Endometrium thickness

Does clomid really thin out the lining more than injectables? The literature says that it only does this when taken on its own, but not when supplemented with estrogen.
From Dickey and Holtkamp, Human Reproduction Update 1996, Vol. 2, No. 6 pp. 483–506

Does endometrium thickness affect IUI outcome? Yes, significantly (p < 0.01). IUI birth rates per cycle for endometrium thickness at time of HCG trigger:

Regimen	6 mm or less	6 to 8 mm	8 mm or greater
Clomid	0%	7.0%	14.0%

From Dickey and Holtkamp, Human Reproduction Update 1996, Vol. 2, No. 6 pp. 483–506

At my scan yesterday (CD14) my endometrium thickness was 6.9 and my dominant follicle measured 19.6. We triggered last night, and the IUI is today. Looking over my last three cycles, I analysed my data and saw that, while Menopur thickened my lining more quickly, I also ovulated earlier at CD9. For all three cycles, my lining is around the same thickness right before ovulation, and it is far below average. At least this time it's above 6, which means we have a shot.

IUI#3 CD12

I do love having my cycles monitored. I love graphs and tracking my numbers and knowing exactly what is happening. I like knowing what my ovaries are up to and how everything is progressing.

However, our clinic is not very empowering in that respect. They never tell me my hormone levels, and I have to quickly memories my ultrasound numbers as they appear on the screen. Today I asked the midwife what the procedure is, if we decide to move onto IVF. Her response was "you do not decide to move onto IVF, the professor will decide." She went on the explain that for IVF to be covered by the Belgian health care system, patients generally must try three IUIs first.

We are lucky to live in one of the few countries that provides six cycles of IVF to most residents. It pays for this cost by mandating that many of these must be single embryo transfers, which decreases the number of multiples born, and thus lowers the higher costs associated with multiples. The savings made on decreased newborn intensive care usage pays for the cost of providing IVF.

IVF coverage in Belgium:

age	IVF 1 to 2	IVF 3 to 6
Less than 36 years	single embryo transfer	two embryo transfer
36 to 39 years	two embryo transfer	three embryo transfer
More than 39 years	three embryo transfer	three embryo transfer

As for me, my dominant left follicle is still only at 13 mm, and my lining is still only 5.3 mm. Moving very slowly this time around. I'm guessing the IUI might be on Wednesday? We shall see.

IUI#3 CD10

I was randomised to clomid this cycle (clomiphene citrate CD3 to CD7, estrogen CD8 to CD12), and as I had some at home that meant that I didn't have to go into the clinic until today. The midwife who was taking my blood looked so young that I was worried that she would be incompetent. I think however the problem was that I am getting old, because she was fabulous. In fact, she coaxed out so much of my blood that I didn't realise that I was continuing to leave little drops of the stuff over the chair and floor of the waiting room. I was so embarrassed to have to get one of the midwives to clean it up for me. Still, better that than leaving human blood around the place.

My follicles seem to be ripening more slowly this time around. Last CD10 with clomid my dominant follicle was at 16 mm, but this time around it is only 11.7 mm. This is great, because I need time for my endometrial lining to thicken up. My lining is only 3.7 mm, the thinnest it has ever been at CD10 - it's gone from 7.6 mm (IUI#1 Menopur) to 4.8 mm (IUI#2 Clomid) to 3.7 mm (IUI#3 Clomid). I have been reading through the literature, and it really needs to be at least 7 mm on the day of the HCG trigger for a good chance of success.

The good news is that the dominant follicle is on my left ovary with the good tube. I should know more when I hear from the midwife this afternoon, but my guess is that I will have another scan in two days (CD12) and that the IUI will be on Monday (CD15).

IUI#2 Day 3

Three days ago.

"An exciting day today, yes?" The nurse asked me while taking my blood.
"Well, it is a rainy day" I answered. I didn't have the heart to tell he that I had already taken a home pregnancy test and recieved a negative result. She just seemed so excited, and then so disappointed when she called me at 4:02pm to tell me the result.

But the good thing is we can sneak in another IUI before everything closes for Christmas. This time I was randomised to Clomid, so fewer injections but perhaps more side-effects.

They are going to start monitoring me earlier, as I responded very quickly to the stimulation last time. My first ultrasound is next Tuesday, December 1.

Today.
Today is day 3, my endometrium is at 3.05mm, I have no ovarian cysts, my bloodwork looks good, so we have the green light.

We have one last chance for a positive pregnancy result in 2009.