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Have Pcos. Trying To Conceive. Prescribed Duphaston After IUI. Should I Take Medicine To Reduce Prolactin Level?
Question: Trying to get pregnant for 2 years, currant age 27, Height 153 CM and weight 63 kgs. PCOS since age of 18, irregular periods, laparoscopic Polycyctic ovarian drilling done on 4th Feb 2013
Laparoscopic findings- Uterus size and shape is normal, bilateral tubes normal, bilateral ovaries enlarged and polycyctic.
other test results
FSH -5.70 mIU/ML
LH - 5:50 mIU/ML
PROLACTIN -21.40 NG/ML
T3 101 NG/DL
T4 8.40 UG/DL
TSH 1.2 uIU.ml
Did not ovulate after ovarian drilling
Took Regestrone 5 mg , tab Bromocriptine 1.25 mg for 20 days,
Myotol F 2 tablets daily
Got periods on 19:3:2013
Took Tab clomipine 150 mg - 1 tab 5 days, Tb Progynova 2 mg - day 7 to 17, Injection inducent day 5, 7, 9,
15th day of periods, 19mm egg on left ovary ruptured after HCG short - IUI performed 5 hours later. Endometrical thickness 7.5mm
MY question is
1.) is the treatment right? Is there anything lacking in my treatment.
2') After IUI Doctor has prescribed duphaston 10 mg - 2 times a day, folic acid 5 mg daily, she had asked me to stop Myotol F. Should Myotol F be stopped or should I continue it and until when?
3.) Is my PROLACTIN level hight - test shows 21.40 NG/ML , should i be Taking broom tablet to lower prolactin levels.
4) Are my thyroid reports normal.
My husbands sperm count is 9 million and motility rate is 80%.
What are my chances of conceiving, is there any other steps I can take so that this IUI is successful?
Kindly guide me in details.
Thank you
Laparoscopic findings- Uterus size and shape is normal, bilateral tubes normal, bilateral ovaries enlarged and polycyctic.
other test results
FSH -5.70 mIU/ML
LH - 5:50 mIU/ML
PROLACTIN -21.40 NG/ML
T3 101 NG/DL
T4 8.40 UG/DL
TSH 1.2 uIU.ml
Did not ovulate after ovarian drilling
Took Regestrone 5 mg , tab Bromocriptine 1.25 mg for 20 days,
Myotol F 2 tablets daily
Got periods on 19:3:2013
Took Tab clomipine 150 mg - 1 tab 5 days, Tb Progynova 2 mg - day 7 to 17, Injection inducent day 5, 7, 9,
15th day of periods, 19mm egg on left ovary ruptured after HCG short - IUI performed 5 hours later. Endometrical thickness 7.5mm
MY question is
1.) is the treatment right? Is there anything lacking in my treatment.
2') After IUI Doctor has prescribed duphaston 10 mg - 2 times a day, folic acid 5 mg daily, she had asked me to stop Myotol F. Should Myotol F be stopped or should I continue it and until when?
3.) Is my PROLACTIN level hight - test shows 21.40 NG/ML , should i be Taking broom tablet to lower prolactin levels.
4) Are my thyroid reports normal.
My husbands sperm count is 9 million and motility rate is 80%.
What are my chances of conceiving, is there any other steps I can take so that this IUI is successful?
Kindly guide me in details.
Thank you
Hi,
Thanks for your query.
I read your query and understand your concerns.
Following is my reply:
1) Your treatment is going on well except for few things. Progynova should be started when follicular diameter is more than 10 mm. IUI should have been performed atleast between 24 to 36 hours of injection hCG and not after 5 hours as in your case. I am not sure why it was performed earlier
2) Myotol F can be stopped. No need of that tablet.
3) Prolactin levels are normal. No need to take bromocriptine. You can stop the same.
4) Thyroid reports are good. You dont need treament.
