Tuesday, December 18, 2012

On Uterine Lining

Since my primary issue seems to stem from my uterine lining, I decided to do a little internet research on it.

From looking at my ultrasound slips, I've noted there are 3 types of lining "grades" that my RE likes to know about: TL, IE, and HH.

From Livestrong: "The pattern changes during the menstrual cycle; a good pattern in the first half of the cycle, before ovulation, is not a good pattern after ovulation. A trilaminar lining, also called a triple lining or a TL pattern before ovulation is best for conception. Once your body produces progesterone, your lining should change to a homogenous pattern, sometimes called an HH pattern. A lining of between 7 and 12 millimeters is optimal for conception, but people can and do get pregnant with linings as thin as 3 millimeters, Dr. Timothy Hickman of Houston IVF reports on the Fertility Today website..."

From INCIID: "As you approach your LH surge, it should be above 6 mm, ideally between 8 and 12 mm. (If it is much more than that, it may be advisable to ask about a hysteroscopy or sonohysterogram to see if perhaps there is a polyp inside the uterus). You want to have a triple stripe pattern around the time of the LH surge and ovulation. Towards the time of implantation, you want to have a more integrated HH or IE pattern. The triple stripe occurs in response to estradiol; the HH/IE conversion is in response to progesterone. It should also be noted that, although most doctors prefer the above pattern of linings, there is no conclusive research on whether a better pattern actually results in higher pregnancy rates..."

Then, I found this article about pregnancy rates and lining, which shows that the lining should be at HH 3 days after transfer (in IVF, so you'd have to conclude the same should be true for IUI).

I had an IE pattern yesterday at my baseline, now time to see how it goes the rest of the cycle. At my last cycle, I had HH (I forget what thickness) at 7DPIUI, and that's when the nurse said I needed the progesterone injections daily versus every other day.

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