2Ballz:


Go and do it again, and this time with endometrial biopsy to confirm this endometrial atypical or hyperplasia.

Ok Dr. Thanks and good morning

2Ballz:


Depends on the one that gave the letrozole for the endometrial hyperplasia.

When was the last time you had a check on your endometrium, or rather pelvic ultrasonography?

I did TVS, about 3 months ago. I had 20mm endometrial lining thickeness caused by clomid, but I haven't gone for another check up, since then

[quote author=2Ballz post=67589507]

Letrozole is a good trial for endometrial hyperplasia,and by swerve consistent in helping infertility. There is a possibility of either having a low Estradiol after use,or just more.[/quote


Thanks for the response Dr. I think the endrometrial hyperplasia is caused by too much estrogen and low progesterone (hormonal imbalance). Although I ovulate regularly. For how long does one take the letrozole?

Good day Dr. Please, can letrozole (femara) be used to treat endometrial hyperplasia if trying to conceive? How effective is the treatment and is there any side effects? Thanks.

missyblissy:


Wow!!!! Good news.. I pray that the castor oil therapy removes this seedling of fibriod I saw recently. And AF wey suppose show today never show. Ok ooo make. The seedling follow. The AF come out abeg

Please wait for your period to start before doing the castor oil therapy, it might be bfp.
When it shows eventually, then use the castor oil therapy consistently, It might work for it.

LuckyG1:


Tailored to your quest,you may require some medications that could be of help to shed the endometrium. This may prove helpful. But in such stances I will require a recently done profiling and a Hysterosalpingogram of the uterus( hysteroscopy is okay too).

Thanks Dr, the evacuation was done about two years ago, and my period has been normal afterwards, everything else seems to be ok except the thickened endometrial lining. It was even thicker than usual when I used clomid.
I did sonohsg about three months ago, and repeated hsg a month later for confirmation. Is that recent enough and ok by you? I was told everything was fine but tvs revealed a 20mm endometrial lining thickeness.

LuckyG1:


Having seen a fibrous tissue on the endometrium does not really mean,uterine adhesion. A certain threshold is allowed before or growth pattern seen to presume it as such. Another assumption for the above occurrence could have been that the fibrous layer hasn't gone down deep into the functional aspect of your uterine lining. So it can be eroded...

Thanks a lot Dr, have done hormonal profile and everything seems to be fine, though the progesterone is a bit low, and the prolactin slightly higher than the normal range. I see my period regularly and also ovulate monthly. But having difficulty to conceive since I had an evacuation after a miscarriage. That's why am concerned about uterine synichiae, since everything else is fine except the thickened endometrial lining.

LuckyG1:


Another name for this condition is Uterine fibrosis.

Thanks Dr, is hsg and sonohsg realistic enough to diagnose uterine synichiae? Before I went for Hsg, I did tvs and the scan indicated 'fibrous deposits in the anterior wall of the uterine cavity'. So I did castor oil massage and used serrapeptase and clean point tampons. During the next period some tissue like substance fell off. So I later went for Hsg and sonohsg and nothing else was found. The cervical and uterine cavity were declared normal, but I have a thickened endometrial lining. That is why I'm concerned.

LuckyG1:


Seriously I respect your experience though I really may not know your course of duty in life. You have shown no difference in any of us learned in clinic matters. I shouldn't pretend to say you have done most of our jobs and especially in the way simple enough to explain issues that matters.

If I beg to defer hnot on the above, I would sincerely make it a bit unserious that Uterine adhesion necessarily doesn't mean that interior of the womb is adhering. No! It means the functional or parenchymal aspect of the womb is getting composite of fibrous tissues resulting from too much scraping of this layer. The tissue may appear simply as a scar. Just like a sore getting healed. The reason itself for a low menstrual fluid turn is not farfetched. Firstly,the scar tissues are non-endometrial and if so, don't expect them to participate in uterine shedding. Scars normally may not need perfusion as much as normal functioning tissues. This is like not encouraging shedding of the uterine lining. Also,scar also encourages thickening of the endometrial plate too.

As you know, whatever has the ability to outwaged a normal menstrual cycle can as well cause infertility too,lastly.

Please, can you explain a bit further about uterine synichiae and how it causes thickening of the endrometrial plate. Is it the same as thickened endometrial lining? I thought anyone with uterine synichiae use to have thin endometrial lining... and is fibrous deposits the same as uterine synichiae?

LuckyG1:


Making another SFA to confirm this analysis.

Use sensitivity to treat the scanty e.coli activity having not become infectious for the now.

An infectious seminal vesicles or right from the testis as with E. coli can cause inflammation of the of tubules and tubes collating sperm cells before maturity. This can affect infertility in someway and the unnecessary discomfort that comes too.

Long residing bacterial activities could affect seminal fluid pH and color.A case where there is a leak of seminal fluid into the urine,this may cause cloudiness of the urine,and malodorous at short time standing. This is an indication of infection somewhere.

SFA is good,everything in life deserves improvement...

Thanks a million doc, God bless you abundantly.

LuckyG1:


Colour: As expected. Shows no bacteria activity.

Volume: falls within a normal range. Thus,no blocked seminal fluid was implicated.

