Lining stuck after myomectomy

Lining stuck after myomectomy

Joined: December 8th, 2006, 6:35 am

April 6th, 2011, 8:04 pm #1

Hi Gals:

I had a myomectomy in February and we are now doing a mock in preparation for a fresh donor cycle. I was pleased with my lining being at 6.8-7 a week and a half ago, but today, on 6 vivelle patches, I am still stuck at 6.8. If this were a fresh cycle, I'd be in trouble!

I have always had a nice lining, between 11-13, although my last donor cycle we had to add estrogen injections to get there.

I am starting estrace today.

For those of you who have had myomectomies, how long did it take to get your lining on track? Did you continue to have problems? I am switching REs, but this current RE oversaw the myomectomy and is very conservative about estrogen levels -- I am thinking I should just take myself over to the new RE...

Any thoughts?

I admit, I have not been very good about this mock -- not keeping up with vitamins and water, etc. I just was not super worried about it.
Quote
Like
Share

Joined: July 23rd, 2008, 6:49 am

April 6th, 2011, 9:46 pm #2

As you know, I have atypical (flat scar tissue) Asherman's that covered 2/3 of my uterine wall. Of course my lining in the other 1/3 of my uterus was always going to get stuck around 5 to 6mm, despite using Viagra, drinking raspberry tea, doing acupuncture, etc.

I will say though that before the miscarriage that caused the Asherman's, things like Viagra suppositories and acupuncture did help considerably, and I never had a lining less than 9 or 9.5.

Okay, so before my last transfer, when I already knew about the Asherman's and knew the Viagra and acupuncture would not work on me, my RE suggested being on the estradiol for one month. He said that's pretty much the limit (otherwise the endometrium gets old and less hospitable). I have taken estradiol valerate injections and used patches in the past to no avail but this time all we did were the estradiol tablets, given vaginally three times a day. I don't remember the exact dose but I think it was 6 mg daily per vagina. That's a pretty high dose for a non oral administration -- remember that oral doses are always much higher than other routes of administration because the liver chews up most of it before it can get to the uterus. After one month, my lining was up to 8.5! Obviously this was deceiving because it only was measuring the 1/3 of my uterus that HAD endometrium, but the u/s cannot tell you that. Interestingly, I had implantation, the first and only implantation in 4 years of doing multiple DE transfers. It was a good implantation too, with high betas. Unfortunately there was no fetal pole when all was said and done.

So my advice to you would be, yes, drink your water, your raspberry tea, consider acupuncture and definitely consider Viagra, and think about prepping your uterus for 3 weeks instead of the usual 10 days or so.

I had a friend who had a myomectomy and she noticed the exact same thing that you did. Viagra and acupuncture helped her a lot.
Quote
Like
Share

E&H
E&H

April 6th, 2011, 10:05 pm #3

Hi Gals:

I had a myomectomy in February and we are now doing a mock in preparation for a fresh donor cycle. I was pleased with my lining being at 6.8-7 a week and a half ago, but today, on 6 vivelle patches, I am still stuck at 6.8. If this were a fresh cycle, I'd be in trouble!

I have always had a nice lining, between 11-13, although my last donor cycle we had to add estrogen injections to get there.

I am starting estrace today.

For those of you who have had myomectomies, how long did it take to get your lining on track? Did you continue to have problems? I am switching REs, but this current RE oversaw the myomectomy and is very conservative about estrogen levels -- I am thinking I should just take myself over to the new RE...

Any thoughts?

I admit, I have not been very good about this mock -- not keeping up with vitamins and water, etc. I just was not super worried about it.
With lots of top RE's. We have a lady at the moment with very similar issues and her Dr has tried everything. In this symposium it was stated that the new Viagra which is in tablet form does not help the uterus but the old Viagra which was in gel form does. It is also said that what is good for the uterus is not good for the breast so massive doses of estrogen for long periods can be bad for us and we should follow up with mammograms. one of the doctors I work with says that too much estrogen can also cause the lining to look patchy and not healthy. This very renowned RE here says that the important thing when building a lining is uterine receptors, not necessarily the thickness. a lady can have a 6 mm lining with good receptors and get pregnant whereas another can have a 12 mm lining with bad receptors and not get pregnant - this RE also believes as yours does with being conservative with estrogen. I'm hoping you get a good response on your real cycle. will you be doing another mock or going straight on to the fresh cycle?
Quote
Share

Joined: December 8th, 2006, 6:35 am

April 6th, 2011, 10:52 pm #4

As you know, I have atypical (flat scar tissue) Asherman's that covered 2/3 of my uterine wall. Of course my lining in the other 1/3 of my uterus was always going to get stuck around 5 to 6mm, despite using Viagra, drinking raspberry tea, doing acupuncture, etc.

