Initial Investigations to Order

FSH (2 values done 1-2 months apart, should both be < 40, and done with estradiol

Karyotype testing, fragile-X testing

TSH, free T3, freeT4, anti-thyroid-peroxidase antibodies (rule out other autoimmune diseases)

Fasting Glucose (to rule out DM or glucose intolerance)

Calcium, Phosphate (to rule out hyperparathyroidism)

B12 (to rule out pernicious anemia)

beta-hCG, prolactin (for amenorrhea testing)

Bone Mineral Density testing (for baseline assessment)

Cosyntropin stimulation test (for anti-adrenal antibody testing)

electrolytes

Yearly / Followup Investigations

Fasting glucose, fasting insulin

TSH

CBC

Calcium, Phosphate

Consider Bone Mineral Density testing

To reduce the risk of Ashermans syndrome and stimulate/improve development of a healthy endometrial lining, it is recommened to leave a foley catheter (or equivalent space occupying device) in the uterus for approximately 7 days.

Intrauterine Foley Catheter Orders:

Estrace 2mg PO qdaily x 30 days

Provera 10 mg PO qdaily, starting on day 20 of estrace, continue x 10 days

Doxycycline 100 mg PO BID x7 days (until intrauterine foley is removed)

Remove intrauterine foley on POD#7