Right Ovary: 16.5, 15.5, 13, 12, 11.5, 11.5, 10
Left Ovary: 17, 17, 12, 10
Lining: 6mm
Is this really so horrible? Yes, it is rather odd to have eleven follicles at least 10mm on day ten when I am only on LETROZOLE, for pity’s sake, but looking around the Interweb (surely the best and most reliable source of information) I see plenty of people who had more than three mature follicles at trigger. My clinic is concerned, obviously, about the largest four, all around 16-17mm. But how many follicles are too many? If I don’t take a trigger shot, will they all ovulate? What are the chances that we really would end up with high order multiples if we had plain old sex? (I’ve had three miscarriages—how likely is it that I would end up with too many healthy pregnancies?) What would you do? Would your doctor have cancelled? Could I somehow convert to IVF? Why is my lining so thin? What could they possibly do differently next time? Why did the nurse have to poke at my already tender right ovary SO VIGOROUSLY with her ultrasound wand? Why didn’t I ask these questions while I was at the clinic?
UPDATE: It is Saturday morning, and I am feeling much better. A little embarrassed at how I reacted, but better, nonetheless. Thank you all for being so kind. I have a call into the clinic to find out what I do next to end this cycle, because I do not remember, and I may casually ask them about the convert-to-IVF idea, which I fully expect to be shot down. Of course we will NOT be having sex—the fact that I even considered such a thing, given my terror of multiples, illustrates just how not-myself I was last night. Probably part of that was the pitcher of consolatory Margaritas. Speaking of which, I’m off to find some aspirin…
{ 22 comments… read them below or add one }
I’m pretty sure that the cycle that resulted in my lil’ man, my lining was only 6 mm. Could be that lack of sleep is messing with my memory, but I distinctly remember thinking “it’s too thin! this’ll never work!”
I vote for converting to IVF, if that’s financially feasible. Can you call the doctor on Monday and discuss this in more detail? Is there any sort of debriefing appt?
I definitely think there should be a newlywed loophole wherein you get one free and successful cycle while basking in the glow of the wedded bliss.
Yes, you will still ovulate w/o the trigger. The trigger is to insure the timing, which is generally 36 hours after trigger.
If I had that kind of response, I would convert to IVF, especially if it’s possibly to plump up the lining to around 9.
The question to ask yourself about multiples is if you are willing to reduce at the risk of losing them all; unless of course you are prepared to deal with the alternative.
I know that Julia (of here be hippographs) had an IUI canceled for too many follicles and they went ahead and had sex. But, she was prepared to go the SR route if needed. If you scan her archives you can probably find where she made her decision to just have sex. I know I’ve read a few other IF blogs who have done the same thing, but no names are coming to mind right now .
I was wondering that about your earlier post – can you convert to IVF? It seems like – from my fairly limited IF knowledge – that would be the best scenario.
The decision about having sex or not is a big one, but ultimately up to you guys – how do you feel about multiples/selective reduction, etc.? If SR is something you’ll consider, then GO FOR IT! You’re newlyweds, for chrissakes!
Either way, I’m sorry this cycle didn’t work out as planned.
E
WHYBAML had a deathly fear of hyperstimulation, so for my Letrozole IVF cycle he was rather conservative. Looking at my archives I discovered that right before trigger I had two follicles (follies, heheh) at 17-18mm, and an “assortment” at 14-15mm. He suspected at the time that it would yield 15-20 eggs. 12 were retrieved a few days later.
I was, and am, terrified of the idea of multiples, so I personally would opt for conversion to IVF if at all possible. I had no problem with selective reduction if needed, but it’s a rather expensive option if you end up not getting even one child out of it.
Alexa, it is always entirely possible that you would conceive multiples,a nd with that many follicles, quite a lot of multiples. No clinic in Europe would let you trigger with that many follicles, and they’d tell you not to have sex although of course that’s entirely up to you. I know it seems counter-intuitive and just plain frustrating, but responding this well is potentially a huge gift for you if you do go on to IVF (and this result may indicate that that is the best option for you as you can control how many embryos are put back).
Dude, that sucks. I’m so sorry.
Wow. That’s a double-edged-sword sort of response. Good that you stim so well, but not THAT well. At least for an IUI.
The lining is thin, but it is only day 10, so the follicles are not producing the optimal amount of estrogen . . .it will probably climb pretty significantly as they mature.
Multiples are certainly a risk you would be taking, and not just twins, either. SR could be on the table – that is something to really consider. And if you could not do SR (I don’t know if I could), then you could be faced with triplets or quads. People have done it, but it’s not a guarantee for healthy babies.
I believe there are around 23 lifetime movies detailing a similar scenario to yours if you are interested in completely scientific research.
