Lueal Phase Defect

[shishka]

Hello. We have been TTC for 3 years.I had ovarian Cyst removed in 2003 and doctor found some endometriosis and cleared it. We did 3 IUIs before we did 2 IVF no succes. We changed our RE and he started me on clomid the first month for clomid challenge test. My FSH came back 9.2 on both day 3 and day 10. I am 30 years old, so he said this was little on the high side. DH did SA and morphology is only 4% normal. RE put me on Femara this month and did IUI again, unfortunately did not get pregnant. I started having cramps on 6 DPIUI and spotting. My period came early. I usually have 28 day cycles and I always thought I ovulated on day 14. This past two month U/S confirmed that I ovulated later than I thought. Example: LMP was 2/11,took Femara day 5-9, HCG shot- 2/26, IUI-2/27, Period started 3/09. Do you think I may have LPD? What are my chances of getting pregnant with my history. Thank you.

[shishka]

Thank you very much. You gave me lots of hope. They did not use ICSI. At the time of IVF my husbands SA came back as 1% normal morphology and they never discussed ICSI with us. First time they were able to get 6 eggs and four was fertilized. 8A, 8B, 7A, 7B. 2 was transfered. Second time 4 out of 6 was fertilized, 2 was transfered. My RE is puting me on injectables this cycle to do IUI. I will try it for maybe 2 cycles and will go for IVF.

Thank you again.
Ruhiyya

[Forum-M.D.-SP]

I do not think you have LPD. Regardless, one of the treatments for LPD is clomid, or letrozole. In my experience, letrozole (femara) often results in later than expected ovulation - not a bad thing but a characteristic of the medication. Concerning the 4% morphology, a better test of your partner's sperm's ability to fertilize your eggs is your IVF history. Were there any problems with fertilization? Was ICSI used? If you did not have ICSI, and fertilization during IVF was good, then I would not worry about the 4% morphology.  Generally, after a total of three failed cycles of clomid-IUI you and your REI might want to think about either injections with IUI, or IVF again. My vote would be for IVF, assuming that you had good egg yield and good fertilization your first two tries. Remember in nature the chances of getting pregnant every month are at best less than 30% - you just may not have given IVF enough of a chance.

[shishka]

Sorry I mean Luteal Phase