Hi Dr. Sher,

I am hoping you could help me know what to do next.

I just turned 37 and did my first IVF cycle. We retrieved 6 mature eggs. Prior to this I had been trying for about 6 months naturally, during which time I noticed I had an extremely light period (1 or 2 days of using just a panty liner and some minor clots, generally old looking blood). I then tried 3 IUIs. I got pregnant on my second IUI but it ended in a missed miscarriage at about 8 weeks, even though we had heard a heartbeat at 6 weeks. Throughout the IUIs I had consistently thin lining (I was on letrozol). A day or two before trigger I would supplement with vaginal estradiol which would get my lining to about 6mm only but trilaminar (I got pregnant on that). During this IVF cycle i was on 150 (then 225) menopur and 450 gonal F for 11 days on injections. During that time my lining didn’t budge. It stayed at 4.8 mm.

I previously had been on mirena hormonal IUD for 12 years which I truly suspect has had a very negative impact on my lining but no doctor takes that seriously. I also had a fibroid removed in 2019. When we started TTC, we found out I had uterine scarring. It was not severe and got resolved after 2 hysteroscopies (cleared on my last Saline sono) but that did not seem to improve my lining…

I wanted to try different things or test to help me figure out what’s wrong with my lining while we wait for the results of our embryo genetic testing (PGT-A). What would you recommend I look into or ask my clinic? I asked them about PRP but they do not offer that nor seem knowledgeable about it. What can I do to improve my chances of improving my lining? Is there hope? Or do I just have to accept this and think of surrogacy?

Thank you so much.