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Can I Conceive With Bicornuate Uterus While Taking Ovofer?

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Posted on Wed, 22 Jan 2014
Question: Hello: I am 27 year old from India, I am married since 2009 November and started family planning form 2011-2012, but so far could not conceive. Recently, we started medical consultation and were referred for the following tests for me and my husband: FSH: 0.56 LH: 2.31 Semen: Sperm Count 210 million/ml TVS: Normal bladder, Uterus shows normal test, right ovary measures 27X16 and left measures 26x15. Uterus size 63*28*20 mm HSG: Bilateral patent fallopian tubes but Bicornuate Uterus. I was advised to take ovofer 100 mg which I am taking from third to seventh day of the cycle also. Also, I have started with the follicular tests today. Please suggest that can I conceive with Bicornuate uterus or not, as my doctor says that it is a big problem and I am worried about the same.
doctor
Answered by Dr. Aarti Abraham (51 minutes later)
Brief Answer: DETAILED BELOW Detailed Answer: Hello XXXXXXX Thanks for writing to us with your health concern. Firstly, HSG is not confirmatory to diagnose bicornuate uterus. I have gone through the HSG film, and there is definitely an abnormality in the shape of the uterus. Bicornuate uterus means that the uterus is divided into two separate cavities, and a septate uterus means there is a fibrous septum or partition between the uterus, essentially a partition in one cavity. HSG cannot differentiate between these two. The diagnosis is only possible by hysteroscopy combined with laparoscopy. However, both septate and bicornuate uterus have no association with fertility. Conception is not an issue, but there is a higher risk of abortions with both these abnormal shapes of the uterus. SO these should not lead to issues in conceiving. Rarely, bicornuate uterus is complete ( didelphys ) and then there could be partition in the vagina too, and that might lead to fertility issues. Basically go for the following steps - 1. Semen analysis is normal, nothing needs to be done. 2. FSH is low, please go for AMH levels to know the ovarian capacity to form mature eggs. ALso have TSH screening. 3. You are already going for one cycle of follicular monitoring with stimulation using Ovofer 100. During that cycle, you would know how well you are ovulating. You can go for 3 - 6 cycles of follicular monitoring with ovarian stimulation. If these cycles fail, then you need to go for a laparoscopy and hysteroscopy to confirm that fallopian tubes are indeed open and to confirm type of uterine abnormality. 4. Take regular folic acid supplements and maintain ideal weight. 5. If 6 cycles of stimulation fail ( you can combine them with IUI intra uterine insemination ) for better results then you can consider IVF next. 6. If laparoscopy reveals a major abnormality in uterine shape, then corrective surgery can be done simultaneously at the same sitting. 7. Meanwhile, have a thorough gynecological check up to ensure that there is no vaginal septum. Do not stress out more, as bicornuate uterus is not an obstacle to conception.More than 90 % of women with a bicornuate uterus achieve a successful pregnancy and delivery. If you conceive, chances of miscarriage / abortion can be minimized by taking measures like a cervical stitch / giving stronger medications to avoid abortions. All the best. Please feel free to ask for further clarifications.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (12 days later)
Hello Madam, Wish you a very Happy New Year. Please be noted that I have had my follicular test done and the follicle got ruptured on the 20th day. We had intercourse on 15th 19th and 20th day and we are waiting if we are lucky this time. I forgot to mention but my TSH test was done and was within normal limits. Also, to mention i had FSH test between my periods third and fifth day, it was 0.56. Once I did it random before this one it was 10.0. LH between periods was 2.31 and afterwards 25 per day. Prolactin 18.9. T3 109, T4 7.9, TSH 2.24. Please suggest if i need to do any other tests also. Also madam for the last one month I am suffering severe cough, cold, and congestion with coughing. I have had some medicines but is not effective, kindly suggest me some medicines as i am fearing taking any other antiallergic or antibiotic keeping in mind the chance of my conceiving this time. Kindly suggest with some in lieu of that. Also, if i get a pregnancy test now that is within a week, so can we know the results of that now? Regards, XXXX
doctor
Answered by Dr. Aarti Abraham (4 hours later)
Brief Answer: DETAILED BELOW Detailed Answer: Hello WIsh you too a very Happy New Year. Right now you do not need to do any other tests. Make sure that basic tests like complete blood count, Blood group, HIV, HBsAg, HCV , Thalessemia screening are done for botn you and your husband. The other reports are fine. Regarding your cough and cold, it is best to avoid antibiotics . You can take antihistaminics like Diominic DA once or twice a day. Gargle with warm saline water. Use Vicks for steam inhalation 5 - 6 times a day. Drink lots of hot chicken broth / vegetable broth with ginger, XXXXXXX and pepper. Take Vitamin C tablets daily for a month. Protect yourself well in the warm weather. Eat fresh home made hot steamed food . You can use Salin nasal drops before going to bed to clear up your nose. Please let me know the date of your last menstrual period, and the date of ovulation ( follicle rupture ) , so that I can tell you when to take a pregnancy test. Even after egg rupture on day 20, you should remain sexually active for the next 4 - 5 days. All the best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (1 hour later)
Dear Madam, Thanks for your valuable reply. Please note that LMP was on 8th and rupture was 27th December 2013. Regards, XXXX
doctor
Answered by Dr. Aarti Abraham (2 hours later)
Brief Answer: TAKE PREGNANCY TEST AFTER 10TH OF JANUARY Detailed Answer: As the ovulation occurred on 27th December , it is too early to take a pregnancy test. If you do not have your period by the 10th of January, then it would be the proper time to take the pregnancy test. WIshing you lots of luck. Please feel free to contact me directly anytime at - WWW.WWWW.WW
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Aarti Abraham (39 hours later)
Hello Madam, I am from Lucknow itself and will be visiting Lucknow in February, i want to consult you personally.. I have worked in Sahara Hospital as well.. Diominic DA is not available here in Kolkata in any of the medicine shops nor the combination is available... Please suggest any other medicine. Regards, XXXX
doctor
Answered by Dr. Aarti Abraham (19 minutes later)
Brief Answer: DETAILED BELOW Detailed Answer: Please do contact me whenever you require a consultation. You can go for Lemolate or ask the pharmacist for an option to the medication.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Aarti Abraham

