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What Causes Late Perios Post IUI?
Question: I did ovarian drilling last month for pcos and they suggested an immediate iui this month.i did iui followed by duphoston tablets for 20 days.i had irregular menses from day 1 and now I am 31.my period was due on 27th Oct and it is late.i tested it as negative on 29th in upt.i wanted to know if the treatment followed is right approach and why my periods are delayed even after drillin?
Brief Answer:
PLEASE PROVIDE FEW MORE DETAILS
Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Since this was an IUI, can you tell me on what day ovulation was confirmed, and when was the IUI itself carried out ?
Also, what is the normal length and duration of your menstrual cycles ?
What is your height and weight ?
What agents were given for ovulation induction in IUI ?
Is this your first cycle of IUI or ovulation induction , or has any previous treatment been given ?
Can you upload the reports of the laparoscopy done ?
Since how long are you trying to conceive, and was your husband's semen analysis normal ?
Are your thyroid hormone levels normal ?
Please write back with these details.
Looking forward to hearing from you.
Take care.
PLEASE PROVIDE FEW MORE DETAILS
Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Since this was an IUI, can you tell me on what day ovulation was confirmed, and when was the IUI itself carried out ?
Also, what is the normal length and duration of your menstrual cycles ?
What is your height and weight ?
What agents were given for ovulation induction in IUI ?
Is this your first cycle of IUI or ovulation induction , or has any previous treatment been given ?
Can you upload the reports of the laparoscopy done ?
Since how long are you trying to conceive, and was your husband's semen analysis normal ?
Are your thyroid hormone levels normal ?
Please write back with these details.
Looking forward to hearing from you.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello,
I am married since 5 years. My weight is 55Kg and my height is 153 CM. I was under medication (Diane 35) since 18 to 24 years to regularize my periods which did not work out. My periods used to be irregular (once in 5 months) during my early ages. I got married at the age of 26 and continued with some ayurvedic treatment to regularize but did not work out. Since one year I have been trying to conceive with regular treatment. The first 3 cycle were given oral medication where no DF found. After that continued with FSH injections for another 3 months wherein there were follicles development count being +5 in each cycles. Initial scans were conducted till one of the follicle size become 18 and another HCG injection was given. Henceforth no more scans where conducted. So I am not sure when the ovulation happened. In many of the cycles I remember the scan continued till 18th day after the trigger but couldn’t see the ovulation. I believe it might have ovulated by 22nd or 25th day. My husbands sperm count is normal and have enough motility. Before laperaoscopy I did 3 cycles with FSH injection. In those cycles sometimes cyst were also developed without ovulation. After laperoscopy IUI was done in Oct '2014. On my 9th day I was given trigger and then followed by IUI on 10th and 11th day. After which there were no scans nor lab test done. So I am not sure when I ovulated. Doc. Suggested to come 2nd day pf periods again.
The oral medication initially used is CCYILA 100.
I wanted to know if the method used in the treatment is right and any correction is required. I have attached my prescription of the medicine followed for IUI, lab report done on 12th day before my Lap, biopsy reports and Lap report.
Thanks
XXXXXXX
I am married since 5 years. My weight is 55Kg and my height is 153 CM. I was under medication (Diane 35) since 18 to 24 years to regularize my periods which did not work out. My periods used to be irregular (once in 5 months) during my early ages. I got married at the age of 26 and continued with some ayurvedic treatment to regularize but did not work out. Since one year I have been trying to conceive with regular treatment. The first 3 cycle were given oral medication where no DF found. After that continued with FSH injections for another 3 months wherein there were follicles development count being +5 in each cycles. Initial scans were conducted till one of the follicle size become 18 and another HCG injection was given. Henceforth no more scans where conducted. So I am not sure when the ovulation happened. In many of the cycles I remember the scan continued till 18th day after the trigger but couldn’t see the ovulation. I believe it might have ovulated by 22nd or 25th day. My husbands sperm count is normal and have enough motility. Before laperaoscopy I did 3 cycles with FSH injection. In those cycles sometimes cyst were also developed without ovulation. After laperoscopy IUI was done in Oct '2014. On my 9th day I was given trigger and then followed by IUI on 10th and 11th day. After which there were no scans nor lab test done. So I am not sure when I ovulated. Doc. Suggested to come 2nd day pf periods again.
