Case of the month Aug/Sep '08: Episode #6
Click here for episode 1
Six months had passed since Irene’s positive LAC (Lupus Anti Coagulant) test. The initial relief and excitement she had felt had gone away and she came in to discuss her options. After all, she had suffered four miscarriages, but then finally learned a reason for the miscarriages. We were ready with an intervention for her next pregnancy, but it had now been a year and a half and still no pregnancy. That had never been a problem in the past. She was surprised. She really thought she would have been pregnant already.
When they came in, I asked for an update on their lives. They were both still working the same jobs (nursing for her and the painting business for him), busy as always. They were paying attention to Irene’s ovulation dates and trying to be diligent about having intercourse during those days.
Their situation had now turned into a combination of infertility and recurrent pregnancy loss. They had gone a year and a half with no pregnancy and they still had their past track record of four pregnancies with four losses. I offered them a chance to boost their odds and speed up time to their next pregnancy. They enthusiastically agreed. I explained that we were going to do a standard cycle of ovulation induction to grow extra eggs. Then at the right time, we would inseminate Harold’s own healthy sperm into Irene’s uterus. Her instructions were to call with her next menses.
Three days after her period started, Irene came in. The baseline ultrasound was normal. The uterine lining was thin (not at all surprising because it had just bled out). I decided on a protocol of 150 IU daily injection of Follistim. She took the medication from days 3 to 7 and on day 8, we brought her back for evaluation to see what kind of follicular growth she had.
Click here for episode 7
