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Unsatisfactory results with clomiphene, switched to oestrogen, failed conception, again advised clomiphene. Reason and suggestion?

hello i m having an ovulatory cycle confirmed by follicular study. but my gyn used clomiphene from 3 rd to 7th day. on 9th day during follicle scan they found my endometrium was oonly 3.5mm she advised to insert sildenafil thrice a day for 10 days but my endometrium grew only till 7 mm. i was unable to conceive. then a senior gynaec advised not to take clomiphene but to take oestrogen 2mg tab from day 3 rest of the treatment was same so on day 12th endometrium was 10 mm follicle size was good hcg 5000iu was injected but due to anxiety we cud not maintain intercourse; now my husband says we will go for iui but the fertility expert again suggested to take clomiphene now i m really confused pls help me
Asked On : Sat, 12 Jan 2013
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OBGYN 's  Response
Spontaneous ovulation does not need added induction. If there is evidence of thin endometrium, it needs to be thickened. The optimum thickness of the endometrium favorable for implantation according to studies is between 6-14 mm. Clomiphene has a negative effect on estrogen as it helps regulate the luteal phase and therefore can cause thinning of the endometrium. So, if Clomiphene needs to be administered as part of the treatment, estrogen when added, helps to make the situation stable by improving the thickness of the endometrium. Sildenafil is also effective. Since you did not have a successful intercourse, you can go for another cycle. Discuss with your gynecologist thoroughly before embarking on any plan. Good luck.
Answered: Thu, 17 Jan 2013
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