Insemination and job of ovaries

[Taniulya]

Situation at us following: 28 years, primary sterility or barrenness, 2 years of a sexual life without preservation. Spermogramma the husband of 28 years (the CART, strict morphology on Kruger) - norm or rate. At such parameters it is possible to be the donor , - the doctor has commented. (the MAR-test did not do or make).

Research on hormones - in norm or rate (IFA). 10 day of a cycle: Oestradiolum - 77,66 u/mA at norm or rate 30-120 u/mA. Progesteronum - 2,97 ???y/l at norm or rate 0,2 - 4,0 ???y/l. Prolactinum - 436,01 ?N/L at norm or rate 57-600 ?N/L Testosteron-Depotum - 0,92 ???y/l at norm or rate *lt; 4,6 ???y/l, TTG - 1,50 ??N/l at norm or rate 0,3-4,0 ??N/l; 3 - 1,35 ???y/l at norm or rate 1,2 - 3,2; 4 - 72,66 ???y/l at norm or rate 54,2 - 155,0.

21 day of a cycle: Oestradiolum - 15,54 u/ml at norm or rate 70-250; Progesteronum 36,72 ???y/l at norm or rate 8-78

IPP it is not revealed, according to monitoring a menstrual cycle the ovulation occurs or happens. According to US - attributes of a chronic right-hand salpingitis. The right ovary at a rib of a uterus. A roentgen of a uterus and pipes (metrosalpingografija) - permeability of pipes is saved. A chronic right-hand salpingitis. The postcoital test handed over twice in different cycles later 5 - 5,5 hours after the sexual certificate or act. One cycle - natural, another - with application of stimulation by Clostilbegytum. Both of the test or dough negative. A level antispermalnyh antibodies (total or cooperative) - 8,72 at norm or rate 0-60 N/ml.

The first insemination passed or took place without stimulation of an ovulation (the right ovary was active), pregnancy has not come or stepped. Have decided to pay attention to the left ovary (earlier at monitoring a menstrual cycle, at carrying out of postcoital tests worked left). However three cycles were worked successively with the right ovary, inseminations all were postponed. On a following insemination have decided to try or taste stimulation by Clostilbegytum for activation of the left ovary. And again donimantnyj the follicle has ripened in right (already 4 cycles successively). It was necessary to cancel once again insenimatsiju. In a following cycle have decided to make even more powerful or potent stimulation (I hope any more Clostilbegytum).

There are questions: the right ovary will be how long active? To theories it is written, that work alternately. Whether is it disturbance in job of any organs? Whether it is necessary to subject an organism once again to stimulation or to wait for a natural cycle? Perhaps, it is in addition necessary to pass or take place still inspections (genetics, immunity)?

P.S. A laparoscopy I shall do or make, as soon as the situation with an insemination will clear up at job of the left ovary.



In advance I thank.

[boris]

Uv. Taniulya!





There are questions: the right ovary will be how long active? To theories it is written, that work alternately. Whether is it disturbance in job of any organs? Being the student I considered or counted, is what is it valid so, however in practice it will be impossible to predict or forecast how long to work one of ovaries. It not nurushenie.





Whether it is necessary to subject an organism once again to stimulation or to wait for a natural cycle? Both of a variant priemlimy.



Perhaps, it is in addition necessary to pass or take place still inspections (genetics, immunity)?

P.S. A laparoscopy I shall do or make, as soon as the situation with an insemination will clear up at job of the left ovary. A diagnostic laparoscopy.

[silver]

In your inspection otsutststvuet the information on level LG and FSG-3 day of a cycle

It is cardinally important for an assessment of works of ovaries

[boris]

In your inspection otsutststvuet the information on level LG and FSG-3 day of a cycle

It cardinally important for an assessment of works of ovaries Any researches should be carried out not from idle interest, and not proceeding from the list of the existing researches given by clinic.

At purpose or appointment additional/recommended isledovanija the doctor should be guided first of all odnimjudvumja by questions:





Whether the additional information will give an occasion for change/specification taktiktiki forthcoming treatment?

Whether the additional information can spend more precisely correction of already spent therapy?

Unfortunately, very much often a lot of the researches, recommended to the patient, not only cannot respond on vyshepostavlennye questions, but also to be though however or as or are competently interpreted, and their purpose or appointment is caused or dynamic stereotypes, or others.... The reasons.



I do not think, that at:



*quot; Progesteronum 36,72 ???y/l at norm or rate 8-78 *quot;

*quot; according to monitoring a menstrual cycle the ovulation occurs or happens. *quot;

*quot; Have decided to pay attention to the left ovary (earlier at monitoring a menstrual cycle, at carrying out of postcoital tests worked left). However three cycles were worked successively with the right ovary, *quot;

There is no necessity for carrying out of additional hormonal research (*quot; in your inspection otsutststvuet the information on level LG and FSG-3 day of a cycle it is cardinally important for an assessment of works n????o*quot;).





Unless it is not enough available data for an adequate assessment of works of ovaries?????

[silver]

And unless the potential of ovaries is not interesting to you?

In fact in this case it is possible or probable in the long term ivf

By the way how much coh with or without iui you recommend before transition to ivf?

[boris]

And unless the potential of ovaries is not interesting to you?

In fact in this case it is possible or probable in the long term ivf



Conversation virtual, and, proceeding from the presented data I believe, that all OK. Probably at internal acquaintance I would expand volume of inspection.



Algorithms of inspection are really important, but not always it is meaningful to expand or dilate (read: to increase or enlarge stomost) obem inspections.



By the way how much coh with or without iui you recommend before transition to ivf? Researches on cost-have shown efficiency, that carrying out of the above-named programs is meaningful no more 3-4- cycles.

Further:



Or change of tactics treatment: more often IVF

Or expansion obema inspections (as a variant a laparoscopy) if earlier spent only GSG