Monday, November 26, 2007

How many follicles is too many?

I met with my RE today to go over our next move. I was wary of this conversation, since the fact she wanted to meet with me at all suggested she was hesitant about the course we've been taking, but I wanted to hear her out.

First, she mentioned her concern that I'm really sensitive to the Follistim--giving me 75 IU gives a big response, and dropping just to 50 IU really slows down the progress of the follicles (and subsequently my estrogen levels).

Next she brought up the increased risk of multiples, and how I might be particularly prone to this, since I had so many follicles last cycle. My RE seems very concerned that with that many follicles, I could conceive triplets or quadruplets, and then face the dilemma over whether to do selective reduction. In the last cycle, I had one follicle that was around 18 mm, and three that were 13-14 mm. From what I've read, this really isn't that many. It sounds like it's pretty common to do IUI with 3-4 mature follicles, to increase the chances of success. Am I wrong about that? Is she just being really conservative?

She once again brought up the option of going straight to IVF. I explained my reasons why I'm not ready to try that yet: that I don't have any IVF coverage, so we would pay for all of it out of pocket, and that I'm not ready to play my last cards yet. She seemed to understand that, and gave me the go-ahead to start another Follistim cycle tonight. We agreed that we would try as many as six Follistim/IUI cycles before moving on to IVF.

We're going to do the same dosage that we did for the last cycle: 75 IU for three days, then dropping to 50 IU. I'll go in for an ultrasound and bloodwork on Friday morning, after four days of dosing.

57 comments:

nancy said...

All I can say is my RE cancels cycles with 3 or more follicles. I'm only allowed for an IUI when there are only 2 (or 1) mature follies.

Good luck with the drugs this time!

Nulligravida said...

Nancy, that's interesting. What does your RE consider to be a mature follicle? Greater than 18 mm at the last ultrasound before IUI?

I guess I could understand if I had 3-4 that were at 18 mm or above, but last time I had one >18 and the rest were 13-14 mm.

nancy said...

You know, I've never asked what he considers "mature" in the aspect of cancelling. I know what mature means in the aspect of triggering, but not in a cancellation sort of way. I'll try to ask next time, but I can tell you that you'll be in the office before me.

Anonymous said...

Nancy, what was the outcome? I too just got stimulated with one follicle at 19.6mm and the remaining 3 follicles between 13.8-14.9mm. My doc said anything under 18 is considered "borderline". He said it isn't likely that 13mm-18mm is mature enough, but because it is considered "borderline" I should prepare myself for the possibility of multiples. He said if all 4 were over 18mm he wouldn't let me continue, but because 3 were considered "borderline" we went forward. Now I just wait for the pregnancy test and cross my fingers there aren't more than 2.

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This is great info to know.

Anonymous said...

Does anyone know how much the follicles can grow in a day? I guess I am wondering because I had one 10 mm on one side and two 12mm and two 14mm on the other side... totaling five, but maybe only the two 14mm will mature enough by next Wednesday... ??? Any feedback would be helpful! Thank you... baby dust to all!

Anonymous said...

I am with the above comment. DOes anyone know how fast they grow. I have four follicles (1 x 16mm and 3 x 13-14mm). As it is only day 9 the Dr thought this was a really good result but an increased chance of multiple birth.

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