Ever had fertility treatment and had your lining measured? Please advise.

[Shellster52]

My period is VERY light. It hardly lasts two days and I bleed about one tablespoon. I then read that a thicker lining statistically increases IVF implantation success so after two failed embryo transfers, I wondered if this is my problem and asked my IVF doctor for vaginal viagra to take with my next IVF cycle to thicken my lining. He said that my lining was 9 and 7.5mm at my last ultrasound before each of my transfers and that this was good and once the lining gets too thick, this can also be bad for implantation.

I have read that a period lasting 5 days is associated with optimal fertility. So I don't understand why if my lining is perfect thickness at 9mm, then why do I barely get a period?

So I would love to know if you have ever had any fertility treatment and had your lining measured, what was it's thickness? And then what sort of a period do you have?

Hello

Not sure what the ideal is but mine was 9mm on day 10, I stimmed for another 2 days after that

I imagine the drugs help you build a thicker lining too x

I understand your concern. I had a similar pattern though yours sounds even lighter. My period changed distinctly at about 35 and I am convinced that my fertility declined at the same time. I am digressing ... (And speculating!)

Anyhow, I remember a bloody awful follow up consultation after my second failed ivf where I asked about this and the consultant almost rolled his eyes. He looked back at my measurements and said all had been well. On my 4th, successful, round another consultant said that in the days before egg collection my lining wasnt thickening fast enough so gave me extra oestrogen (I think this is what it was - forgive me if I have it wrong as I think I have suppressed some memories!). I had the removal and was told the lining was now marginal and that if it didnt improve i would be advised to freeze my embryos. At 3 days I went back in expecting a transfer or to be told they were being frozen. I was overjoyed to be told that although my lining had thickened I had three excellent embryos that they wanted to take to five days.

So, what to take from this? I think the key thing is that regardless of period you have to trust in their measurements and believe that if all were not well they would advise freezing and going again to get an optimum lining. I know that is a leap of faith. The eye rolling consultant said to me that the reason most ivf fails is because the embryo is not viable. This was especially so for me as I was 40 so the chances of genetic flaws eye were so much higher. I suppose his impatience stemmed from women (me!) not wanting to hear this as it is unsolveable where as loning issues you can do something to try and help. I totally get why you are concerned about this though and see your train of thought.

Hi to answer your question: I had 3 IUI's and 1 IVF (successful). My lining measured in the same range (usually +- 9mm) as yours during the treatments and I had 3-4 day periods.
The lining is shed when estrogen level drops, so it might be worth having your estrogen tested when your period is due.
A treatment that is popular now here in South Africa is to have an endometrium scratch before implantation to improve chances of implantation. That could be an option to discuss with your doctor.

Not sure if the drugs make the lining thicker than a natural cycle Lauren. My cycle seems a very light two days regardless of natural or IVF.

I have heard a few stories lozster where women notice a distinct change in their periods give or take mid thirties so makes sense that fertility takes a nice little nose dive around this time. You don't actually mention your lining thickness measurements. Wonder if the first eye rolling consultant had a different idea of a 'normal lining' compared to the second who gave you extra estrogen. I have been told very different measurements about what is ideal. Maybe not what you were planning for me to get from your story, but what I take from it is that doing something to thicken your lining worked. I will definitely be trying the Viagra supps next IVF. The 'trust' factor is out the window with my fertility specialists experiences in the last two years so I just have to do what I think is right so I can know I have given it my all and be at peace.

Thank you HeleenC for giving me your stats. My estrogen has been tested and does drop right down when AF arrives, so I just don't get why your period lasts four and mine barely two when both our linings thicken to =/-9mm???? I have heard of the endometrial scratch but thanks for the reminder. I have an appt on the 4th Feb and will definitely add this to my list of questions. I am in Australia and not something I really hear of here so I doubt it will happen but no harm to ask.

