Infertility and Endometrium / Lining Issues

[funkymonk]

Please join here if you are experiencing infertility as a likely result of lining issues... Support and chat needed...

[bananafish81]

User

Assume you've had oestrogen pills / patches on your stims cycles as well?

Stuff to ask about

• viagra
• trental + vitamin E
• G-CSF wash
• tamoxifen

[user1468907307]

Hi i posted via user1468907152 above

Bananafish81
I did with patches progynova viagra before

From singapore
Here did not use G-CSF wash before

[GlummyMummy]

Hi folks, I'm back again on IVF attempt number 3!! Just had day 8 scan today and EC booked for Monday.....however, my lining is thin again at 6.4mm. Better than this time last attempt when it was 4mm, but worse than our successful attempt in 2013 when it was 9mm at this point. I'm convinced my bleed after giving birth has caused my lining issues now in trying to conceive number 2.

Going all out with food and heat packs etc to try and thicken it in a week!

[bananafish81]

Ah good luck Glummy!

I'm facing a cancelled FET, lining hasn't moved from 6mm, no triple line - being scanned on Sunday, and expect the cycle to be cancelled unless I've had some miracle transformation

We're doing an ovulation induction FET, apparently 3 follicles doesn't seem to be enough, plus 6mg progynova

Imagine cycle will be cancelled on Sunday

Next steps I guess will be doing full IVF stims - thinking thick for you Glummy

[GlummyMummy]

cheers Bananafish! As I said on the other thread, hard to find info on how to increase lining naturally BEFORE egg collection. most things eg pineapple, rasp tea are meant to be good for after EC

[Sunflower13]

Hi Ladies,

I have just stumbled across this thread after having my 1st IVF cycle cancelled today due to a persistently thin lining.

I have tried various combinations of Viagra, patches and oestrogen tablets and down reg. injections. My lining has still only managed to reach 5.7mm. Starting to panic that it is not going to be possible for me to get pregnant.

Have any of you tried any other forms of medication? My clinic has said that they do not know how else to treat this problem. Any advice/ support/ help would be greatly appreciated as I'm not quite sure what to do now.

[bananafish81]

Hi sunflower

I'm so sorry to hear this - I've also just had a cycle cancelled due to thin lining (2nd attempt at a medicated FET)

Have your clinic checked your uterine blood flow?

Have they done a saline ultrasound and / or hysteroscopy to check the uterine environment?

Just important to rule out any adhesions that might be causing the thin lining

What is your lining like in a natural cycle?

I didn't respond to oestrogen pills or patches, the only time my lining has thickened up was in a fresh IVF cycle when my oestrogen levels were sky high due to a gazillion follicles

My Dr said some women don't respond well to artificial oestrogen but do when their body's own natural oestrogen is in the mix

He said natural oestrogen was far superior than anything we could give artificially, and in an ideal world we would have done a natural FET

We tried doing an ovulation induction FET - stimming me gently with some light stims to produce a few follicles, to try and thicken my lining up with my body's own natural oestrogen

Unfortunately I didn't get above 6mm and not triple line so we've had to cancel

We are trying a Neupogen (G-CSF) uterine wash tomorrow as a rescue treatment - the studies have shown this can be effective in women with treatment resistant thin lining

We aren't going to transfer this cycle because of the poor quality of the lining, but if I respond to the Neupogen wash, we will add it into the protocol next time

I'm having it tomorrow evening (consultant has never done one before but agreed it was worth a try as the studies so far were very compelling - and nothing to lose by trying) so will report back. I'm to have one before trigger, then we will check the lining 2 days later and possibly repeat

My issue is to do with sleepy oestrogen receptors, probably from long term use of the pill, which is why all the treatments that work on uterine blood flow (viagra, l-arginine, vitamin E, acupuncture etc) have done sod all for me - my uterine blood flow is fantastic, my endometrium just needs sledgehammer levels of oestrogen to thicken up

