QuestionQUESTION: Hello doc, iam 35 and writing to you from India.. i have been trying to conceive for last 2 years..i have hypothyroid which is now under control with 50mg of eltroxin/day. I was not ovulating when i went to the gynae for the first time and thats whn i got to know from my blood tests that i have Hypothyroid,.withina month of medication i started ovulation around day 13-14 of my cycle and i do feel the O pain.I have extremely painful periods too..got all the tests done including HSG/Biopsy for endo and all came normal..my hubbys sperm is also normal but somehow iam not able to conceive..i have had stimulated cycles with medicines as well as injections to get muliple follicles and i did have 3-5 of them for IUI but it didnt result in conception..Iam on my 2nd IUI now and i had watery discahrd on 10DPO for a day and pain whole night..whatdo u think it could be? now iam 18DPO and have all the signs of bad period cramps:(..if this cycle fails too then howmany more times should i do IUI..? i normally dont have much discharge..could it be the reason for my infertility..why did i have watery discharge n pain on 10 days post IUI?? pls help..my gynea is says i come under"unexplained fertility" what do i do??
ANSWER: Hello Aadya from India,
I cannot explain the discharge for you without examining it, and of course, I can't do that via the internet. It could be normal, as increased estrogen levels will cause increased discharge.
If you have had two good IUI cycles, and it has not worked, you could try up to four IUI cycles. Statistically it will work by four attempts. If it does not work by then, we recommend you proceed with IVF.
You are technically not "unexplained" yet, unless you have already had a laparoscopy and it was normal. Many of the patients that don't have obvious causes for infertility, have endometriosis, which can only be diagnosed by laparoscopy. So, one option that you have before proceeding further with IUI is to undergo laparoscopy. Sometime, treatment of this by laparoscopy will solve the problem. Often it does not and IVF becomes the treatment of choice. I don't particularly like the term "unexplained infertility". Rather I prefer "undiagnosed". In some cases, we find problems at the time of IVF such as poor fertilization or poor egg quality or poor embryo development. And in some cases we just don't have the technology to find what is occurring.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf, and follow me on Facebook at http://bit.ly/9Iw9oV
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QUESTION: thanks Doc...regarding Lap..when i told my doc i had extremely painful period she did mention i may have endo.but after all these tests she said all normal..but if ur saying lap is required to check that then i will ask about endo once again.
about IUI..how long does washed sperm stay in your body
AnswerHello Again,
If you have had painful periods then it is very likely that you have endometriosis and that is the cause for your infertility. Unless you are planning to proceed directly to IVF, I would recommend the laparoscopy.
In terms of sperm survival in the body, that is an unknown, since it is not possible to aspirate sperm from the tubes to see if they are still alive. We believe that it lasts 12-24 hrs.
Sincerely,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf, and follow me on Facebook at http://bit.ly/9Iw9oV
