Part =2. If no pregnancy?
Whose fault is that if no pregnancy after ovulation induction with all hope?? What
went wrong, doctor???? Was doctors expectation in ovulation induction was
wrong?? . The doctor who is in charge of
CC, Letroz and TMX (Tamoxifene) ovulation induction if the induction cycle fails
after all hope and faith on doctor and team members declare your induced cycle
is futilethen doctor says he/she is just sorry. He/ she don’t think there is
any lapse on his/ her planning.
Was doctors expectation was wrong?? Will
couple and neighbors loose faith on doctor?? Let us face the facts in the light
of science. Require serum estradiol levels ≥ 50 pg/mL to be effective. Why
progesterone assay?? Reason?? Is it not a wide ball?? Unnecessary expenses!!! Ipsilateral
follicle development is inhibited when the serum progesterone level is ≥ 0.9
ng/mL AS such Initiating Ovulation induction
with CC , Letrozole or TMX (not to speak
of Gonadotropins or IUI or ART cycle
with long down regulation) before these levels are attained will result in no
or reduced follicle development. Admittedly, not all time planes lands in right
time neither train arrives destination at exact schedule Serum levels usually
reach these parameters on the third menstrual cycle day, but may require seven
days or longer in patients with PCOS or persistent corpus luteum cysts. Serum
estradiol levels normally double every two days, and progesterone levels
normally decrease 50% per day during the early follicular phase of the cycle,
and do not need to be rechecked unless they would require more than three days
to reach the level required to start. Delaying the start of CC or TMX until
hormone levels are in the desired range will increase the chance of successful
stimulation. Take home message there is undeniable evidence that not only
in IUI ore ART cycles. Even in CC/Letroz cycle costly and harassing, you may
call it, the use of estradiol
and progesterone levels is helpful is initiating the starting day.
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