My Dr said he hoped cumulative oestrogen exposure would help to upregulate the oestrogen receptors in my endometrium (ie wake up the sleepy antennae so they would tune in properly)

My lining did thicken up in my second IVF cycle once we added in progynova, and we did proceed to transfer - I got pregnant but miscarried at 10w. However it seems the 2 months of oestrogen exposure from all the progynova I took while pregnant did seem to have an effect - as in my 3rd IVF cycle in May I got to 11mm!! We were doing an elective freeze all cycle to do PGS, so unfortunately we didn't transfer into that nice thick lining

Dr Sher recommends something similar for thin lining - 3 months of cyclical oestrogen therapy (ie cyclo progynova - 3 weeks of oestrogen then a week of progesterone to induce a bleed) to prepare the endometrium

In my case, as a medicated FET and ovulation induction FET have both been cancelled due to thin lining, we know they're not effective routes for me

We know that my lining CAN thicken up when my ovaries are producing shedloads of natural oestrogen, so we are going to do another fresh IVF cycle, to grow LOTS of follies, to try and thicken up my lining that way. We will have to collect the eggs due to the OHSS risk, but will be putting back a PGS tested frosticle

This is a very extreme measure (ie doing a fresh cycle in order to do a FET) but as natural cycle, medicated and ovulation induction FET have all failed, this is our best shot

The Neupogen wash tomorrow will serve as a saline ultrasound to let the Dr have a better look at the uterine cavity and examine the endometrium more closely.

If he is happy with how the endometrium is looking, we will go straight into a stims cycle as soon as I get my period

If he isn't happy with how it's looking, we will do another hysteroscopy and insert a copper coil, for 1-2 months

The coil creates an inflammatory response in the endometrial lining which helps it to regenerate - a bit like a turbo version of having an endometrial scratch. It's why women who have a copper coil tend to have heavier periods.

It's often used to treat women with Ashermans syndrome (intra uterine adhesions), to let the endometrium repair after the adhesions have been surgically removed.

So, things for your clinic:

• uterine blood flow?
• extended oestrogen priming?
• ovulation induction?
• hysteroscopy?
• endometrial scratch and / or copper coil?

I feel your pain - it feels like everyone else manages to grow decent lining and I'm the freak who can't. I'm sorry to hear you're going through a similar experience - don't know if any of the above is helpful? Will report back after the Neupogen wash and let you know how it goes...

[Sunflower13]

Thanks Bananafish, that's so useful, thanks for taking the time to reply. I haven't tried any of those options that you have suggested and my clinic hasn't mentioned them to me either.

How do they check uterine blood flow? The clinic are happy with the look of my endometrium and say the 3 lines are visible. I really wonder whether I am in the same situation as you with regard to the pill making the receptors sleepy. So you got to 11mm after cumulative oestrogen exposure?

You've given me so many other options to explore, thank you. Going to book a Holiday and try to get some sort of normality back after what has been a very tough time before trying other options.

Good luck with the Neupogen wash and please let me know how it goes, I'd be really interested to hear.

[GlummyMummy]

sunflower - I am similar to you in that my clinic are happy with my lining but I would prefer it to be much thicker!

Had egg collection today so was gobsmacked to get 13 eggs (previously only ever got 7!) Just have to wait and see how many (if any) fertilize, bit worried I might have compromised quality with higher quantity. However, despite nearly double the number of eggs in there, my lining is exactly the same as it was at this point in my failed cycle - 7.5mm. Consultant today was happy with that (they say anything over 7 is fine) and said I had triple layer but I am disappointed, had hoped for it to be a bit higher, especially with all the extra follicles and eggs. Consultant seems to say it will continue to thicken over the next few days before possible embryo transfer on Saturday. Fingers crossed for positive result from embryologist tomorrow!

Still eating all the yucky foods to try and help lining - avocado, pom juice, rasp leaf tea and starting to think I might be turning into a brazil nut!!

Anyone else experienced a high (for them) amount of eggs with no change to their poor lining?

