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Re: Unexplained infertility - help!
From: jwang,MD (anonymous@obgyn.net)
Mon, 31 Jul 2000 12:01:09 -0500 (CDT)
Your history is very complex, too complex to be adequately answered on
the internet. Also, some of the drugs you mention are not used here in
the U.S. The bleeding should be able to be diagnosed, or at least
certain conditions can be ruled out by further testing. Most simply, an
endometrial biopsy. Given the complexity of your history, a D&C and
hysteroscopy may be the best procedure. If you are not stiafied with
the answers your getting from your current docs, tell them, or seek
another opinion.
At Mon, 31 Jul 2000, Michal wrote:
>
>Hi all,
>
>I would greatly appreciate it if also an expert could address my
>problem.
>
>Below is my gynecological anamnesis:
>
>1 Age: 37. One and only natural pregnancy; caesarean at the end of week
> 40 (1992) due to improgressive labor.
>2. Use of an intrauterine device right after giving birth, and its
>removal after two years due to an infection.
>3. Attempts to conceive spontaneously during a year (4 years after
>giving birth)
>4. Normal invasive uterine imaging, although followed by an infection.
>5. Hormone treatment with iui 5, healthy sperm; no antibodies to it.
>6. 5 IVFs and one attempt of transferring frozen ebryos. High
>fertilization percentage, but no uterine absorption.
>7. Normal hysteroscopy (twice)
>8. Normal cervical smear
>9. Pipel test showed a few days' delay of endometrial thickness
>compared to the day of the menstrual period.
>10. Throughout the 4 years of trying to coceive, there has been
>constant sanguinous excretion, which is visible by an ultrasound of the
>uterine cavity. These excretions did not stop even during the hormonal
>treatments. In 4 of the hormonal treatments I received cortisone.
>Hormonal treatment for transferring frozen embryos, which included
>Proginova and Astrogen suppositories, did not stop the bleeding.
>The current thesis claims there is no use of performing another IVF/FET
>as long as the uterine bleeding problem is not solved.
>Hormonal profile indicates all is normal and also a hormonal follow-up
>during the IVF treatments shows a normal state.
>11. Hypothyroidism has been treated for years with Altroxin (well
>before the pregnancy)
>12. Uterine contractions with no pregnancy
>13. Can curettage help stop the bleeding?
>14. Can the new drug Yutropan help?
>15. Is this case known in the literature, and if it is, what is the
>required treatment?
>
>Many thanks in advance,
>
>--
>Michal
>Israel
>
--
J Wang, M.D
Assitant Clinical Prof.
Tufts University School of Medicine
>**Note: Opinions expressed here are for educational purposes only
>and, as such, do not constitute a physician-patient relationship.
>This information is not intended to supplant the need for you to
>consult with your physician prior to choosing therapeutic options
>and/or interventions.>
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