The oral medication initially used is CCYILA 100.
I wanted to know if the method used in the treatment is right and any correction is required. I have attached my prescription of the medicine followed for IUI, lab report done on 12th day before my Lap, biopsy reports and Lap report.
Thanks
XXXXXXX
Brief Answer:
IVF OR MAXIMUM ONE MORE CYCLE.
Detailed Answer:
Dear XXXXXXX
THank you for the detailed update .
Well, unfortunately, there is a major flaw in this treatment protocol.
THat is,scans have to be continued till you know whether you ovulated or not, otherwise there is no point in giving such medications and injections.
If you have not ovulated inspite of 7 cycles of stimulation, that is a real difficult situation then.
You have only two options - first is to directly go for IVF - in vitro fertilization.
Second is to go for one more cycle with a different protocol of stimulation, in technical language, it is called ' downregulation '.
You can discuss that with your doctor.
All the best
Please feel free to discuss further.
IVF OR MAXIMUM ONE MORE CYCLE.
Detailed Answer:
Dear XXXXXXX
THank you for the detailed update .
Well, unfortunately, there is a major flaw in this treatment protocol.
THat is,scans have to be continued till you know whether you ovulated or not, otherwise there is no point in giving such medications and injections.
If you have not ovulated inspite of 7 cycles of stimulation, that is a real difficult situation then.
You have only two options - first is to directly go for IVF - in vitro fertilization.
Second is to go for one more cycle with a different protocol of stimulation, in technical language, it is called ' downregulation '.
You can discuss that with your doctor.
All the best
Please feel free to discuss further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi could you please tell me what is down regulation?how many cycles should I go for iui after lap?should I need to go for a treatment to see if I am ovulutng naturally?do you see any issues with the reports ?I am using metformin tablets .should I continue naturally only with these tablets?will I be able to conceive if I ovulute on day?how ivf will be effective if ovulution is on 20th day?I don't prefer to have ivf to be honest.I have heard that ovarian drilling is very much effective for pcos.I see I have two many questions but I really wanted to know different alternatives
Brief Answer:
EXPLAINED
Detailed Answer:
Dear XXXXXX
If you are not ovulating in response to such medications and injections, chances are very low that you are ovulating naturally.
You can go for one cycle of rest and have monitoring during that cycle to observe natural ovulation.
Metformin helps in PCOS, but there is no point in trying naturally, since you obviously have an issue with ovulation.
IVF has a higher protocol of stimulation and ovulation is much more predictable and reliable with IVF doses of medications.
OVarian drilling is not very effective for PCOS, the latest literature says that.
Down regulation is a different protocol where injections and medicines to stimulate ovulation are given for a longer period of time, in slightly varied dosage from routine, to increase chances of ovulation.
You have already had 7 cycles of stimulation.
At the most, try one rest cycle followed by one cycle of downregulation, and then, strongly consider IVF.
Do not hesitate to ask questions, I am always open to any amount of discussions.
Take care.
EXPLAINED
Detailed Answer:
Dear XXXXXX
If you are not ovulating in response to such medications and injections, chances are very low that you are ovulating naturally.
You can go for one cycle of rest and have monitoring during that cycle to observe natural ovulation.
Metformin helps in PCOS, but there is no point in trying naturally, since you obviously have an issue with ovulation.
IVF has a higher protocol of stimulation and ovulation is much more predictable and reliable with IVF doses of medications.
OVarian drilling is not very effective for PCOS, the latest literature says that.
Down regulation is a different protocol where injections and medicines to stimulate ovulation are given for a longer period of time, in slightly varied dosage from routine, to increase chances of ovulation.
You have already had 7 cycles of stimulation.
At the most, try one rest cycle followed by one cycle of downregulation, and then, strongly consider IVF.
Do not hesitate to ask questions, I am always open to any amount of discussions.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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