Wisdom from Wisot Wednesdays - The Final Round

Reprint from Redbook’s Fertility Diaries

Yes, it's true: I'm sad to say that this is the final installment of Wisdom from Wisot Wednesdays and the Infertility Diaries. You'll still be able to access the archives of past blogs, and everyone's favorite fertility expert, Dr. Arthur Wisot, will continue to take questions at the Reproductive Partners bulletin board (though the questions and answers will have to be a bit shorter over there). It seems only fitting that we're winding down with just one last question. But first, the doctor's disclaimer: "My answers to questions on this blog do not constitute medical advice, but are merely meant to create an educational forum for consumers. It is always best to discuss these issues with your health care provider." The good doctor's answer is below, in bold. Baby dust to everyone.

Question: Hello, Dr. Wisot. I'm 31 years old and my husband is 35 years old. I have been trying to carry for 10 years already. I was diagnosed with PCOS and endometrial hyperplasia. I was treated with the hyperplasia and was put on Metformin for the PCOS. I started seeing an infertility specialist and he put me on a combination of Clomid and Dexamethasone. After the 4th cycle I was able to get pregnant but ended up to be a blighted ovum pregnancy, so I am going back for another cycle. My concern is that if I had hyperplasia, isn't it risky to let so much time go by for the hyperplasia to come back? Should I be considering other procedures to have done? I know that I can't afford IVF, but do you recommend something else that's less expensive? I was told by my OB-Gyn that I had to get pregnant soon because I've had the hyperplasia come back two years in a row. Please advise, and thank you.

Answer: I don't know what you mean by "so much time." If they start another cycle and get you to ovulate in a matter of a couple of months, it would be unlikely for the hyperplasia (increased growth in the lining of the uterus) to return in that period of time. The hyperplasia is caused by estrogen stimulation without any progesterone effect on the endometrium. So they could try to get you to ovulate again soon or give you monthly progesterone to try to prevent the hyperplasia from coming back while they are waiting to get you started again. Sometimes that hyperplasia can be relentless, so I hope they will get you right back into treatment; usually there is no reason to wait.
I have enjoyed answering all your great questions over the past few months. I wish you all a quick resolution to your infertility.