[bananafish81]

My consultant just flips a switch on the ultrasound machine when I'm having a date with dildocam, and it brings up the colour Doppler, which shows the uterine blood flow

He checks it pretty much every time - esp to look for any areas of compromised blood flow that might indicate adhesions or similar

In Jan I had a fresh cycle : lining was 7.2mm day before trigger, but regressed to just 5.5mm on EC day. With the help of progynova it thickened up and got to 8.5mm by day 4 - so we proceeded to transfer, and 9 days later I got my BFP

I continued to take the oestrogen throughout my pregnancy. Sadly I miscarried at 10w - tissue testing showed the baby was chromosomally normal, so the problem was with the soil (ie me) rather than the seed

I had a hysteroscopy to check out the uterine environment, to check for scarring or similar.

2 months after my ERPC we began another fresh cycle. I had a LOT of follicles and very high oestrogen levels (got 28 eggs at EC), and got to 11mm all by myself

This cycle was freeze all to do PGS - so we didn't transfer into that nice thick lining

However it seemed that the extended oestrogen exposure while I was pregnant and the high oestrogen levels from the stims did kick my lining into gear

Desperately hoping if it's done it before, that it will be able to do it again

If you get a triple stripe lining that's a great start

Would natural cycle FET be an option if you get a decent lining in a natural cycle?

Holiday sounds like an excellent idea and an essential part of any protocol!

[bananafish81]

Congrats Glummy! Hoping for great news from the love lab tomorrow morning

My lining was as crap in my 2nd cycle (where I got 17 eggs) as in my 1st cycle (where I got 7 eggs)

If anything, it was actually worse in the 2nd cycle than in the 1st

I wouldn't have made it to transfer without progynova added in on top

I think my 3rd cycle thickness was a combination of a LOT of follicles and oestrogen priming of the endometrium

[GlummyMummy]

odd if it's the oestrogen in the eggs that feeds the lining for it to be rubbish with higher number of eggs!

[bananafish81]

To some degree I don't think for most people the number of eggs increases the lining in direct proportion

Most people get a decent lining in a natural cycle when they ovulate one egg

I had been on the pill prior to my second cycle which may have primed my ovaries' response to stims, but blunted the endometrial response to the circulating levels of oestrogen

No idea!!

[loopylou1984]

I was the opposite too. My first fresh cycle my lining was 7.2 (quite good for me) and I had 18 eggs, this time around we only got 9 eggs and my lining reached the magic 8mm.

So far I am pregnant.

I didn't have any extra drugs, so I'm not sure what caused the increase - I know it's not thick by any stretch of the imagination but compared to my FET 6mm rounds I was pleased.

The only things I did differently were:

Accupuncture
Hot water bottle strapped to my stomach up until ET
Femoral artery massage (I know )

[Sunflower13]

Thanks everyone, really good to read your comments and know that I am not alone in this. Good luck to all of you and keep us updated.

Bananafish - I think I will try a natural cycle, I'm not expecting it to be good but might give us a better idea of what I need. I am also going to push for a hysteroscopy. I got pregnant naturally 2 1/2 years ago but had a miscarriage and an ERPC. I'm worried if maybe that damaged the lining.

You've all given me lots of food for thought, feeling like there's a bit of hope after all. Thanks everyone. Xx

[GlummyMummy]

well, embryologist been in touch and disappointed to report that only 5 out of the 13 eggs fertilised. Said most of my eggs were immature. Not sure if it's been the wrong protocol for me or whether I would have benefited from longer on stims. Think my quality was better with a lower number of eggs (1st go I had 100% fertilisation rate, 2nd go was 60%)

[bananafish81]

Big hugs Glummy, must have been a real blow. I know it's quality not quantity etc but hard not to compare quantities across cycles, I know!

What stims protocol were you on this time? Was it different to previous cycles?

Everything crossed these are little fighters xx

[GlummyMummy]

Thanks Banana. This was the long protocol, same as first successful attempt, but with higher drugs. Don't think either protocol is really suited to me! Last time eggs were over mature, this time immature! Can't seem to get it just right!

