Patient: Description of condition (onset, main symptoms, hospital visited, etc.): Hello: I am 34 years old and a patient with endometrial carcinomatosis. After 3 consecutive cycles of high-dose MPA treatment, the last scraping was on December 5, 2009, and the endometrium showed marked interstitial metaplasia and glandular atrophy. After the resumption of menstruation, Mafulon regulated menstruation for 2 months on April 18 this year, the transfer, early May pregnancy (IVF put frozen) has not frozen embryos thawed on the same day 7 viable 5 put 3, HCG doubled very well, but after two months of pregnancy has been no fetal heartbeat, on June 11 to do abortion, my period has not yet come, if not I do? What can I use to protect my lining at the moment? I am afraid that without the protection of progesterone, my lining will recur, when will I scrape again? Zhang Airong, Department of Gynecology, Qilu Hospital, Shandong University
Zhang Airong, Department of Gynecology, Qilu Hospital, Shandong University: At present, ultrasound should be done first to rule out the possibility of incomplete abortion, then apply progesterone capsule 100mg twice a day for 5 days, and observe whether there is menstruation after stopping the medicine. If there is menstruation, MPA treatment can be applied for 3 cycles and then scraping.
Patient: Hello, Director Zhang: I had an ultrasound on the afternoon of the 29th at the local hospital because it’s been about 50 days since the abortion: uterus size 5.2*4.3*2.6 with regular morphology, homogeneous muscle wall echogenicity, centered cavity line, endometrial thickness 0.5 CM. no obvious abnormalities in the bilateral adnexal area. left ovary 3.5*2.3, right ovary 2.8*1.7 right ovary detects 0.7*0.6 The developing follicles of the right ovary were detected at 0.7*0.6. Is it possible to withdraw blood with progesterone at this thickness of lining? I don’t have 100MG progesterone, but only 250MG progesterone, and there is only 20MG intramuscular progesterone locally, which one should I use to withdraw blood? When can I use it? Thank you!
Zhang Airong, Department of Gynecology, Qilu Hospital, Shandong University.
You can use progesterone 20mg intramuscular injection, once a day for 5 days, stop the drug to observe 7-10 days, whether there is a menstrual flow. If there is no menstrual flow, change the treatment to Clomid for one cycle (21 days). If there is still no menstrual flow after stopping the medication, it is recommended to go to a regular hospital for hysteroscopy to exclude uterine adhesions.