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development of lining after a few months of BCPs

lining BCP Lupron short protocol long protocol FET

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#1 returnable

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Posted 27 October 2017 - 08:37 AM

Historically I have had regular periods and during my IVFs and mock cycle I always got my lining to 8.1-8.3 mm.


I had a mock estrace only cycle in May. However I required the use of BCPs for my period to come back and started that round at the end of June (I think I had a 50+ day cycle). To time my next period to start after vacation, I took another round of BCPs in July, and then a round of BCPs (this time only 14 days) in August to start my long protocol for an FET. I did not manage to get my lining to 8mm on the protocol and my cycle was cancelled. My RE believes that I'm one of the 10% that does not do well with Lupron long protocol. Besides not achieving the required lining thickness (I was triple stripe), I also had severe insomnia and water retention from the Lupron.


I'm still waiting for my period to arrive after my cancelled FET (it's now been a bit over two weeks). My questions are:


(1) If I do another round of BCPs to get my period to come, is there any chance that the multiple rounds of BCPs have affected my chances of developing a good lining?


(2) Will my lack of a natural period before my next FET reduce my chances of developing a good lining, or is the fact that I'll be on the short protocol with estrace enough to develop a good lining?


(3) And as a general interest question, how does this history of medical use over the last few months affect natural ovulation, and hence the release of estrogen by my own body?


Thanks in advance for addressing my questions Dr. Hartman.

#2 DrMichaelHartman

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Posted 27 October 2017 - 11:48 AM

Great questions returnable. I would agree with what your REI says that maybe lupron isn't for you and considering another protocol may be advisable. It is also possible that maybe this was just a bad cycle.


I don't think the BCP should have any long-term effects on the lining, but may have some short-term effects (there is not great evidence to confirm this though). Should you go a long time without getting a period on your own I would suggest calling your RE and reminding them about the thin lining and asking if they have any concerns about you taking BCP again. Typically I give a short course of progesterone instead of BCP but they should do the same thing. I think a short protocol is an appropriate next step as there will be less suppression since you are not taking lupron.


I doubt that being on BCP should suppress your ovulation after stopping it. The idea of a "post-pill amenorrhea" is not considered to be normal anymore and certainly is usually not due to BCP use but rather individual patient characteristics (like ovarian reserve).


I hope this helps


Good luck!

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