# Natural or medicate FET with thin lining?



## katkat2014 (Nov 28, 2014)

Good evening,  I hope someone can help me. Should I do a natural or a medicated fet? Is one supposed to be better than the other? 

My lining on a natural cycle is fairly thin and gets to maximum 7mm (at a push to 7.5mm) on trigger day, and 7-7.5mm on embryo transfer day. It is always trilaminar.

The only time I took synthetic estrogen was when I did the ERA biopsy and I took 4mg of progynova per day for 12 days and my lining was a measly 4.5mm!!

The suggested medicated fet would be 6mg progynova plus 1 x estrogen spray (dosage is about 2mg) that goes directly through the skin into the blood stream, so a total of 8mg.  Any opinion on the above would be very welcome!


----------



## LuckyE (Dec 9, 2013)

Hi Katkat

I've been told that the egg quality affects the lining. 

Last year I had a couple of months without estrogen where my lining didn't grow at all.  This year my lining'ranged between 7 - 11 mm - without oestrogen. 

With it was 8.6 mm or something 

Could it possibly be that particular month that the lining didn't play ball?

I would try it with the synthetic estrogen and if it's the same result then I'll know to go natural.


----------



## katkat2014 (Nov 28, 2014)

Hello luckyE and thanks so much for your reply! Bad egg quality is probably the main reason hence we don't have very good embryos either 😕 in any case those I do have I'd like to give the best chance. I manage to get to 8.5-9mm with a stimulated cycle (250 gonal f) but that's of course not helpful. I guess I could just try the progynova cycle as you say and worst thing that could happen is that I wasted a month (although at nearly 42 every month counts!). I'd just like to know if this kind of a cycle is supposed to be inferior or superior to just going with your natural estrogen? On the other hand my ERA was receptive after taking the low dose progynova so synthetic estrogen can not be that bad? I just don't want to waste these hard fought for blasts I have and it's so difficult to know what's best 
Ps. My lining on a natural cycle is consistently thin, the thickest it's ever been was 8mm naturally and that was after ovulation on around day 25


----------



## MadameG (Jan 13, 2012)

Hi kitkat, the alternative to progynova is to do low dose stims (eg gonal f) to build the lining rather than follicles. My lining was miffed by synthetic estrogen tablets where it would grow and then start to break down, but did grow better and evenly with estrogen patches. My next FET would have been with stims but I went for a fresh cycle instead. There is a long thread on thin lining issues if you want lots more options! Good luck  xxx


----------



## katkat2014 (Nov 28, 2014)

Thanks MadameG and congratulations! With low dose stims what would have been your protocol? Would you take an antagonist and trigger shot with it too? While I am nearly 41 and my amh is quite low, I still have a good afc and am just worried  that all 9 or so of my follicles will grow with low dose stims (I had 12 follicles with femara and 100mg gonal f - but just 3 eggs and only 1 mature even though with good size follicles; not that this is relevant 😄).


----------



## MadameG (Jan 13, 2012)

Thanks kitkat  it probably would have been the equivalent of short protocol with low dose menopur/gonal f, followed by a trigger and then whatever luteal support needed (lots in my case!). I don’t know how much extra follies would matter as they should become nice progesterone pumping corpus luteums once they’ve popped anyway. Worth asking your clinic if you want to have some control over your cycle. Saying all that, your natural lining seems to get to a decent thickness but I understand that you would ideally prefer it to be thicker. Let us know how you get on xxx


----------



## katkat2014 (Nov 28, 2014)

Thanks  madameG! Hmm a 7  or 7.5mm lining  isn't amazing though on a natural cycle. Again and again I read it should be minimum 8mm but better 9mm or more 😕 anyway my clinic said I should  try the progynova option but altered this to 2mg morning and 2mg evening plus add one estrogen  spray in the morning and one in the evening making it about 7mg (but the spray works more like a patch apparently). If this doesn't work then I will suggest the stim and yes you're right I will have some nice corpus luteums.

Sorry one more thing if anyone is reading.  I am told my transfer will be around day 21 in this case.. is this OK or a bit late as I keep on reading days 18 or 19 are normal? Also I am to add clexane from day I take progesterone as the estrogen will thicken the blood. Is this a bit late maybe as heard of women taking it from day 1?


----------



## MadameG (Jan 13, 2012)

I started fragmin with progesterone. I wouldn’t worry about the transfer date at this point as I assume they will be waiting for you to ov, or perhaps just get to a good lining level, then transfer 5 days after starting progesterone. I think technically anything triple striped above 6 is considered okay (up to a max thickness of something I can’t remember but in the teens somewhere I think) but I think my clinic aimed for approx 8. I haven’t checked my diary but believe my lining was 7 something before ec this time xx


----------

