lining issues, is there hope??

[Guest]

Hello...I was wondering if there was hope with these issues and outcomes:

I had an 11 week miscarriage about 1.5 yrs ago due to Turners Syndrome needed D&C and then 2 subsequent chemical pregnancies, 1 natural, 1 with medicated iui.

My Dx: MTHFR homozygous C, homosysteine levels at 7
ovulatory disfunction
lining issues
low hypothyroid = 4.6
Tx thus far:
2 hysteroscopies, 1 adhesion removed on first, minimal spotty scarring removed on second. Md said uterine walls looked really good.
50 mcg for thyroid
Fragmin (5000 units bid) given at time of ovulation for MTHFR, foltex and asprin daily

2 medicated ivf cycles...good responses, 20 eggs and 32 eggs, total of 15, 5 day frozen embryos. No transfers done because lining was too thin.

First ivf cycle was antagonist protocol. My estrogen was really high but my lining never responded and stayed at 5mm, no triminlinar appearance.

Second ivf was on micro lupron. Responded great with follicles. my lining got up to 6.5mm, but then estrogen shot up to 3000 and lining started to decrease and ended up at 4mm day of retrieval.
I still had a normal period (not scanty) after cycles lasting 4 days with 3 additional days of spotting.

My lining starts at 4-5mm at the beginning of each cycle, starts to respond, and then when estrogen dramatically rises, lining goes back down to 4mm...but I still have normal period.
I've utilized accupuncture (swedish protocol), abdominal massage, yoga. I also added viagra during my second ivf (on my own). Massage therapist say I have aortic blood flow resistance.
Is there anything else I can do, any other protocols? Is surrogacy my only option?
The Md's mentioned possible damage with D&C, but they can't identify any during hysteropscopy.
Would adding fragmin at beginning of cycle help??

Before my first miscarriage I was healthy, active, in shape, irregular periods but normal volume. Still work out (not stenuously) eat healthy, and have normal bmi.

Please help/advise!!!!!
Thank you!!!
amy

[Dr Jeffrey Fisch]

We generally use injectible estradiol valerate in conjunction with Viagra suppositories. In some women we also add a small dose of Terbutaline. If we cannot get the lining thick enough, we may decide to try transferring embryos into you any way. We have seen pregnancies with linings <7mm, although less often. A surrogate is always a last option.

Jeffrey Fisch
jfisch@sherinstitute.com

[Guest]

Dr. Fisch,

Thank you for your timely reply. Two more quick questions:
1. Is viagra better to take in a "suppository" form made by a pharmacist or is the pill form to be taken vaginally just as good? The reason I ask is because I've only ever been given viagra 25mg in pill form to place vaginally. I've never been able to find a pharmacy that provides it in suppository capsules.
2. What benefit does Turbutaline give those with thin linings?

Thank you very much for your time one these questions!!!!
Amy

[Dr Jeffrey Fisch]

We have no experience with the pill vaginally, but the experience of others doing it this way has not been encouraging. Terbutaline is a smooth muscle relaxer and may also help to increase uterine blood flow.