Sorry shelster - I had so many measurements done including for clomid rounds that the figures escape me so i can't help with that beyond saying that when mine were low it was picked up and corrected with oestrogen. As to whether there are different guidelines I don't know. Fwiw I was a satellite patient at Liverpool women's so measured there and at the local hospital and at a private clinic for one round and the verdicts concurred between the satellite centre and LWH. I am sure that there is variation in judgement as you say though. Even if they work to the same range one dr may tweak at the lower end and one not. It's the same with stim dosage too - on my successful round on the final scan at the satellite clinic the consultant said it might be worth doing a final, extra shot that afternoon. Cue a run to the pharmacy, a run back to the clinic for the needle them a panic at work as I had no opener for the glass vial so had to ask for help from oc. Health on site before injecting.

Ivf seems at times to be as much an art as a science. There were some other differences too on my final round that may have helped apart from the oestrogen. The most likely thing in my favour was having takem dhea to help my elderly ovaries. also i was given an ultra sound guided transfer. Standard practice in most countries and clinics but not at L WH. I have a kink in my cervix and the nurse couldn't get the catheter in so called for a dr who said the catheter that she thought was 'just about in the right place' was no where near... Because my eggs then embryos were so good, I went for the first time to a five day transfer with one blasto and one morula. Now, my partner and I have discussed the lining issue at length as he is agog that the final stage of ivf (implantation) is such a chance occurance. He thinks the embryo needs to be tucked in with a warm blanket! So, I wonder if the advantage of a five day transfer isn't just that you are likely to be transferring a better embryo but that you are also transferring it to a thicker lining? Of course this is lay person speculation but I think more could be known about optimum lining.

I hope it works out for you this time - I shall keep my fingers crossed.

Hmmm, scarring can cause light periods and non-optimal lining but your lining during IVF would likely not get to 9 if that was the issue (or you'd have a heavier period during IVF and not the rest of the time).

There's so much they still don't know in this field :(

Thanks so much lozster for taking the time to reply. You are a very nice person to still be lurking around giving others advice when you have the result of your IVF and don't need to bother with this anymore. I can't wait to be free of the internet obsession once I get my BFP!

I have been taking DHEA for a while now and have seen gradual improvement over each of my three IVF's so at least that is reassuring and gives me hope to continue. So it is nice to hear this worked for others. Was there a definite embryo quality improvement after the DHEA?

So were you not given ultrasound transfer on your previous 3 IVF's and only on your successful one? I did my last 3 IVF's at a cheaper clinic where they do not do u/s guided transfer but am paying more for my next cycle at a newer clinic that does do it. The new IVF dr seem convinced that this improves implantation success as there is a specific spot where the embryo is most likely to implant. So you too give me some faith that this will make the difference this time. Last time my embryo looked great quality but then I had a bloody nervous trainee doing my transfer. If you say the nurse thought your catheter was in the right spot but it was no where near it, I wonder how far off the trainee was without u/s? Gives me hope that this could have been a major problem last round and it will work next round.

My old clinic did day 2 transfer but my new clinic does 5 day transfer. I have a low AMH and don't produce many eggs so first things first - I have to have a couple of eggs make it the 5 day distance but if I do, I will feel like I am in with a fighting chance.

The fact that doing something about your lining worked for you also gives me hope because my gut just knows this is part of the problem. I am going to take Viagra next cycle (the cycle before my IVF cycle) just to know that it will work for me (I will determine success by a heavier period) before I waste $$$$ on another IVF cycle if Viagra doesn't work during the actual cycle. I have also read that a period lasting 5 days leads to optimal success for pregnancy the following cycle. Maybe because there has been lots of blood to my reproductive organs and the antral follicles preparing them for the next cycle? Either way, by taking Viagra the cycle before, I will be reassured during my IVF cycle if it gives me a heavier period before my pregnancy cycle (hey, I can be hopeful!)

Hamster, yeah I have read that scarring can cause a thin lining but as you say, my lining would not have gotten to 9mm if this was an issue. I do not have any history that would cause scarring. They say the Viagra doesn't work if the lining is scarred so at least I have some hope that Viagra will be the solution I am after.

Still completely in the dark as to why my lining of 9mm is considered good yet my period is so light and barely lasts two days.