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What Do These Following Blood And Ultrasound Reports Indicate?
Question: Hi
Here is my case history.
1) Married for 6 yrs, age 36 yrs 10mth, husband 36 yrs. For first 4.5 yrs of marriage didnot try for baby, natural method adopted (abstinence during fertile period).
2) I missed my period in March 14 , I thought I am expecting but wasn't, was given XXXXXXX for 21 days. Because of age my doctor started clomid along with follicular study in June-14. Ovulation happened naturally without trigger on 15 th day but still wasnt able to conceive. Tried on more round of clomid without follicular study , still no success. In August-14 got HSG done- B/L free spill. Husband semen report normal.
3)Kept trying naturally in Sep-14, and changed gynae , who did follicular study without any med, Ovulation happened normally on 16th day without trigger. She also got my hormone test done. Here are the values
FSH- 4.8,
LH-6.8
AMH-11.5
Prolactin-16.59
In Oct-Nov 14 she put me on fertomid with follicle study but no success, in Dec-Jan-15 again was on fertomid. In feb -15 she wanted to try IUI so I thought of going to fertility specialist( that's why took second opinion from you) rather than normal gynae, but my family insisted on changing gynae.
4) In feb- 15, on family insistence I went to one of the renowned gynae in XXXXXXX She got my complete ultrasound done in March-15 ( scan attatched). to my badluck polyp and cyst appeared in my uterus and left ovary.
She suggested laproscopy supposed to be done in apri-15 , but in april suddenly my thyroid levels came out abnormal. so laproscopy cancelled. I have never had thyroid issues till that time. was referred to endocrinologist who got all sort of test done, thyroid ultrasound, thyroid scan etc. Post which I was told that I have subclinical thyroidism but no med suggested.
5) In May-15 I went through laproscopy and poly an chocolate cyst removed. June-15 I tried naturally and in July 15 did another round of fertomid along with follicular study, took trigger shot for ovulation as well. But no success.
6)In August-15, I finally convinced my husband to visit fertility specialist. So here we were at one of the clinic nearby , one of my friend had triplets after getting treatment from there.
7) On my first visit to the specialist, post TVS I was told I have PCOD (new shocker), never ever any ultrasound showed this. Given the time I wasted on fertomid , I told her I want to do IVF straight instead of IUI first. She did estradiol (84.6 pg/ml)and prolactin test so as to decide whether to proceed or not. Did TB PCR ass well- negative
8) In Aug-15 I started my first round of IVF with following med/injections.
- HMG 450IUI I/M from day 3-day12,
- Ovurelix 0.25mg S/c day9-day-13
- Decapeptyl 0.25mg s/c on day 13
- Ecospirin 1 tab daily from day 3
- Progynova 2mg 6 tab daily from day 3
- Folic acid 5 mg daily from day 3
- Silnafil 25 mg vaginally once from day 13th
On day 15th was ER, 11 eggs retrieved, 8 fertilized, transferred 5 on 2 day post retrieval.
Post transfer given following med
- Monocef 200mg twice for 2 days post transfer.
- Rantac 150mg- twice daily
- Wysolone- 5mg twice daily
- Folic acid 5 mg daily
- Ecoflora 150mg 1 tab daily
- Duphaston 10mg 3 tab daily
- Progynova 2mg 6 tab daily
-Silnafil 25 mg vaginally once daily
- Puregest 400mg vaginally twice daily
- Natturogest gel 8.0% once daily vaginally.
From 7th day post transfer took HCG 5000 IU I/M for 3 days every alternate day.
Beta HCG was 29, 16 day post transfer, stopped all med , got period 4 days after.
9) Sep-15 took ovral once daily for 21 days. Also took Normoz, folic acid and ecospirin. Got period in 30 days.
10) Oct-15 , E2 (77 pg/ml) and prolactin (24 ng/ml) tested, started 2 nd IVF with following med
-HMG 450IUI I/M from day 3-day12,
- Ovurelix 0.25mg S/c day9-day-13
- Decapeptyl 0.25mg s/c on day 13
- Ecospirin 1 tab daily from day 3
- Normoz twice daily
- Metformin 500mg SR twice daily
- Cabergolin 0.5mg once every week for 6week
- Progynova 2mg 6 tab daily from day 3
- Folic acid 5 mg daily from day 3
- Silnafil 25 mg vaginally once from day 13th
On day 15th was ER, 13 eggs retrieved, 10 fertilized, I wanted 5 day transfer, 4 reached blastocyst stage, transferred all.