[mouldycheesefan]

I had poor uterine blood flow but didn't find out till cycle 4 of icsi. Lining fine. Had treatment plus immunological treatment (not bloods) and finally icsi worked in that cycle and I had twins.
Previous cycles:
1-chemical pg
2- no embryos to implant , poor quality eggs(big shock)
3-negative
4-immunological, changed clinics threw everything at it, twins.
Good luck to you all

[bananafish81]

Ah how frustrating Glummy!

I've no experience of long, only short. Ironically (as I think you know) my ovaries had some kind of ridiculous turnaround so I've been both a low and high AMH-er (AMH 1.5 when I did my first two cycles in Sept and Jan, then AMH of 62.2 when I did my third cycle in May) and did short protocol for all three.

Although the first two cycles started on high stims and the third on low stims, all three cycles were step down. So dose was started higher and dropped down to avoid stimming too quickly. Towards the end the stims were much much lower, to give the little uns time to catch up, without sacrificing the leading follicles

[GlummyMummy]

Bananafish - wow, can't believe your AMH went up so dramatically! You should write a book about your experience! Like the idea of starting a cycle on high stims and then reducing as I think I've either had overmature eggs or immature so this could be avoided.

Had embryo transfer today with a lining of 8.6mm....way less than first IVF attempt and even less than last time in my failed cycle. So not holding out much hope at all for this time. I had a bleed 5 days past embryo transfer last time so I'm bracing myself for the same again. So frustrating as again my embryo was top quality - seems like such a waste! At least we have one to freeze though this time

[bananafish81]

8.6mm is brilliant!! Congrats on being PUPO! I got pregnant with 8.5, so it was definitely enough to implant!

There's nothing to say this embryo won't implant either

Are you on extra progesterone given the bleed last time?

[bananafish81]

Update from my lining saga

So I had the Neupogen wash on Tuesday scan 48h later showed my lining was looking better . Not massively thicker but Dr said the appearance was better, and the outline was regular. We did another wash and I'm going back on Weds for a scan to see how it's looking (we triggered on Tues so it should have compacted under the influence of progesterone)

The key deciding factor in next steps is whether I have a proper bleed or not. If I do actually menstruate, with 2 days of actual red flow (big issue is that I don't seem to shed the lining properly) then we could go straight into starting sstims in 2 weeks time. The plan is to do a whole fresh cycle in order to try and grow my lining, to put back a PGS tested frostie (and donate the eggs to medical research)

That's absolute best case.  

I suspect I won't get a proper period - in which case the far more likely option is that we would be looking at another hysteroscopy, probably early September. 

Then 1-2 months of a copper coil + progynova / patches

If we can get me bleeding then we would then do a stims cycle. 

So if we could actually then get my lining to thicken up, we'd be looking at transfer some time around Nov / Dec. 

If after the coil we still can't get me to bleed, then we're into desperate measures like Tamoxifen to try and grow the lining before we can try stimming me. 

Depressing to think my due date was early October.

[GlummyMummy]

thanks Banana, and pleased to hear your wash thing might have done something. No, I've not been offered anything extra, just one Crinone pessary a day as before. They said they didn't really offer anything extra if it wasn't a frozen cycle....pretty useless I know! Was half tempted to take two pessaries a day then say I lost some and could I get some more!

[bananafish81]

Even after bleeding early?! A friend who bled early on her fresh cycle was given Gestone for her next cycle, am shocked they wouldn't even up your Crinone. What did they say about bleeding early last time? I would deffo bung some extra up there!

I didn't bleed early or have any progesterone absorption issues, as my progesterone levels were great when they were tested when I was pregnant. However the plan would still be for me to take both Cyclogest and injectable progesterone (Lubion rather than Gestone, as it's more patient friendly!) - Dr said Cyclogest am and Lubion pm. Point being that would suggest there isn't any issue with taking too much progesterone - as if we're just giving me extra as a belt and braces measure for an empirical immunes protocol, I'm sure an extra Crinone won't do any harm....