I will say though that before the miscarriage that caused the Asherman's, things like Viagra suppositories and acupuncture did help considerably, and I never had a lining less than 9 or 9.5.

Okay, so before my last transfer, when I already knew about the Asherman's and knew the Viagra and acupuncture would not work on me, my RE suggested being on the estradiol for one month. He said that's pretty much the limit (otherwise the endometrium gets old and less hospitable). I have taken estradiol valerate injections and used patches in the past to no avail but this time all we did were the estradiol tablets, given vaginally three times a day. I don't remember the exact dose but I think it was 6 mg daily per vagina. That's a pretty high dose for a non oral administration -- remember that oral doses are always much higher than other routes of administration because the liver chews up most of it before it can get to the uterus. After one month, my lining was up to 8.5! Obviously this was deceiving because it only was measuring the 1/3 of my uterus that HAD endometrium, but the u/s cannot tell you that. Interestingly, I had implantation, the first and only implantation in 4 years of doing multiple DE transfers. It was a good implantation too, with high betas. Unfortunately there was no fetal pole when all was said and done.

So my advice to you would be, yes, drink your water, your raspberry tea, consider acupuncture and definitely consider Viagra, and think about prepping your uterus for 3 weeks instead of the usual 10 days or so.

I had a friend who had a myomectomy and she noticed the exact same thing that you did. Viagra and acupuncture helped her a lot.
Remember the days of the high fsh boards? I remember thinking, "at least I don't have this and that and the other thing..."

Now I am pushing 44, have some uterine scarring from all these attempts and subsequent losses, and have even lost my ability to create a good lining and have a failed de cycle following all those OE cycles! UGH!

Thanks for the post BBG.
Quote
Like
Share

Joined: December 8th, 2006, 6:35 am

April 6th, 2011, 10:55 pm #5

With lots of top RE's. We have a lady at the moment with very similar issues and her Dr has tried everything. In this symposium it was stated that the new Viagra which is in tablet form does not help the uterus but the old Viagra which was in gel form does. It is also said that what is good for the uterus is not good for the breast so massive doses of estrogen for long periods can be bad for us and we should follow up with mammograms. one of the doctors I work with says that too much estrogen can also cause the lining to look patchy and not healthy. This very renowned RE here says that the important thing when building a lining is uterine receptors, not necessarily the thickness. a lady can have a 6 mm lining with good receptors and get pregnant whereas another can have a 12 mm lining with bad receptors and not get pregnant - this RE also believes as yours does with being conservative with estrogen. I'm hoping you get a good response on your real cycle. will you be doing another mock or going straight on to the fresh cycle?
Thanks so much E&H.

I am doing this mock with my RE who I like but do not plan on cycling with as he is not very open about heparin (I have a positive iGm). However, we went straight from my myomectomy into the mock, so I just went with it and figured when we were done, I would go to the new RE.

But now I think I may take this mock to the new RE. I am awaiting his response.

I hope we do not have to do another mock! UGH!

And yes, I have super lumpy breasts and have been on so much estrogen the last 7 years it is ridiculous...
Quote
Like
Share

Joined: February 6th, 2007, 1:08 am

April 7th, 2011, 2:25 am #6

He says the best lining in a case like yours would be a natural lining - which is more or less impossible when doing a DE cycle. If you are still ovulating you can mimic a natural lining by the use of FSH and LH with a trigger shot on the same day as the donor. If you are having to wait for a donor it may be worth going for a scan on day 13 or 14 of your cycle just to see what your natural lining is like - if it is good maybe your RE might recommend a different protocol. Good luck.
Quote
Like
Share

Joined: June 2nd, 2007, 7:45 am

April 7th, 2011, 5:28 am #7

Hi Gals:

I had a myomectomy in February and we are now doing a mock in preparation for a fresh donor cycle. I was pleased with my lining being at 6.8-7 a week and a half ago, but today, on 6 vivelle patches, I am still stuck at 6.8. If this were a fresh cycle, I'd be in trouble!

I have always had a nice lining, between 11-13, although my last donor cycle we had to add estrogen injections to get there.

I am starting estrace today.

For those of you who have had myomectomies, how long did it take to get your lining on track? Did you continue to have problems? I am switching REs, but this current RE oversaw the myomectomy and is very conservative about estrogen levels -- I am thinking I should just take myself over to the new RE...

Any thoughts?

I admit, I have not been very good about this mock -- not keeping up with vitamins and water, etc. I just was not super worried about it.
what a pain in the proverbial. No advice sorry as this was one of the few things my body did well...
Raspberry leaf tea?
keep us posted honey.
L
[li<a href="" rel="nofollow">http://lilypie.com][img</a> noborder]<img src="http://lmtf.lilypie.com/rdnXp12.png" alt="[linked image]">[/img][/link]
Quote
Like
Share