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Suggest Treatment For Infertility

Posted on Thu, 29 Jan 2015

Question: Hi Doctor,
I am 35 years and trying to conceive for last one year. I have gone through all the test. everything looks fine.
I was given Progynova 2mg, two tabs twice a day from the 8th day of my cycle (Last period: 25th Nov 2014). I had two follicles both with approx 23-24 mm but my endometrium thickness was not increasing. On day 14th of my cycle the size went to 7.3 mm. I got intact with my husband on 9th Dec, and also took trigger on same day (15th day). Next day when I went for follicular study it showed both eggs have Ovulated but the size of endometrium measured as 6.8 mm. I was put on Susten 200mg twice a day and Ecosprin 1 tab along with Progynova with same dose for 17 days.
I went through home pregnancy test on 26th Dec and it came negative.
My doctor stopped all the medicines on 26th Dec.
I got my period on 30th Dec morning but it stopped in evening. My doctor told me to wait for 2-3 days for periods, but not sure why I did not get my periods back. I took the home pregnancy test again on 1st XXXXXXX 2015 and it again came negative.
I'm little worried why I am not getting my periods at the same time getting no hopes for positive pregnancy test.
Please advise.

Answered by Dr. Richa Agarwal (44 minutes later)

Brief Answer:
May be due to hormonal imbalance(luteal phase defect).

Detailed Answer:
Hi,

Thanks for writing to us about it.

I can understand your concern here.

I have worked through your history and in my opinion delayed menses can be due to hormonal imbalance.

There are two possibilities in your case-

-Endometrial thickness is not appropriate (thickness should be in between 8-13 mm considers normal, in your case it is thin)
-Luteal phase defect- period after ovulation is not normal due to hormonal deficiency (progesterone deficiency).

You should wait for your period for one week.

Do not carry stress and try in the next cycle.

Hope it is useful, feel free to ask more questions.

Good luck.
Regards
Dr.Richa

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Richa Agarwal (3 hours later)

Thanks Doctor for the explanation.

Can you please advice how endometrium thickness can be improved?

How to improve Luteal phase defect?

Please advice.

Thanks,

Answered by Dr. Richa Agarwal (8 hours later)

Brief Answer:
With the use of hormone pills.(Estrogen and progesterone).

Detailed Answer:
Hi,

Sorry for delay in my response.

You can consult with a gynaecologist and take hormonal pills containing estrogen and progesterone in it.

Estrogen improved endometrium thickness and progesterone is helpful in luteal phase defect.

Hope it is useful, feel free to ask more.

Good luck.
Regards
Dr.Richa

Above answer was peer-reviewed by : Dr. Prasad