OBGYN

Practicing since :1998

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Can I Conceive With Bicornuate Uterus While Taking Ovofer?

Brief Answer: DETAILED BELOW Detailed Answer: Hello XXXXXXX Thanks for writing to us with your health concern. Firstly, HSG is not confirmatory to diagnose bicornuate uterus. I have gone through the HSG film, and there is definitely an abnormality in the shape of the uterus. Bicornuate uterus means that the uterus is divided into two separate cavities, and a septate uterus means there is a fibrous septum or partition between the uterus, essentially a partition in one cavity. HSG cannot differentiate between these two. The diagnosis is only possible by hysteroscopy combined with laparoscopy. However, both septate and bicornuate uterus have no association with fertility. Conception is not an issue, but there is a higher risk of abortions with both these abnormal shapes of the uterus. SO these should not lead to issues in conceiving. Rarely, bicornuate uterus is complete ( didelphys ) and then there could be partition in the vagina too, and that might lead to fertility issues. Basically go for the following steps - 1. Semen analysis is normal, nothing needs to be done. 2. FSH is low, please go for AMH levels to know the ovarian capacity to form mature eggs. ALso have TSH screening. 3. You are already going for one cycle of follicular monitoring with stimulation using Ovofer 100. During that cycle, you would know how well you are ovulating. You can go for 3 - 6 cycles of follicular monitoring with ovarian stimulation. If these cycles fail, then you need to go for a laparoscopy and hysteroscopy to confirm that fallopian tubes are indeed open and to confirm type of uterine abnormality. 4. Take regular folic acid supplements and maintain ideal weight. 5. If 6 cycles of stimulation fail ( you can combine them with IUI intra uterine insemination ) for better results then you can consider IVF next. 6. If laparoscopy reveals a major abnormality in uterine shape, then corrective surgery can be done simultaneously at the same sitting. 7. Meanwhile, have a thorough gynecological check up to ensure that there is no vaginal septum. Do not stress out more, as bicornuate uterus is not an obstacle to conception.More than 90 % of women with a bicornuate uterus achieve a successful pregnancy and delivery. If you conceive, chances of miscarriage / abortion can be minimized by taking measures like a cervical stitch / giving stronger medications to avoid abortions. All the best. Please feel free to ask for further clarifications.