Question:
Dear Sir, I have hypogonadotropic hypogonadism. I am trying to get pregnant and did IUI twice, but did not succeed. I was injected with GMH 150. I had to take around 26 injection to develop my follicles and then had to be injected with HCG for ovulation. My E2 level was 2250 and 4 big follicle. After IUI my doctor gave me only progestrone support. My question is that " is there no need of any other hormone medication as my body don't produce any hormone"? After fertilization can egg produce enough hormone which need for proper implantation. Can taking so many injections for stimulating the ovary affect the ovary or uterus in future? M. from India
Answer:
Hello M. from India,
In order to get you pregnant, you need to take supplemental FSH and LH (such a Menopur) and then when the follicle is appropriate size (18-22 mms), HCG is given to trigger ovulation. Progesterone supplementation is then started 3-4 days after the HCG to support implantation. You also have to consider that since this is a "natural" treatment, and most normal women don't get pregnant immediately when they begin trying for pregnancy (it usually takes 8-12 months of trying), this treatment is just making you into a normal ovulatory woman and so it may take several tries as well.
Finally, you have to make sure that you are taking thyroid hormone and adrenal hormone (cortisol), as well so that all your hormones are normal. If you don't, that could affect your ability to become pregnant. It sounds like your doc is doing the proper thing so you should trust in him/her, and ask him/her the same question.
Follow-Up Question:
Hello Dr., Good news. After HMG therapy and IUI, now I'm pregnant. 3rd month is going on, right now I am taking progestrone support only. I want to know in future will breast milk produce naturally or I have to take any hormone replacement for that. Will my baby affect because of my diseases? Thank you!
Follow-Up Answer:
Hello Again,
The pregnancy takes over hormone production, so you should not have problems producing breast milk. Your disease should not affect your baby unless it is due to some sort of congenital/genetic disease that is passed to your child.
Congratulations!
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
http://www.montereybayivf.com/
Monterey, California, U.S.A.