Post transfer given following med
- Monocef 200mg twice for 2 days post transfer.
- Rantac 150mg- twice daily
- Wysolone- 5mg twice daily
- Folic acid 5 mg daily
- Ecoflora 150mg 1 tab daily
- Duphaston 10mg 3 tab daily
- Progynova 2mg 6 tab daily
-Silnafil 25 mg vaginally once daily
- Puregest 400mg vaginally twice daily
- Natturogest gel 8.0% once daily vaginally.
- Exhep Inj 40mg S/c alternate days.
- Normoz twice daily
- Metformin 500mg SR twice daily
- Cabergolin 0.5mg once every week for 6week
Tested bhcg today 9 dpot , beta HCG was <1.2
11) nov - no meds taken, dr reviwed my laproscopy video, she had suspicion of tb so did quantiferon tb test, but negative.
12) dec- got period in 30 days now starting on akt-4
S o wanted to ask is it fine to start ivf when on akt-4 and if there is anything wrong with protocol
Here is my case history.
1) Married for 6 yrs, age 36 yrs 10mth, husband 36 yrs. For first 4.5 yrs of marriage didnot try for baby, natural method adopted (abstinence during fertile period).
2) I missed my period in March 14 , I thought I am expecting but wasn't, was given XXXXXXX for 21 days. Because of age my doctor started clomid along with follicular study in June-14. Ovulation happened naturally without trigger on 15 th day but still wasnt able to conceive. Tried on more round of clomid without follicular study , still no success. In August-14 got HSG done- B/L free spill. Husband semen report normal.
3)Kept trying naturally in Sep-14, and changed gynae , who did follicular study without any med, Ovulation happened normally on 16th day without trigger. She also got my hormone test done. Here are the values
FSH- 4.8,
LH-6.8
AMH-11.5
Prolactin-16.59
In Oct-Nov 14 she put me on fertomid with follicle study but no success, in Dec-Jan-15 again was on fertomid. In feb -15 she wanted to try IUI so I thought of going to fertility specialist( that's why took second opinion from you) rather than normal gynae, but my family insisted on changing gynae.
4) In feb- 15, on family insistence I went to one of the renowned gynae in XXXXXXX She got my complete ultrasound done in March-15 ( scan attatched). to my badluck polyp and cyst appeared in my uterus and left ovary.
She suggested laproscopy supposed to be done in apri-15 , but in april suddenly my thyroid levels came out abnormal. so laproscopy cancelled. I have never had thyroid issues till that time. was referred to endocrinologist who got all sort of test done, thyroid ultrasound, thyroid scan etc. Post which I was told that I have subclinical thyroidism but no med suggested.
5) In May-15 I went through laproscopy and poly an chocolate cyst removed. June-15 I tried naturally and in July 15 did another round of fertomid along with follicular study, took trigger shot for ovulation as well. But no success.
6)In August-15, I finally convinced my husband to visit fertility specialist. So here we were at one of the clinic nearby , one of my friend had triplets after getting treatment from there.
7) On my first visit to the specialist, post TVS I was told I have PCOD (new shocker), never ever any ultrasound showed this. Given the time I wasted on fertomid , I told her I want to do IVF straight instead of IUI first. She did estradiol (84.6 pg/ml)and prolactin test so as to decide whether to proceed or not. Did TB PCR ass well- negative
8) In Aug-15 I started my first round of IVF with following med/injections.
- HMG 450IUI I/M from day 3-day12,
- Ovurelix 0.25mg S/c day9-day-13
- Decapeptyl 0.25mg s/c on day 13
- Ecospirin 1 tab daily from day 3
- Progynova 2mg 6 tab daily from day 3
- Folic acid 5 mg daily from day 3
- Silnafil 25 mg vaginally once from day 13th
On day 15th was ER, 11 eggs retrieved, 8 fertilized, transferred 5 on 2 day post retrieval.
Post transfer given following med
- Monocef 200mg twice for 2 days post transfer.
- Rantac 150mg- twice daily
- Wysolone- 5mg twice daily
- Folic acid 5 mg daily
- Ecoflora 150mg 1 tab daily
- Duphaston 10mg 3 tab daily
- Progynova 2mg 6 tab daily
-Silnafil 25 mg vaginally once daily
- Puregest 400mg vaginally twice daily
- Natturogest gel 8.0% once daily vaginally.
From 7th day post transfer took HCG 5000 IU I/M for 3 days every alternate day.
Beta HCG was 29, 16 day post transfer, stopped all med , got period 4 days after.
