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Trying To Conceive, Undergone IUI. Done AMH Blood Test. Why Am I Unable To Conceive?

Posted on Wed, 24 Oct 2012

Question: Hello Doctor,

I have been trying to conceive since 2 yrs. I have been married since 5 yrs, last 2 yrs we are planning for our 1st baby. I have undergone IUI for 4 times last year, but unable to conceive.
pls find my reports as below
AMH serum blood test is 5.4 last month done
t3 2.6
t4 1.01
tsh 3.25
E2 level 37
prolactin serum 17.82
fsh 8.82
LH 4.6
Blood sugar normal
Husbands reports are normal.
Pls let me know what could be the reason that I am unable to conceive.
Pls guide

Regards
XXXXXX

Answered by Dr. Sree Gouri SR (3 hours later)

hi XXXXXX,
Thanks for the query.

according to the reports given by you your hormonal levels are almost in normal range, except estradiol which is on lower side, usually it will be around 50, but reference ranges of labs may differ,
so discuss this with your doctor whether there is any effect on your ovulation because of this, as that may cause problems in ovulation and implantation,
to get success of IUI procedure following measures can help,
-IUI to be done on the same day of ovulation,
-at least 1 million of motile sperms to be inseminated,
-ovulation to be confirmed by ultrasound,
-there should not be any blockade of fallopian tubes, better to go for hysterosalpingogram in case of repeated failure which will rule out tubal blockade and uterine adhesions,
-possibility of pelvic adhesions to be ruled out by ultrasound, diagnostic laparoscopy may be needed sometimes.

Hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please rate the answer after closing the discussion.
Take care.

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

Follow up: Dr. Sree Gouri SR (2 days later)

Dear Doctor,

Thanks for your reply. But 1 yr back laproscopy was done, and no blockages found, there was some infection, which was removed, and after that doctor has done IUI. Even then was unable to concive.

Reports of laproscopy as below
Uterus AV NS
Bilateral tubes N
Bilateral spill +
Both ovaries polycystic dulling done
Endometriotic implants +
Fulgurated left with bipolar tube N
Hysteroscopy Cavity N
Curettage done

After that they have sent for
Endometrium sent for TBPCR : Result: Mycobacterium Tuberculosis complex RRNA not detected.
Medicines given after Laproscopy
1. Taxim 2. Rantac D 3. Enzoflam

Pls guide, what could be the problem.

Regards
XXXXXX
Mumbai

Answered by Dr. Sree Gouri SR (3 hours later)

hi XXXXXX,

according to your laparoscopic report,
your tubes are normal,
you had PCOD and endometriosis, and underwent treatment for them,
then the possible causes for your IUI failure could be,
-not following any one of the measures I told previously,
-recurrence of PCOD or endometriosis, leading to difficulties in ovulation or implantation,

so what you can do is,
-undergo ultrasound once to rule out the possibility of recurrence of the problems,
-this time follow ovulation with follicular study and go for IUI on the same day of ovulation with sufficient sperm count, if needed you can go for more than one attempts,
-after ovulation continue undercover of progesterones and also with other tablets you are taking,
with these measures possibly you can have successful pregnancy,
if not better to go for other artificial reproductive measures.

Wish you Good Health, If you are satisfied with my response please rate the answer after closing the discussion.
Take care.

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