Asynchronous endometrium with glandular-mucosal-hypotrophy

Dear Dr. Sher,

I have a complicated medical history but I will try to keep it as short as possible. I am 35 years old and exactly a year ago I have undergone 3 ovarian stimulations that resulted in 6 embryos. One of the embryos was transferred last April and it was a complete failure. Since then I have requested for more tests and I have undergone a laparoscopic surgery. Please note that left tube was previously removed due to an ectopic pregnancy (conceived naturally last year). Right ovary was removed through a hernia surgery when I was very young and was informed about this after my last 2 laparoscopic surgeries (they couldn’t find the ovary and they believe it was surgically removed and YES I have low AMH). Right tube was destroyed by an adhesion and was a sactosalpinx. It was removed during the surgery this year (it was creating a mess). Superficial endometriosis in the uterosacral ligaments was found and removed.

They also performed an endometrial biopsy which showed high levels of endometritis. I took doxy for 2 weeks and repeated the biopsy which now seems to have disappeared. However, both times I have undergone an endometrial biopsy, the diagnosis was:
(FIRST TIME – POSITIVE FOR ENDOMETRITIS): Asynchronous endometrium of early (predominant) secretory type, irregularly secretory-cystic and proliferative advanced, with polypoid component, and with mild/partial glandular-mucosal hypotrophy. Test was done a day after ovulation (in fact the corpus luteum was observed during laparoscopy).
(SECOND TIME – NEGATIVE FOR ENDOMETRITIS): Asynchronous endometrium of advanced proliferate type, early secretory endometrium and irregularly proliferate-secretory with mild/moderate and extensive glandular-mucosal hypotrophy. Test was done either on the day of ovulation or a day before.

I have asked the doctor that analyzed the sample what could it mean and he said they usually see this with people that are on the pill or that have undergone ovarian stimulation. I am not on the pill and the last stimulation I have undergone was almost exactly a year ago.

I should probably note that my endometrium normally reaches 8-9 mm and I still have regular periods of 27-28 days. What are your thoughts on this? What is causing my endometrium to be asynchronous? My fertility doctor is planning to follow a modified natural cycle for a FET with an HCG injection and progesterone supplementation and I am worried that if my endometrium is asynchronous it will result in another failure.

Thank you in advance for your response. It is highly appreciated that you are devoting time in answering our questions. I have learnt so much from your articles and it is because of you that I am able to discuss things with my fertility doctor.

Thank you again,
Constantina

Author

Scroll to Top