Good article explaining the basics of AMH:

Anti-Müllerian Hormone (AMH)
Müllerian Inhibiting Substance (MIS)

http://www.repromedix.com/pdf/AMHbL17CF181.pdf

The question is how severe is the adenomyosis is. If it is localized and can be excised completely, then surgery is a possibility. However, if it is diffuse and clearly the reason for the failure to conceive, surrogacy may be the only option.

- Answers kindly provided by Dr. Stephan Volschenk -

This is due to the “1^st pass” phenomenon. Oral absorption is not nearly sufficient enough to obtain and maintain adequate levels in the uterus.

- Answers kindly provided by Dr. Stephan Volschenk -

Statistically the likelihood of a good outcome during the 2^nd or 3^rd attempt is higher. This is due to the fact that so much information, that were previously not known, is now available and can be used to optimize and tweak the next attempt.

- Answers kindly provided by Dr. Stephan Volschenk -

- Answers kindly provided by Dr. Stephan Volschenk -

If the male partner has a chromosomal abnormality that has been documented, the sperm should not be used for IUI at all. Furthermore, the success rate of  IUI’s in people without any problems at all is between 18-20% per attempt. If you have compromised gametes, this chance of success will clearly be less.

- Answers kindly provided by Dr. Stephan Volschenk -

The size for trigger is 18mm. With 2 follicles present, one would time the trigger on the size of the leading follicle, i.e. as soon as the leading one reaches a mean diameter of 18mm.

- Answers kindly provided by Dr. Stephan Volschenk -

Menopur is likely to increase the estrogen level. The growth of the lining is dependant on the amount of estrogen, hence the use of the Menopur. Presumably you have had some sort of cavity assessment to exclude any pathology inside the uterine cavity that might lead to a thin lining?

- Answers kindly provided by Dr. Stephan Volschenk -

As long as the Beta in doubling every 48 hours and there is no bleeding or cramping, the pregnancy is ongoing until proven otherwise.

- Answers kindly provided by Dr. Stephan Volschenk -

With an AMH of 0.6, a history of stage 3 endometriosis and failed inseminations with good quality donor sperm, IVF is without a doubt the next step sooner rather than later.

- Answers kindly provided by Dr. Stephan Volschenk -