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PCO and preganancy
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haraf posted:
hi, im 31 year old, married been trying to get pregnant for almost a year now, i was diagnosed with PCO and have underwent D and C for abnormal bleeding. Right now, Im taking up clomid, so far i always have dominant follicle ranging from size 19 to 23 or 26..I was also given duphaston, folic acid and vitamin c..My latest US result was thati have dominant follicle oon my right ovary with the size of 19 on my day 13, but my endometrial stripe is jus about 7.8 and my Ob told me that is somewhat thin...do i have the chance to get pregnant or do i need to work out first my E.stripe..my fallopian tubes are patent also..I need more info with regards to my situation..thanks
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Jane Harrison Hohner, RN, RNP responded:
Dear haraf: My understanding is that an endometrial lining ("stripe") of 7 mm or less at the time of ovulation is linked to a decrease in pregnancies. According to a current OB/GYN textbook (TM Goodwin, p 434), the dominant follicle should be at least 18mm and the stripe at least 7mm before hCG is given. Obviously your own infertility specialist is in the best position to judge your chances for conception this cycle.

Hopefully you will get pregnant. If a too thin endometrial stripe seems to be an obstacle, an additional medication may be suggested. Another source suggested that Clomid exposure can slightly depress endometrial thickness.

Finally, if you are using timed intercourse a lit search at the National Library of Medicine site yielded this reassuring citation:

Acta Obstet Gynecol Scand. 2011 Apr;90(4):344-50. doi: 10.1111/j.1600-0412.2010.01063.x. Epub 2011 Feb 14.
Intrauterine insemination versus timed intercourse with clomiphene citrate in polycystic ovary syndrome: a randomized controlled trial.
Abu Hashim H, Ombar O, Abd Elaal I.
Source

Department of Obstetrics & Gynecology Department of Diagnostic Radiology Department of Clinical Pathology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt. hatem_ah@hotmail.com
Abstract
OBJECTIVE:

To compare the efficacy of intrauterine insemination vs. timed intercourse with clomiphene citrate as a first-line treatment for anovulatory infertility associated with polycystic ovary syndrome.
DESIGN:

A randomized controlled trial following the CONSORT criteria.
SETTING:

A university hospital and a private practice setting.
PATIENTS:

188 women (525 cycles) with polycystic ovary syndrome.
MAIN OUTCOME MEASURES:

Women received three consecutive cycles of ovulation induction with clomiphene citrate and intrauterine insemination (n=93, 259 cycles) or three consecutive cycles of clomiphene citrate with timed intercourse (n=95, 266 cycles).
OUTCOME MEASURES:

Clinical pregnancy rate per cycle, number of growing and mature follicles, serum estradiol, endometrial thickness at the hCG day, serum progesterone, ovulation, miscarriage and live birth rates.
RESULTS:

There were no differences between the two groups regarding the clinical pregnancy rate per cycle or per woman (8.49 vs. 7.89% and 23.6 vs. 22.1%; p=0.26 and p=0.33, respectively). Two twin pregnancies occurred in each group. Miscarriage and live birth rates were comparable (18.1 vs. 19% and 19.35 vs. 17.89%; p=0.31 and p=0.33, respectively). No ectopic, higher-order pregnancies or cases of ovarian hyperstimulation syndrome occurred. No differences were found regarding the number of follicles, serum progesterone, ovulation rates, estradiol levels or endometrial thickness at the hCG day (7.7?0.4 vs. 7.5?0.6mm; p=0.54).
CONCLUSIONS:

Ovulation induction with clomiphene citrate and timed intercourse is as effective as that with intrauterine insemination for achieving pregnancy in polycystic ovary syndrome and could represent the initial treatment option, being less invasive and less expensive than intrauterine insemination.

Yours,
Jane


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