The questions was: is it necessary to take progesterone if you are doing clomid or FSH injections with iui?   The answer is that you may not need progesterone for these cycles because the ovary can do a great job of producing high levels of progesterone. The corpus luteum is not disturbed by an IVF needle. Also, we usually do not give lupron or antagon or cetritide for an IUI cycle. Personally, I usually do not give progesterone for IUI, but I will in some select cases. Some doctors give progesterone because of the high estrogen levels produced by the fertility drugs. They feel that if the estrogen is high, the progesterone needs to be high too. This is a theoretical concept and has not been shown to be valid for women on fertility drugs. Certainly if the period is coming early after the iui, progesterone should be considered.

 

HA stands for Hypothalamic Amenorrhea, which is when there are no periods due to extreme exercise, stress, etc, despite a good number of resting follicles and a low FSH.  It’s the hypothalamus that sends signals to the pituitary to make FSH and LH. If the hypothalamus doesn’t send the signal (GnRH), the pituitary does not make the FSH and LH. It’s the brain’s way of preventing pregnancy if the body is too stressed. 

 

Moving from Clomid Straight to IVF for PCOS. FSH iui in women with PCO can be done safely, without the production of too many follicles, providing the starting dose of the FSH is low enough.  Even in such cases careful frequent monitoring and occasional cancellation, is necessary. Talk to your doctor about this. Again, the starting dose needs to be very low. In general, 3 cycles of Clomid are attempted before going to the next steps, however there is an exception in women with PCOS. If you are not getting regular cycles off Clomid, and Clomid straightens things out, more attempts, around 6, may be ok. 

 

Abnormal Sperm Morphology Causing Miscarriages: I have not seen this connection, and I have seen tons of men with low morphology. Now maybe you are one of the couples where there is a connection, but you will need to discus this more with your doctor or a second opinion.

 

An 8 mm uterine lining is not thin, it’s fine.

 

An antral follicle count of 11 is fine, you don’t need more. “Normal” FSH can mean many things. In other words there is a big difference between 6.8 and 11.2, and both are in the normal range.   If it’s on the lower end, you will be ok. If you are on the higher end, you may also be ok. You may produce fewer follicles that another woman with more resting follicles, but it sounds like there are enough.

 

Thanks for reading and please see disclaimer 5/17/06. Dr. Licciardi