Abnormal Bleeding and Endometrium during Infertility Treatment

Abnormal Bleeding and Endometrium during Infertility Treatment

Dr .R .Taheripanah

Infertility  & Reproductive Health Research Center

Pregnancy

• 3 parameters are necessary  for Pregnancy:
• Embryo with  good quality
• Endoemtrium
• Dialogue between  these 2 items

Infertility causes 

• Female factors
  • Ovulatroy
  • Tubal
  • Uterine
  • Cervical
  • Peritoneal
• Male factors
• Unknown
• Combined
• Treatment of all of these factors cannot result to pregnancy  unless there is a good endometrium with good receptivity
• It seems that the drugs and induction ovulation have adverse effects on the endometrium and decrease the pregnancy rate in the stimulated cycles
• The most important factor is the hormonal imbalance between estrogen and progesterone and hyperesterogenic situation during the ovarian stimulation

Endometrial effects of induction ovulation drugs

• The most common cause of ovulatory factor is the PCOD
• Clomiphen is the first line treatment for the induction ovulation in these groups
• Although the ovulation rate is 80% , but the pregnancy rate is only 40% ,
• This difference is in part due to anti-estrgoeinc effects of CC .
• There is thin endometrium in midcycles with CC and also very low and thick cervical mucus that don’t permit to pass the sperm
• These is some letolysis effect  and luteal phase deficiency is higher with CC .
• Higher rate of spotting and short luteal phase