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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes reduced thickness of endometrium inspite of being on Clomid?

Answered by
Dr.
Dr. Mahesh Koregol

Infertility Specialist

Practicing since :2000

Answered : 3781 Questions

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Posted on Tue, 2 Jun 2015 in Infertility Problem
Question: I am currently undergoing a micro IVF cycle. I took 100 mg of clomid on cycle days 2-6, then 2 shots of low dose bravelle (75 iu) on CD 7-8. Today, CD 9, I had my first ultrasound and was devastated to find out that my uterine lining was slightly below 4 mm (0.38-0.4 mm). The follicles are still small but the lining is really, really bad.
I just got back from the doctors office and can't stop crying. Based on your experience, is there still hope that my lining will catch up? Should I insist that my doctor prescribe something like estrace or is it too late for that?(the doctor was not in the office yet when I was doing monitoring) I normally ovulate rather late in non-medicated cycles, by which time my lining is normal (I usually start thin). But with the meds I just don't know if I have enough time. ..Please help
doctor
Answered by Dr. Mahesh Koregol 36 minutes later
Brief Answer:
Clomid reduces endometrial thickness

Detailed Answer:
Hi,

Clomid is known to reduce endometrial thickness. Micro IVF protocol may not suit you.

It is too early to start estrace as follicles are still small. I suggest you cancel this cycle. Go with gonadotropin injections next cycle. Your endometrial thickness will be normal.

Let me know if you need any more clarification.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Mahesh Koregol 14 minutes later
Since I already paid 4 thousand dollars for this procedure wouldn't it be reasonable to wait a few more days and see what happens? Or 4 mm at cd 9 definately means that the cycle is doomed? I had 2 IUIs prior to this (medicated with femara) and did not trigger until day 13 and 14..,,
doctor
Answered by Dr. Mahesh Koregol 6 hours later
Brief Answer:
Difficult to improve

Detailed Answer:
Hi,

My other concern is follicular size. Your follicular size is still small.

You should get some gonadotropin injections to increase follicular size too which also increases endometrial thickness.

It is unlikely for follicular size to improve more in next 6 days.

If you cancel cycle at this stage, you may not lose all money as procedure is not done yet.

You will be deducted only few dollars for injections. Please confirm it from your doctor.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Mahesh Koregol 37 hours later
I took two more shots of bravelle and today, cd 11, my lining is at 5.6 mm. The follicles did grow. I have one @ 15 mm, one @ 14, one or two @ 13 and a couple smaller ones 9-11.
I do not know the bloodwork results yet but the opk is negative.
The question is how thick the lining would have to be for an egg retrieval/transfer to make sense? Is anything less than 8 mm essentialy a waste of money?
If the lining grows to 6-7.5 mm as I hope it will, would doing an IUI instead of a XXXXXXX IvF give me a reasonable chance of conceiving?
p.s I have no female factor except for age (almost 36), the basal afc is 20, high amh, and normal fsh. Its just that I need to use donor sperm.
T
doctor
Answered by Dr. Mahesh Koregol 2 hours later
Brief Answer:
IUI if endometrial thickness is less than 7 mm

Detailed Answer:
Hi,

Endometrial thickness more than 7 mm with triple line character is good enough.

I hope your lining reaches this at least on the day of egg pick up. Anything less than 7 is not ideal. You can convert into IUI.

Good to see that follicles are coming up. If there is male factor, donor sperm IUI is a good option.

I don't know what is XXXXXXX IVF. it's IVF or IUI.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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