WOMENS-HEALTH Messages for October, 2008: Re: GYNECOLOGIC: Amenorrhea following D&C

Re: GYNECOLOGIC: Amenorrhea following D&C

From: William F. von Almen, II, MD, FACOG (anonymous@obgyn.net)
Tue, 7 Oct 2008 20:08:35 -0500 (CDT)

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Amy

No clue about KB test. I would suggest a progesterone withdrawl first. That may jump start your hormonal axis and get you back to normal. Estrogen priming and then progesterone withdrawl follow this, and you may need hysteroscopy to rule out Asherman's syndrome-uterine scarring after D&C...Dr. von Almen

At Mon, 6 Oct 2008, Amy wrote: >
>I am 27 years old with one child. My husband (same father) and I have
>been trying to conceive for one year (had Mirena removed exactly one
>year ago this month). Since then I have had 4 chemical pregnancies and
>one missed miscarriage (slow heartbeat detected at 6 weeks, empty sac at
>8 weeks). D&C performed at 9 weeks (June 10) after cytotec failed to
>induce miscarriage. Accidentally kleihauer betke was performed prior to
>D&C (not sure why this was done as I am Rh positive) but result was 0.9%
>
>Since D&C, have not had any bleeding (now going on 4 months) although I
>have felt I am ovulating and am having menstrual cramping for 2 days
>each month. Because of this, my physician ordered hormone testing,
>which I had done approx 5 days after ovulation results are:
>Progesterone : 5.7
>LH: 8.6
>FSH: 5.8
>Prolactin: 9.9
>HCG: <1
>KB: 0.9% (re-drawn strictly for curiosity)
>Antibody screen: negative
>Thrombophilia panel appears normal (not all tests have been completed)
>HSG done in April (prior to D&C) normal.
>
>Just hoping someone can give me another opinion on what would be the
>next step of testing at this point specifically regarding the
>amenorrhea? Progesterone withdrawl? Estrogen/progesterone challenge? Any
>any ideas on why I would have an elevated KB???
>
>Thank you!

-- 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. ** Private emails cannot be entertained due to time constraints; consequently, they will receive no response.

William F. von Almen, II, MD, FACOG Private Practice New Orleans, La.

Next message: William F. von Almen, II, MD, FACOG: "Re: MENORRHAGIA: 5 Months w/ no period and several neg. pregnancy tests..."
Previous message: William F. von Almen, II, MD, FACOG: "Re: MENORRHAGIA: Menstrual bleeding non stop since 2001"
In reply to: Amy: "GYNECOLOGIC: Amenorrhea following D&C"
Next in thread: T. Lyons, MD: "Re: GYNECOLOGIC: Amenorrhea following D&C"

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