5) Husband's semen analysis shows oligospermia. normal sperm count should be atleast more than 15 million per ml.
6) Your chances of conception with IUI are low as your husband's semen has oligospermia. Chances of successful IUI increase with normal sperm count.
7) If you dont succeed with IUI, I recommend you going ahead with ICSI ( Intracytoplasmic Sperm Injection) treatment which is next step in ART ( Advanced Reproductive Technology).
I hope I answered your query. I will be available for any follow up query you have.
Regards,
Dr. Mahesh Koregol
IVF & Infertility Specialist
Thanks for your query.
I read your query and understand your concerns.
Following is my reply:
1) Your treatment is going on well except for few things. Progynova should be started when follicular diameter is more than 10 mm. IUI should have been performed atleast between 24 to 36 hours of injection hCG and not after 5 hours as in your case. I am not sure why it was performed earlier
2) Myotol F can be stopped. No need of that tablet.
3) Prolactin levels are normal. No need to take bromocriptine. You can stop the same.
4) Thyroid reports are good. You dont need treament.
5) Husband's semen analysis shows oligospermia. normal sperm count should be atleast more than 15 million per ml.
6) Your chances of conception with IUI are low as your husband's semen has oligospermia. Chances of successful IUI increase with normal sperm count.
7) If you dont succeed with IUI, I recommend you going ahead with ICSI ( Intracytoplasmic Sperm Injection) treatment which is next step in ART ( Advanced Reproductive Technology).
I hope I answered your query. I will be available for any follow up query you have.
Regards,
Dr. Mahesh Koregol
IVF & Infertility Specialist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. XXXXXXX
Below is the latest semen analysis report of my husband. I am sorry I had given you the wrong number.
Actively Motile: 60%
Suggishly Motile: 30%
Non Motile: 10%
RBC'S: NIL
WBC'S: NIL
Epithelial Cells: Nil
Total Sperm Count: 96 million/cumm
Secondly, I was given the hcg short at 6 pm on 1st April, at 2 pm on 2nd April the snography showed that the egg had ruptured. At around 5 pm the IUI was performed. So basically 23 hours after the hcg short.
I have a few more questions.
1.) My current Doc also pointed out that LH/FSH ratio is not good. Is it right?
2.) If my husbands sperm count is right and in case the IUI is unsuccessful what should be the next step?
3.) Is there anyway I can bring hormonal balance and regulate my periods and conceive naturally?
4') Could you tell me what really is the cause of PCOS and non ovulation in my case?
5.) Are they any other tests I should undergo to find out the cause?
6.)Can I go for brisk walks for 45 mins after an IUI?
7.) Are they any other medications I should take since I have PCOS OR steps I should take to better the chances of a successful IUI this time.
8.) My Doc has given me duphaston 10 mg, one morning one night. She says this will help with conceiving after the IUI. Is the dosage right, is the tablet right?
I am working towards losing weight, have come down from 70 kgs to 63. have stopped processes foods, eat only natural food.
Thank you very much!
Regards,
Below is the latest semen analysis report of my husband. I am sorry I had given you the wrong number.
Actively Motile: 60%
Suggishly Motile: 30%
Non Motile: 10%
RBC'S: NIL
WBC'S: NIL
Epithelial Cells: Nil
Total Sperm Count: 96 million/cumm
Secondly, I was given the hcg short at 6 pm on 1st April, at 2 pm on 2nd April the snography showed that the egg had ruptured. At around 5 pm the IUI was performed. So basically 23 hours after the hcg short.
I have a few more questions.
1.) My current Doc also pointed out that LH/FSH ratio is not good. Is it right?
2.) If my husbands sperm count is right and in case the IUI is unsuccessful what should be the next step?
3.) Is there anyway I can bring hormonal balance and regulate my periods and conceive naturally?
4') Could you tell me what really is the cause of PCOS and non ovulation in my case?
5.) Are they any other tests I should undergo to find out the cause?
