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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Uterine Bleeding During Pregnancy?

Am a 34yrs young woman trying to achieve a third pregnancy for 18months now.Had a history of oligomenorrhoea,menarche @ 14yrs and 6mnths.Never been on birth control pills,no surgery of any kind,neither a D&C.Been on withdrawal or barrier method to prevent pregnancy.when trying to achieve conception initially,I passed through a progestin test,my period came,then clomid.I had my second cycle,was given clomid again-still 50mg,and promolut N was taken on CD 21- I conceived. My second pregnancy the same treatment was given but the second cycle on which I conceived,HMG 75ul start was added with clomid and was given on CD 9.That pregnancy had 2 sacs,one was viable and the other an embroynic pregnancy.These kids are now 5 and 3 years respectively and both pregnancy were SVD.Now,the gynae that treated me then is no more,my new gynae knows my history,I ve passed thru progestin test over and over with him,he keeps giving me 50mg clomid only -this was Dec.2012,Jan 2013 and April 2013. Btw jan and April there s no periods no pregnancy.I had to do progestin test again,in May 2013 he gave me an unknown fertility drugs from CD3- CD7 and an injection on CD4,he refused to let me know these drugs name. I so reacted with this drugs,never had hot flushes,but I d it,breast tenderness,bloating,back pain and nausea and my period was delayed till CD 47-that was May 19,period came again june 19,my husband had travelled,we both worked interstate,we re not meeting.In july 25,2013,AF arrived again on its own,I decided to visit my gynae again,this time around,I was only given the same unknown fertility drug CD2-CD6.I d the same previous reaction except hot flushes,and a very lighter periods on CD37-CD39,there was no pregnancy,neither ectopic or blighted ovum.My ultrasound results always reads normal abd/pelvic,the endometral lining always thickened(11mm-12mm) @ the end of each of these treatments. I forgot to mention I d a functional in April 2013 treatment. I went back to my gynae and complain bitterly about my response to this treatment,we waited for another onset of AF from August -Oct 2013. He put me through another progestin test,this time AF was not normal,I d heavy uterine bleeding,I was given 50mg Clomid CD2-CD6- no pregnancy,no periods. In Dec.2013,another progestin test was done with 50mg clomid + FSH 75ul stat on CD9,no pregnancy,AF came exactly 30days which is my normal cycle,my husband has gone back,scan result still reads normal and thickened endometral lining*premenstral*.Before now my hormonal profile reads low on FSH,progesterone and normal on low end in LH.In March 2014,I passed through progestin again with 50mg Clomid+ FSH 75ul stat,still no pregnancy,AF came on its own-April 12, March 12, jan 21 and dec.23 2013.Now,this is my story,am presently on CD6,still on 50mg Clomid,this time my gynae said I would not be given any gonadotrophin,only clomid 50mg CD3-CD7,it did not go down well with me,if you observed I usually conceived on my second cycle and my husband is going to be around till CD24.Please can you help,I have been on folic acid and Eviol since Dec.2013 till date.Thank you for your time.I really need your advice on this. Ijeoma- Nigeria
Thu, 22 Jan 2015
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OBGYN 's  Response
Hi, thanks for writing..
Yes, from your history it is clear that you will resn, you respond only with FSH.. So in my opinion, you shoukd take clomphinene 100 from day 2 for 5 days and take rFSH from day 7 to 9..Foolkw up eith follicular study kn day 11 till folliclr size reaches 20 mm and give inj hcg for ovulation to occur... Get IUI done this time.. If your husband goes get his semen cryopreserved for IUI.. Hope I have answered your query.. Good day.
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What Causes Uterine Bleeding During Pregnancy?

Hi, thanks for writing.. Yes, from your history it is clear that you will resn, you respond only with FSH.. So in my opinion, you shoukd take clomphinene 100 from day 2 for 5 days and take rFSH from day 7 to 9..Foolkw up eith follicular study kn day 11 till folliclr size reaches 20 mm and give inj hcg for ovulation to occur... Get IUI done this time.. If your husband goes get his semen cryopreserved for IUI.. Hope I have answered your query.. Good day.