# Anyone had FET lining issues when previously fine?!



## MrsH344 (Jul 9, 2014)

Hi,

I've never posted here before, but have spent several years trawling the internet for threads that will answer my questions!

I'm really looking for some insight and support from you lovely ladies out there. Answers to questions as well as just knowing that I'm not the only one going through this crappy journey!

We've been ttc number two for over two years. My first pregnancy was conceived quickly and naturally, as was the second which ended in mmc almost two years ago. I haven't had a since BFP since then.

We started fertility treatments in the US (where we're living at the moment) at the end of last year. I had three unsuccessful IUI's with clomid, followed by a laparoscopy / hysteroscopy in March to unblock one of my tubes and remove some minor adhesions in my lower uterine cavity that were probably the result of the ERPC I had. My doctor said these adhesions had probably not prevented me from getting pregnant. 

My first (and only) fresh IVF cycle was two months ago, which produced 11 eggs, 9 fertilised with ICSI (not bad for an old girl of almost 39!), but only one embryo made it to blast by day 6. Fortunately though it's 5AA quality and tested chromosomally normal. So then we went into a FET (because I missed the window for fresh transfer), and all of a sudden I have lining issues! I've never had lining issues before. Why does it feel like you get so close and then the carrot is snatched away again?! My lining wouldn't get above about 5.5mm, despite increasing doses of Estrace (orally and vaginally), and then a high dose of Premarin for two weeks just to see whether it would grow. No budging at all! I finally asked to stop the drugs and just have a month off. We're back to the UK for a few weeks which forces a break anyway, and then I want to try a natural FET in Aug.

I've read of other ladies who've had this issue on medicated FETs, but I just wondered whether anyone reading this has experienced it too? My lining was 12mm for my IUI cycles, but then only 9mm after IVF stim drugs followed by a really light period, which wasn't a great sign. 

I had a diagnostic hysteroscopy following the surgery, which showed my uterus looked fine, but when my doctor repeated it after 2.5 weeks of Estrace for the FET there were white patches in the upper cavity. This area wasn't touched during surgery and my doctor was completely perplexed! I did however have what looked like a normal period when I stopped taking the pill (on it for 15 days) prior to starting the stim drugs, which my doc said is a good sign that I can still grow a decent lining.

I'd love to hear from anyone who has had similar issues during IVF / FET when their lining was previously fine. What was the outcome?

I'd also really like any insight into why this happens. I read somewhere that some women just don't respond well to external oestrogen, which would explain my FET issues, but during the fresh IVF I had 12 follicles pumping out E2 and still had a thinner lining than usual! It seems that doctors don't fully understand what causes lining issue, or probably the impact that these strong medications have on our bodies.

Sorry this is so long and thank you for reading. It was quite therapeutic just writing it all down!

Good luck to all on this rocky road.

Caroline x


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## lara lara (Jun 17, 2014)

Hi Caroline ,

Have you used lupron shots before your medicated FET Or only estrogen from the first AF Day?


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## MrsH344 (Jul 9, 2014)

Hi Lara,

It was just estrogen from CD 4, no lupron. Do you think lupron helps?

Thanks,

Caroline


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## mierran (Apr 24, 2009)

Hi,
I would definitely go with your gut and try natural. I had 2 medicated fets - bfn with no implantation. Lining looked great. 
Natural fet - lining 13.8 so thicker than medicated and bfp. Seems I may not express factors for implantation on exogenous oestrogen.

if you still have a very thin lining you are looking at something like ashermans syndrome. That is a whole other ball game, and difficult to treat. 

Alternatively drugs such as tamoxifen can help. Some women also use low dose stims for a fet.

See what happens with a natural cycle.

You can do a natural cycle several ways. 

One - use ovulation predictor sticks twice daily at least from day 8 of your cycle. Once you measure lh surge contact clinic. You will ovulate 40 hours after this. Transfer of your blast would be 5 days after that ie 1 week after you detect surge

Two - get scanned and bloods every one to two days to detect lh surge and ovulation . Not many clinics do it this was as v labour intensive for them

Three - get scanned every few days until large natural follicle over 17mm ( mine was 25mm ) . You then take a trigger shot same as in an ivf cycle. Instead of egg collection 36 hours later you ovulate about 40 hours later. Et is 5 days after that ie 1 week after your trigger shot
( this is the protocol I did. My clinic didn't originally want to as they only do medicated cycles but boy, am I glad they did agree in the end )

Lining issues aren't that uncommon in medicated fets. Down regulating first can make them worse but isn't the sole reason.

I certainly would advise a mock monitored natural cycle with eg a single scan just before you are due to ovulate to check lining thickness etc. Assuming you have a regular cycle say 28 day you will have lh surge day 12 to 14 and ovulate day 14 to 16 ( assuming a 12 to 14 day luteal phase ). So a scan day 13 will five you optimum thickness and let you decide way forward.

Good luck

x x


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## lara lara (Jun 17, 2014)

Hi Mirrean, 

What for Supplements for the natural FET have you take? And have you triggered with ovitrelle Or pregnyl?
Have you took lupron for your previous medicated  FET?  
With lupron, there should be no lining problems.. But as you had no linings problem with both! It was maybe the better quality of your embryo who sticked Or your doc had made a better  transfer, without damaging Embryo..?

Big hug!


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## MrsH344 (Jul 9, 2014)

Hi Mierrean,

Thank you for your reply, I really appreciate it, and congratulations on your bfp! It's interesting to know that you had a thicker lining and eventual success on your natural FET.

What's frustrating for me is that my doctor actually recommended a natural FET for me, but because my lining had seemed iffy to me on my stimulation cycle, I asked for a medicated FET. Ah well, I suppose it's trial and error if nothing else!

Take care xx


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## mierran (Apr 24, 2009)

I triggered with pregnyl. I didn't down regulate as I respond badly to it but it is more likely to cause lining problems than not using it as it thins the lining down. 
I had 5 top grade embryos transferred at 2 clinics and hcg less than 2 so not even the start of implantation. It is highly suspicious that there are attachment factors missing in my uterus on synthetic oestrogen. I discussed this with my gynaecologist about the factors involving implantation and he said that tbh so much is not known. He agrees that it is quite possible,  and known that in some women factors necessary for the embryo to recognise and  implant are not produced on synthetic oestrogen at the correct time or in the correct amount . 
It may be that the was a problem with embryo quality but given I got implantation every time on every other cycle ie fresh x2 ( even my single cr*ppy oe embryo implanted ) and  natural, and given hcg under 2 both times on synthetic oestrogen , it is possible another factor was at play.

Oh and re supplements,  I took selenium and pregnacare conception

good luck


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