Hallow Dr. Ravindra, From your history I have understood that the cause for Mrs. Shikha s abortion was intrauterine septum. Now that is removed. However, with all the surgical interventions she has undergone (including D&C), it seems that her endometrium is damaged and has become very thin. This is known as Aschermann s Syndrome, wherein there are adhesions in the utrerine cavity. She had Multiload in her uterine cavity to keep both the walls of the uterus apart and facilitate the healing. Oestrogen preparations are given to facilitate endometrial growth. . Many reports in the literature inform us that endometrium between 9 mm to 13 mm with triple line appearance are conducive for implantation of the blastocyst (fertilized ovum). Hence, before you attempt any IVF, please undergo ultrasonography to find out the endometrial thickness. From your history it appears that endometrium is not well built up as yet. I would suggest you to wait till endometrium attains thickness of at least 9 mm before you attempt IVF. For taking care of synachae, continue with Multiload. For endometrial growth, take oestrogen preparations only (without any progesterone) for continuous 3 months without any cyclical break. Thus she should not have menses for three months. Monitor the treatment at monthly interval by ultrasonography to find out the endometrial growth. Once the endometrium is built up to 9 mm in thickness with triple line appearance, you can attempt pregnancy. In fact, her previous pregnancy was a natural pregnancy. Now you are finding difficulty in conception due to thin endometrium. So I feel, once the endometrium is built up, she may conceive naturally also. However, considering her age, she may have low oocyte reserve left in her ovaries. Hence, you may not give trial for natural conception very long. I would suggest you following: 1. While her endometrium is getting built up, monitor her ovulation by ultrasonography. If she is ovulating normally, you may attempt natural pregnancy by planning your intercourses on and around the day of ovulation. 2. If it fails, you may opt for Intrauterine insemination for 3-6 months. 3. If that also fails, then you may think of IVF & ET. After conception due to any method, please support the pregnancy by hCG and/or Progesterone. However, this all is after the endometrium is well built, between 9-14 mm. So my answer to your query in one line would be not to attempt any method of conception till the endometrium is not 9 mm thick. I would like to guide you more in details if you ask me Direct questions with uploading all het images and reports. Dr. Nishikant Shrotri