Tweet
Hello, we have been pursuing pregnancy with IUI with donor secondary to my age and spouse infertility. I am now 42 and have been treated for endometrial hyperplasia. We have done 5 IUI's with letrozole, and produced 2 follicles 3x, 3 1x and 1 1x. Follicles have been 23-31mm each time except one when they were 18 and 20 mm. 4 IUI's on day 11 and one on day 12. I understand with age and stimulation that the follicles produce sooner but am concerned the size is too big. Is this an issue and is there anyway to stimulate them to a more appropriate size? Thank you.
-
-
Hi,
Did your RE tell you what the odds are of pregnancy in a 42 year old who undergoes letrozole/IUI? Just want to make sure you're aware....
Also, what caused the hyperplasia? Are you significantly overweight? Did your doctor tell you why he/she thinks you developed this?
Dr. Roseff in Florida -
follicle/hyperplasia
Hi Dr. Roseff, Thank you so much for your quick reply. Of course we know that age is a big factor right now. We initially did 3 IuI's with my ob/gyn with a family member as donor. We consulted 2 RE's and both recommended 3 more IUI's since I had never tried to get pregnant before this.
I would love your insight on the hyperplasia, nobody has any good ideas on this. I had no symptoms and was diagnosed on day 3 US with polyp and discovered Hyperplasia after D/C. I have gained 10#/ since we started 5'5" , 158# right now. I have had light periods for several years. My labs are WNL with recent elevated FSH and decreased AMH. I have been treated for hypothyroidism with T3 for 10 years. No diabetes or HBP, i have low cholesterol and low BP overall. I asked my RE how I can have hyperplasia which indicates higher estrogen and still have a light cycle. I would appreciate any suggestions on what else to look at for my long term health. The idea of continued provera is not the route I want to go. right now I am taking compounded progesterone since my lining is thinner after several months on provera.
Is the follicle size an issue?
Thank you again!!Comment
-
Hi,
The follicle sizes are OK, as long as the hormone (estradiol and progesterone) levels in your blood were OK, too, the day those follicles were measured... What were the hormone levels in your blood the day they were 23-31mm each and 18 and 20mm?
Dr. Roseff in Florida
PS - You didn't mean you are on compounded progesterone daily, did you?Comment
-
prog/estradiol
Hi, thank you again for you quick reply. I have not had estradiol/progesterone measured on those days. What levels should they be? I take the compounded progesterone on days 16-28. I appreciate your help and any insight on the hyperplasia diagnosis. Thank you.Comment
-
The estradiol should be at least 200 pg/ml (assuming you're in the U.S.) and the progesterone should be less than 2.0 ng/ml. I can't offer you any help on the hyperplasia diagnosis without reviewing your records in their entirety.
If I may say so, it sounds like you're not really focused on the right path here....
Dr. Roseff in FloridaComment
-
?
I will discuss the hormone levels you suggested with my RE. What do you mean by not focused on the right path? I was told the hyperplasia would not effect pregnancy attempts. However I am concerned about it long term and the fact that I don't fit the profile and my hormones are somehow off in a way that is not detected and in addition in affecting pregnancy attempts. Please clarify!? Thank youComment
-
Johnson...I too am 42. I had one IUI resulting in a pregnancy that ended in a miscarriage and two unsuccessful IUI's. My RE said that after 3 tries with IUI it is best to move onto IVF. The success rates are much higher with IVF although still not great for women our age. However, I have seen plenty of women that were successful with IVF at our age or older (with their own eggs)! Look for a center that has a good success rate for your age category.Comment
-
Johnson - Hyperplasia, if not reversed, may decrease the odds of implantation and/or increase the risk of pregnancy loss. Also, the statistical likelihood of pregnancy success in letrozole/IUI cycles in 42 year old women is extremely low (though certainly not zero) - and what I meant was to say if that's understood by you and acceptable to you, then you wouldn't be spinning your wheels in doing this type of treatment.
All my best,
Dr. Roseff in FLComment
-
Thank you Dr. Roseff, I do know my other limitations with age and hyperplasia but wanted to be sure follicle size was not too large. I know ideal size is less than what i have been producing.Comment
-
A follicle can be mature if it is at least 15 mm diameter and has an estradiol level of about 200 pg/ml on the day it is considered "ripe".
Dr. Roseff in Wellington, FLComment
Comment