6.)Can I go for brisk walks for 45 mins after an IUI?
7.) Are they any other medications I should take since I have PCOS OR steps I should take to better the chances of a successful IUI this time.
8.) My Doc has given me duphaston 10 mg, one morning one night. She says this will help with conceiving after the IUI. Is the dosage right, is the tablet right?
I am working towards losing weight, have come down from 70 kgs to 63. have stopped processes foods, eat only natural food.
Thank you very much!
Regards,
Hi,
Your new accurate information makes things easier.
1) Your husband's semen analysis is good. dont worry.
2) Your IUI was done after one day of injection hCG. Hence it is good enough. Not after 5 hours as you stated previously. So yur doctor has done right job.
3) Your LH : FSH ratio is more in favor of poly cystic ovary ( PCO ). But your ovulation and other parameters appear good. Hence ratio does not matter in your case since you had a good follicle and ovulated with hCG.
4) If IUI is unsuccessful, I suggest you undergo some more cycles ( about 4 to 6 totally) of IUI. If you still fail to conceive, IVF ( test tube baby) will be next step.
5) The cause of PCO can be never known. Probably it will be genetic with someone in your family tree having it.
6) You XXXXXXX need to go in depth testing for cause of PCO. There is no use. Think only how to deal with it.
7) You can do serial follicular monitoring and take inj. hCG when atleast one follicle is 18 mm or more. You can either have intercourse or IUI following that.
8) You can start your brisk walking about 3 days after IUI.
9) Duphaston is a good progesterone support. Your doctor is right.
Continue with your weight loss programme. It will definitely help you more than any medicine.
I think I clarified your doubts. Get back to me if you have more queries.
Regards,
Dr. Mahesh Koregol
IVF & Infertility Specialist
4)
Your new accurate information makes things easier.
1) Your husband's semen analysis is good. dont worry.
2) Your IUI was done after one day of injection hCG. Hence it is good enough. Not after 5 hours as you stated previously. So yur doctor has done right job.
3) Your LH : FSH ratio is more in favor of poly cystic ovary ( PCO ). But your ovulation and other parameters appear good. Hence ratio does not matter in your case since you had a good follicle and ovulated with hCG.
4) If IUI is unsuccessful, I suggest you undergo some more cycles ( about 4 to 6 totally) of IUI. If you still fail to conceive, IVF ( test tube baby) will be next step.
5) The cause of PCO can be never known. Probably it will be genetic with someone in your family tree having it.
6) You XXXXXXX need to go in depth testing for cause of PCO. There is no use. Think only how to deal with it.
7) You can do serial follicular monitoring and take inj. hCG when atleast one follicle is 18 mm or more. You can either have intercourse or IUI following that.
8) You can start your brisk walking about 3 days after IUI.
9) Duphaston is a good progesterone support. Your doctor is right.
Continue with your weight loss programme. It will definitely help you more than any medicine.
I think I clarified your doubts. Get back to me if you have more queries.
Regards,
Dr. Mahesh Koregol
IVF & Infertility Specialist
4)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Thank you very much! You have cleared all my doubts.
I have just one more question.
After IUI, should one abstain from intercourse. 2 days after my IUI I had an intercourse with my husband. Will this pose a threat to conceiving.
Regards,
Thank you very much! You have cleared all my doubts.
I have just one more question.
After IUI, should one abstain from intercourse. 2 days after my IUI I had an intercourse with my husband. Will this pose a threat to conceiving.
Regards,
Hi XXXXXXX It is advisable to have intercourse for 2 to 3 days after IUI as natural chances of pregnancy add up along with IUI. Hence there is no problem of having intercourse. Infact its good. I am glad that you are clear of your doubts.Feel free to contact or call up through healthcare magic when ever you wish. Kindly accept my answer if you think my answers were of help to you and write a review. Regards, Dr. Mahesh Koregol. IVF & Infertility Specialist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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