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Have PCOD, Taking Thyroxine For Hypothyroidism, Taking Duphaston. Spotting Before Periods

Posted on Mon, 24 Sep 2012

Question: 31 y /f
spontaneous conception in dec 2011
medical method termination at 6weeks 0n 10 XXXXXXX 2012
now pre menstrual spotting 3-4 days before period

1) PCOD profile --- day 2 Lh 1.6., fsh 4.3 , E2 18 ,PRL --27, AMH 3.22
2) SUBCLINICAL hypothyroism -- tsh initially 5.9 , started on 50 microgram thyroxine . currently 2.2 , prl 29
day 21 progesterone 9 , 2,5,2.5, 2.5
3) follicle monitoring rupture on day 13-14 , afc-good, volume rt ovary 10.4 cc. left 5.4 cc, endometrial thickness 12-13 mm at ovulation
3)Started duphaston 10 mg bd , day15-24 , taken for 2 cycle , no response

Answered by Dr. Mahesh Koregol (4 hours later)

Hi XXXXXXX

Thanks for your query. I understand your concerns. Following is my reply:

1) Your hormonal profile seems to be perfect. Absolutely no problem.

2) Thyroid is well controlled. Please continue the same dosage.

3) Follicular monitoring and rupture seem to be well in normal limits.

4) The success rate with this type of treatment is around 20 %. I guess you will conceive soon. Please continue the same for few more cycles.

5) If you dont succeed then try with IUI.

I hope I answered your queries. Please accept my answer if no more queries.

Regards,
Dr. Mahesh Koregol
IVF & Infertility Specialist

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

Follow up: Dr. Mahesh Koregol (1 hour later)

will taking 21day dupharton help does .it impair fertility
does it mean i have only 20percent chance to conceive.

Follow up: Dr. Mahesh Koregol (13 minutes later)

how will iui help in my case .- will it hold then,
will clomiphend citrate help

Answered by Dr. Mahesh Koregol (1 hour later)

Hi, glad to see you back. 1) Clomid is given at beginning of cycle to get a big size (dominant) egg. Clomid definitely helps. 2) Pregnancy rates are slightly better in IUI. But still around 20%. Either IUI or trying naturally. 3) Duphaston from day 21 definitely helps as support fir pregnancy if pregnancy has occurred. If not it helps to get back the pregnancy on time. I hope i answered your query. Please accept my answer if no more queries. Regards, Dr. Mahesh Koregol

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

Follow up: Dr. Mahesh Koregol (11 hours later)

sorry , what i was trying to ask that i have endogenous progesterone deficieny as doccumented by day 21 progesterone levels for 4 months
1) will taking clomid help luteal phase implantation also
2) i have been told that i should take duphaston from day 5-25 , ie 21 days .... what is better day 14-25 or 5-25
3) will my lpd correct ... when should i expect response, ie normal cycle without spotting ....or should i proceed to clomid with iui
4) will micronised progestreone give better result with lpd

Answered by Dr. Mahesh Koregol (1 hour later)

Hi,

Following is the reply to each queries.

1) Clomid will not help luteal phase implantation.

2) Day 14 to 25 is better. If you start from day 5 it is bad for you as early starting of progesterone will affect follicular growth.

3) Proceed to clomid with IUI. LPD can be taken care by progesterone tablets like duphaston and other injectable and vaginal preparations.

4) micronised Injectible and vaginal progesterone suppliments do help for LPD. If LPD is main concern you can take all forms of progesterones if need be. There is no harm.

I hope I answered your query.

Regards,
Dr.Mahesh Koregol
IVF & Infertility specialist

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