Smell: Abnormal but could have been long time stayed for liquefaction. If not colour could have had some indication to it. Hence,it is normal.

Liquefaction: Since it within a 60-min range,it is okay.

Motility: Encouraging.

Morphology: Encouraging. With more increase in count, I think morphology may increase.

Sperm count: It is okay. But shouldn't fall down anymore.


A confirmatory screening is advised...

Thanks doc and God bless. Please what is a confirmatory screening and how do we go about it. The urine culture and analysis showed moderate growth of e. coli. Does the infection in the urine have any effect on the sfa. Is the sfa good enough or can it be improved?
Thanks once again

Hello joyful mothers of children,am new here, been ttc for almost two years now , however all my test came out fine, except for blocked tubes which have been flushed about three months ago and are open now, but up till now no bfp. Here is my husband sfa. Is the result okay or is there anything we can do to improve. Please would appreciate your comments and contributions.
Colour: grey-white
Volume : 2.0ml
Smell: musty
Viscosity : normal
Liquefaction: complete within 30 minutes
Motility: linear progressive 65%(high active :35%, active 30%, sluggish 35%.
Alive : 70%
Dead : 30%
Morphology :
Normal shape: 60%
Abnormal shape:
Double head: 15%
Double tail: 15%
Total count: 17.8 million /ml(normal range 20million/ml)
Pus cells : 8-10/hpf
Epithelia cells : +
Red blood cells : nil
Others : nil
Culture : no bacterial growth after 24 hrs of incubation at 37oc.
Thanks all and may God favour all of us this year in Jesus mighty name amen. Baby dust to all.

Hello Dr, kindly help me analyse my husband sfa, want to know if it's okay or anything we can do to improve on it. We are ttc, however all my test came out fine, except for blocked tubes which have been flushed about three months ago and are open now.
Colour: grey-white
Volume : 2.0ml
Smell: musty
Viscosity : normal
Liquefaction: complete within 30 minutes

Motility: linear progressive 65%(high active :35%, active 30%, sluggish 35%.
Alive : 70%
Dead : 30%

Morphology :
Normal shape: 60%
Abnormal shape:
Double head: 15%
Double tail: 15%

Total count: 17.8 million /ml(normal range 20million/ml)

Pus cells : 8-10/hpf
Epithelia cells : +
Red blood cells : nil
Others : nil
Culture : no bacterial growth after 24 hrs of incubation at 37oc.

Thanks and God bless.

KING of glory... The ocean divider, thank you for everything... Holy is Your name. I exalt You today and forever in JESUS mighty name amen

LuckyG1:


overlook my spelling errs and my sentences flaw...it ain't easy to keep up with women sometimes...

Thanks for taking out time to explain. The explanation is clearly stated and well detailed.
Thanks again, GOD bless.

LuckyG1:


Clomid is not meant for adult female finding it difficult to ovulate. If you're ovulating without any support then you're are not supposed to use clomid at all.

Clomid normally works to stimulate the anterior pituitary to secret into plasma gonadal stimulating hormones that helps in finally ushering ovulation. However, there are supportive texts that insinuating profoundly that this drug could drag binding with site estrogen receptor sites like the normal estrogen should. This means,at the level of consumption as use by you an increase proliferation could cause a spectacular thickening of the endomentrium.

Having this thickening may not stand a big problem since it has no progesteronic activities and so,one should be expecting that after this thickening, after the progesteronic phase leading to bleeding, thinning of the endometrium will set in. The objective of usage then should be satisfied if not, a halt to use should be exercise.

At least Clomid should be used at most 4cycles,if a bfn comes all along,then a continuance of this medication should be discussed with doctor. He may decide to put a period again when you should start the Clomid medication again,or better still add some supplement to help synergize the most required out of this medication.

Size of follicle okay.


Provided that the flushed tube is structurally okay and proper management was done after the flushing exercise. Then,it is alright to prove it worth.


Hope this helps?

Thanks a lot Dr for the detailed explanation... GOD bless you abundantly.

LuckyG1:


Tell me how were you told to start using it and dose(s) to take and day(s) interval asked to.

Just see me in private(charges applicable)

I took two tablets of 50mg daily for five days, from cd 2-6 of my cycle every morning, making a total of 10 tablets altogether.

LuckyG1:


When were you told to start using your clomifene citrate medication your cycle concern?

Day 2-6 of my cycle.

Good day Dr, I had bilateral tubal blockage and the tubes were flushed, the doctor declared them free and patent. Few months later I went for Hsg to confirm and I got the same result...'free spill was noted, both tubes are patent, the uterine cavity and cervical canal appear normal in calibre, shape, size and outline'. I ovulate normally but the doctor prescribed 100mg of clomid for me to aid conception, however when I went for transvaginal scan the clomid did the opposite, I had only one follicle about 22 by 20mm and thickened my endometrial lining to 21mm on cycle day 13. I have never had such before, I thought clomid was supposed to make it thinner and produce more follicles since I ovulate on my own in order to increase the chances of fertilization and conception The sonographer said something about it being overly thick. So I don't know if I can continue with the clomid as I had bfn that cycle. And how efficient are fallopian tubes that were blocked before and flushed opened? should I be concerned about them functioning properly? Is the bfn a result of the lining? and is the size of the follicle normal? Thanks a lot.