Endometrial Function Tests
1 Replies
RICHMONDTB - August 17

Dear Dr. Jacobs
I am currently being evaluated and trying to correct Ashermans syndrome in my uterus. I developed AS after a myomectomy, during the hospital stay, an infection sat in the uterus. 2 months after the myo-I had an abnormal HSG. there were filing defects noted in my medical file. However an evaluative Hysteroscopy was not performed to make further diagnosis of this condition.
After this, we had more(2) uterine fibroid surgeries, with a d&C at the end of each surgery. Just recently we have had a hysteroscopy with microscissors, and hsg. Per this most recent HSG---there is no indication, the uterine cavavity rescarred or formed new bands of scar tissue that goes across the cavavity.


However we are not sure if the scar tissue is still in the endrometrial lining. Next steps include undergoing a mock cycle to determine how my uterus responds to estrogen/progesterone medications, blood work and also an endrometrial biopsy at the end of the mock cycle.

I have had the AS at the beginning of our IVF attempts. We did get pregnant with the AS, however we did miscarry. As was a component for the miscarriage as well as immune issues, and small intramural fibroids.

My question is what is your opinion on th endometrial function test, about the molecular markers to assess the endometrium potential to support implantation after an embryo transfer?

Would this be a reasonable evaluative tool to use evaluate the receptivity of the endrometrium.
I appreciate your insights.

We have 12 donor egg Frozen embryos and 8 of those are highly fragmented and probably will not make the thaw, due to the high fragmentation.Donor hyperstimulated due to # of follicles and or eggs(33 at the start of the cycle) we were not informed of the high number of follicles and the donor was coasted but it was not enough, and the eggs were poor quality due to poor development in the follicular stage of the egg.

the other 4 embryos are in one straw and all will have to thawed at Once, so we would like to thaw them and optimize our chances for conception. Those embryos are frozen at day 1 and good quality embryos, based on the freeze.

This is our last chance for a transfer with the FET as financially we have no other resources available for a gestational carrier and for one shot deal we do not feel it is reasonable to invest the time, money or finances in one shot.
thanking you in advance for your insights and thoughts.
Brenda

 

B. Jacobs, M. D. - August 17

There are a number of publications in the professional literature wit data indicating that the endometrium has to be GREATER than 7 mm thick to support a pregnancy. The test I perform, in an effort to determine endometrial "recptivity", is a test for the alpha 5 beta 3 integrin.
Good luck.

 

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