Dr. G,

After being diagnosed with premature ovarian failure, it took me 2 years to embrace donor egg as my only option to expand my family. This journey has been a frustrating one.  I have only been able to have one fresh ET because my lining was suboptimal. On my first fresh ET, my pregnancy test was postiive.  I was elated !! ...but my beta levels plateau ~200 - 300.  I was given an option for methotrexate to dissolve the pregnancy.  I dont think my RE knew for sure where my pregnancy was.  After healing, several subsequent attempts at frozen cycles were fruitless as my uterine lining was always 5 - 6 mm.  I tried OCP/lupron, then OCP alone both rendering "thin" linings. As far as estrogen, I have taken all combinations of oral, vaginal, and injectable in an attempt to achieve a thicker lining. I have pushed my cycle out to 15 days of estrogen stimualtion to no avail. My most recent cycle (January) was preceded by one month of low dose "HRT" to supposedly prime the uterus, and then estrogen stimulation. After 13 days, my lining was 6.3 !! We decided to proceed with ET. Two weeks later, my pregnancy test was positive !! ....and now today, with a beta of 600,  I have been diagnosed with an ectopic pregancy because the sac is outside my uterus. Need I say more.....I am completely frustrated.  I finally get a point of thickness that was acceptable to my RE and then WHAM!!! I am told today that I have a life threatening condition.

How can I get my lining thicker? and Is there a number that correlates with successful pregnancy? Does this lining problem have something to do with POF?


Please help. 



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Comment by John David Gordon MD on February 11, 2012 at 8:17am

I am so sorry to hear about your troubles. Hard to imagine how frustrating it would be to end up with an ectopic after all that you have been through. Your questions are spot on but I am not sure that we have any absolute answers for you.I have seen successful pregnancies with a lining of 5 mm but most REs aim for 7 mm as a relative minimum. Not sure what else one could do to thicken the lining. I have tried terbutaline and vaginal viagra but have not seen impressed that these made a huge difference. Clearly having one and possibly two pregnancies implant outside the uterus raises concern that the uterus itself is not very accepting of implantation. Not sure how this would relate to the diagnosis of POF. I think that if using a gestational carrier is not an option then I would cycle you for 3 months with relatively high levels of estrogen (estrace 2 mg 3x daily) with a monthly withdrawal bleed before going into another FET cycle. Hoping that persistent exposure to estrogen may help that uterus remember what to do! 

Sorry for you losses. Wish that I had all the answers...


Comment by anonymous on February 16, 2012 at 6:24am

Thanks for your comment Dr. G!

Sorry for the delay, I had to take another dose of methotrexate because my beta leves were not dropping appropriately. Geeeeez.

I picked donor egg over adoption or gestational carrier because of the opportunity to experience the wonderful journey of pregnancy and delivery! I have a 3 year old son, so its hard to believe that my uterus has forgotten that quickly what to do, but I guess all is possible.  It's hard to pick yourself up and try again...but I will take your suggestion to heart.  Thanks again !!!


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