Good grief! That’s a lot of eggs. Should you newlyweds sex it up? No! Would I? Hell, yeah.
Especially if you’d be okay with SR. I believe in statistics…I mean, are all the eggs going to be fertilize? Prolly not.
And, i think you may have the issue that i do…lots of eggs that aren’t the best quality. (am i an ass for telling you that?)
So, i say go for it.
Although, how PAINFUL would it be, if GOD FORBID you get knocked up with seven and have to SR?
I hope you do and get preggy with one. ; )
Oh, bollocks! Why can’t things just go the way they’re supposed to???? I don’t know much about letrozole – would it be possible for them to give you a lower dose on your next cycle?
I think IVF would be a great answer if the clinic (and your finances) can swing it.
So what did the clinic say? Why would they shoot down the convert to IVF? Everyone does it – it’s all the rage! And yes, ovulating will hurt. Better to be prepared, no?
Well, I think that kind of news deserves atleast 2 or 3 pitchers of Margherita’s. It’s much easier to make decisions when pleasantly hydradited with that sweet lemony/salty favor
I hope you get good news about a possible conversion cycle. I know that my old clinic in my old state was all for it, but my more recent clinic in my more recent state didn’t do it because there were certain hoops you had to jump through to be able to do IVF at all (all sorts of STD testing and the like).
If this cycle is a bust, I think an IVF cycle next go ’round might be worth discussing. If you stim so well, the drug costs would be low, the chance of success would be high and the chance of freeze-worthy embryos would also be high.
I am sorry Alexa. This just sucks.
My clinic (in Canada) would only allow IUI w/a max of 3 mature follies. Anything in excess of 4 follies would qualify to convert to IVF if you wanted to. That said, it is early days and there is a possibility some of those follies will fall behind and not develop. I had around 10 follies developing early on in my cycle (and was panicking!) but as I got closer to trigger time only 3 went on to mature and be large enough to trigger (in the 21-23 range if I remember correctly but I may be way off in my recollection) and the rest had all fallen behind. Had they cancelled my cycle (only would have happened if I had 4 follies since that was too many for IUI and too few to justify IVF) I def would have gone for good ol’ fashioned SEX, multiples be damned. As it is, w/3 mature follies, I ended up w/twins. But I would have been ok w/SR if necessary.
Oh and you are very wise to be terrified of multiples. Very wise. Twins are doable (just barely) but anything more than that is madness. And I speak from experience.
Well, I’m in the minoritiy here I guess… My RE had me do an IUI with 10 follicles showing. We did get PG, with 2, but they were ectopic. So in the end it didn’t work out, but they DID have us go forward with the cycle.
BTW – My RE never suggested we convert to IVF. The clinic’s success rates are good, and their high-order multiples rate is very low (3%).
Just 2 cents from my RE’s office…
I’d say see if you can convert to IVF. If you can’t – either for monetary reasons, or b’c the RE won’t go for it – then what the hey – try regular ol’ sex. Chances are not ALL the follicles will release, and even if they did, chances that each one fertilized AND implants AND stays? That would just be craziness.
As for the lining, mine was 6 or 7mm when I got pregnant with DD and everything went just fine. If you need a med suggestion – your doc could put you on Estrace[sp?] the help thicken your lining – but it’d have to be in the beginning of the cycle, day 10 might be too late. I had a very thin lining the cycle we did injectibles and IUI, but with Estrace it thickened up to the 6 or 7 that it was when we were successful.
Good luck – keeping fingers crossed for you!
Sorry you got cancelled–that just sucks, bigtime. The lovely double-edged sword of PCOS–damn ovaries are too stubborn to reliably produce a mature follicle on their own, but hyperstim like mad with just a little extra juice.
I hope you and Dr. Doctor are able to come up with a good follow-up plan.
Got no advice for you as we never faced that situation. Just wanted to send my sympathies- I’m sorry its such a long, frustrating road.
I am hereby adding a new line to Alanis Morissette’s “Ironic:”
“It’s like foo-ooour big follicles in a PCOS patient/When you were just hoping for one.”
Here I am, desperately hoping that when I’m finally able to try Letrozole, I will have at least one “follie that could,” and you’re having to wait because your ovaries are overachievers. Life sucks.
Damn it, that sucks. I hope that you’re able to convert to IVF. Fuck.
Just found your blog. Nice work.
I’m jealous of your ovarian abundance, quite frankly.
The best I can do is two lously follicles on Clomid. Lining 7mm. Yawn.
Geez, if it was me and a cycle like yours (loads of follicles) got canned I’d root with my husband like there was no tomorrow and sort out any mutliples after the fact.