9) Sep-15 took ovral once daily for 21 days. Also took Normoz, folic acid and ecospirin. Got period in 30 days.
10) Oct-15 , E2 (77 pg/ml) and prolactin (24 ng/ml) tested, started 2 nd IVF with following med
-HMG 450IUI I/M from day 3-day12,
- Ovurelix 0.25mg S/c day9-day-13
- Decapeptyl 0.25mg s/c on day 13
- Ecospirin 1 tab daily from day 3
- Normoz twice daily
- Metformin 500mg SR twice daily
- Cabergolin 0.5mg once every week for 6week
- Progynova 2mg 6 tab daily from day 3
- Folic acid 5 mg daily from day 3
- Silnafil 25 mg vaginally once from day 13th
On day 15th was ER, 13 eggs retrieved, 10 fertilized, I wanted 5 day transfer, 4 reached blastocyst stage, transferred all.
Post transfer given following med
- Monocef 200mg twice for 2 days post transfer.
- Rantac 150mg- twice daily
- Wysolone- 5mg twice daily
- Folic acid 5 mg daily
- Ecoflora 150mg 1 tab daily
- Duphaston 10mg 3 tab daily
- Progynova 2mg 6 tab daily
-Silnafil 25 mg vaginally once daily
- Puregest 400mg vaginally twice daily
- Natturogest gel 8.0% once daily vaginally.
- Exhep Inj 40mg S/c alternate days.
- Normoz twice daily
- Metformin 500mg SR twice daily
- Cabergolin 0.5mg once every week for 6week
Tested bhcg today 9 dpot , beta HCG was <1.2
11) nov - no meds taken, dr reviwed my laproscopy video, she had suspicion of tb so did quantiferon tb test, but negative.
12) dec- got period in 30 days now starting on akt-4
S o wanted to ask is it fine to start ivf when on akt-4 and if there is anything wrong with protocol
Brief Answer:
PGS required
Detailed Answer:
Hi,
I understand your concerns about infertility.
Following is my reply :
1) You have undergone fairly good treatment. Unfortunately they failed.
2) I think reason for failure could be related to chromosomal abnormalities that occur with age. Increased age leads to increased chance of genetic abnormalities leading to failed IVF.
3) blastocyst is a very good stage of embryo and should have worked.
4) I suggest you go ahead with PGS (Preimplantation Genetic Screening) of embryos where embryo biopsy is done to identify if there are any chromosomal problems exist in your embryo leading to repeated failures.
5) I don't think you should go ahead with another cycle of IVF without PGS.
6) Antagonist protocol suits you better.
7) I saw the attached ultrasound scan pictures. I don't think it could be TB. anyway continue treatment as you have started.
8) ERA ( Endometrial Receptivity Array) test may be required to check the best day for embryo transfer.
9) In XXXXXXX I suggest you see Dr. XXXXXXX XXXXXXX which is expert in high end IVF procedures like PGS and ERA. Her contact number is 0000.
Let me know if you need anymore help.
PGS required
Detailed Answer:
Hi,
I understand your concerns about infertility.
Following is my reply :
1) You have undergone fairly good treatment. Unfortunately they failed.
2) I think reason for failure could be related to chromosomal abnormalities that occur with age. Increased age leads to increased chance of genetic abnormalities leading to failed IVF.
3) blastocyst is a very good stage of embryo and should have worked.
4) I suggest you go ahead with PGS (Preimplantation Genetic Screening) of embryos where embryo biopsy is done to identify if there are any chromosomal problems exist in your embryo leading to repeated failures.
5) I don't think you should go ahead with another cycle of IVF without PGS.
6) Antagonist protocol suits you better.
7) I saw the attached ultrasound scan pictures. I don't think it could be TB. anyway continue treatment as you have started.
8) ERA ( Endometrial Receptivity Array) test may be required to check the best day for embryo transfer.
9) In XXXXXXX I suggest you see Dr. XXXXXXX XXXXXXX which is expert in high end IVF procedures like PGS and ERA. Her contact number is 0000.
Let me know if you need anymore help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your reply.
Can i start ivf while on akt-4?
Can i start ivf while on akt-4?
Brief Answer:
No
Detailed Answer:
Hi,
You can start IVF only after completion of AKT.
Meanwhile get consultation with doctor I have mentioned and seek details about tips for maximum success in IVF and also PGS / ERA.
No
Detailed Answer:
Hi,
You can start IVF only after completion of AKT.
Meanwhile get consultation with doctor I have mentioned and seek details about tips for maximum success in IVF and also PGS / ERA.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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