

Detailed Answer:
You are Welcome
Above answer was peer-reviewed by
 
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