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Is It Necessary To Undergo DNA Fragmentation And Histoscopy After A Failed IUI?

Posted on Fri, 14 Feb 2014

Question: Hi Doctor, I am fine. Even this time my IUI got failed. Really disturbed. Now, doctor has advised my husband for DNA fragmentation and angiosperm and i need to get my histoscopy done, as it was not done during my laproscopy . But, using XXXXXXX my tubes were checked during laproscopy. This doctor wants to check the lining of my uterus. We are really not able to bare these many expenses. Is this all tests necessary? please advise what can be done, as we both have become blank .

Answered by Dr. Dattaprasad (1 hour later)

Brief Answer: Hysteroscopy is always done with laparosocpy. Detailed Answer: Hi, Welcome back. I can understand your concerns. Normally hysteroscopy is almost always done along with laparoscopy, kindly check your previous reports once more. Need for hysteroscopy depends on what treatment you want. If you want IUI, hysteroscopy will not help (unless some abnormality was seen in endometrium during scan). If you are going for IVF/ICSI, hysteroscopy will help. By the way, when did you receive inj. HCG in this cycle? What was endometrial thickness & pattern (pattern: written on scan report as TL (triple layer) OR HP (hyper-echoic))? What was sperm count & motility after processing sample? Need for DNA fragmentation and angiosperm depends on further plan of treatment. If you are going for IVF/ICSI, it just helps in prognostication for chance of pregnancy & does not increase success rate, and you can skip it. If you want IUI, it will tell whether further IUI will be helpful OR not. If cost of the test is equal to OR more than IUI cycle, its better to go ahead with IUI than to do test to save money. Hope this helps you. Let me know your further plan so that I can assist in decision making. Regards.

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

Follow up: Dr. Dattaprasad (17 minutes later)

Thanks for the advise. HCG was given on day 15th morning 8am and IUI iwas done the next day evening at 6 30pm. but, the day i took HCG, evening i had stomach pain. but i did know to inform doctor about the pain. It would have been good, if IUI i was done in the morning atleast. Endometrium thickness was 11mm and it was triple layer. Sperm count was 81mil and motility was 71%. Volume: 0.5ml

Answered by Dr. Dattaprasad (16 minutes later)

Brief Answer: Everything fine. Detailed Answer: Hi, Everything appears to be fine. You can go for one more cycle (5th?) of IUI if you want. Regarding timing of IUI, don't worry as you had many follicles & follicle can last upto 24 hours in body before degenerating. Another thing, if you had intercourse on the day of HCG, sperm will be available there for fertilization (sperm can stay upto 2-3 days after intercourse, while after IUI, they become nonfunctional within 3-4 hours). If you have decided for IUI, kindly go for it in immediate next cycle for better chance of pregnancy. As the problem is only with husband's aemen volume, you can go ahead with one more IUI cycle. Regards.

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

Follow up: Dr. Dattaprasad (10 minutes later)

But, doctor says for the quality of the sperm to be good atleast there must be 2 days of gap. So, we are giving a gap of 2days before IUI and about my hysteroscopy my previous doctor says its been done and this doctor says its not written in the operative notes. Only its mentioned as cystatomy done and tubes are clear. Also, please let me know drinking tender coconut daily improves the sperm volume and quality?

Answered by Dr. Dattaprasad (7 minutes later)

Brief Answer: Solution already told. Detailed Answer: Hi, I had already told some tips in first consultation. If husband can give sample next day after intercourse & better if he can give two samples (which can be pooled for IUI), 2 days gap is not needed. In fact eggs can rupture from 12 to 56 hours after hCG & sometimes even without inj HCG, and if sperms are not there at right time, whole cycle goes waste. Drinking tender coconut daily is not going to harm anyway, whether it is helpful OR not is not known (No studies). He can continue drinking it. Regards.

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

Follow up: Dr. Dattaprasad (5 minutes later)

can we meet you? anytime you are coming bangalore?

Answered by Dr. Dattaprasad (13 minutes later)

Brief Answer: Not practicing in Bangalore. Detailed Answer: Sorry I don't have practice in Bangalore. Regards.

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