IUI Follicle size question

poohniki

Hi ladies!

I intro'd back in December when I did my first IUI but I am usually over on the IF board. I am now attempting IUI #2 and I have a question- or maybe I'm just looking for some feedback. I went in today for baseline- CD3 and I have 2 follicles at 13mm and a little over 14mm. My RE says not to take the meds and to come back in 2 days.

I am really bummed out because I wanted to see how I responded to a medicated cycle. Also, I have many autoimmune issues and I have been working with a reproductive immunologist.. and since the timing would be so off if I continue this cycle, I have no idea how any of this works. And my lining is only a 2 right now. 

Should there be a minimum lining for an IUI? Does anyone else have any experience with early follicles (definitely not cysts)? or change from medicated to a natural cycle?

I have a super rare egg issue that only shows up when stimulated with meds- which is why we are doing IUI and not IVF- the med dose is much, much lower.  Right now I'm torn about what I even want to happen because I know these dymorphisms never show up in natural cycles..

Thanks in advance

jessimi06

I don't have any experience with having follies so early/going from a medicated to unmedicated cycle, but I hope it's a good sign and everything works out!

As far as lining goes, 9+ is optimal for my RE, but 7mm is the minimum they like to see. You still have time in your cycle to build up your lining, so I wouldn't worry about it right now.

Good luck!

poohniki

Thanks, but I trigger at 17mm / 18mm since  anything bigger was found to be expanded in my ERs. So I don't think I have too much time.

Pintobean39

This may be a stupid question but what's the difference in a cyst and a follicle that early in a cycle? They look the same to me on the us and everytime to me it looked like I had a follicle at cd2-4 they said they were cyst and made me wait. I've never thought to ask what's the difference.

jessimi06

Your RE can give you estrace to help thicken your lining, if needed. Maybe you can ask them about it? The e2 your follies pump out as they mature should help- mine went up 4mm in two days (before my e2 crashed this cycle). Sorry I couldn't be more help though!

poohniki

@jessimi06 - Unfortunately I have to be suppressed on Estrogen to prevent the SER aggregates (my egg disorder). I know I'm complicated.

@pintobean39 - They said by looking at my estrogen levels they can tell that they are growing and I believe cysts typically remain the same size throughout the cycle. (I could be wrong)

Pintobean39

poohniki said:

@jessimi06 - Unfortunately I have to be suppressed on Estrogen to prevent the SER aggregates (my egg disorder). I know I'm complicated.

@pintobean39 - They said by looking at my estrogen levels they can tell that they are growing and I believe cysts typically remain the same size throughout the cycle. (I could be wrong)

What I've been told is as long as your estrogen is low it's fine to continue cycling. From my understanding some cyst do continue to grow and some don't. Example: this past cycle I had an us after being on bcp for 3 weeks and had a follicle that was 19mm which they said was a cyst. My RE said he wanted to look at it in a few days and if it was the same size or smaller he'd continue but if it was bigger than we would cancel. I asked if maybe I just had a period it would go away he said if it was still growing I might not even have a period. A few months back cd2 us showed two follicles 30mm and 20mm that they said was a cyst and so I had to take bcp for 2 weeks to shrink them.

I'm like @CaterinaC‌ I've never had blood work on cd3 to tell me if I can cycle. I do get blood work but they tell me if I can cycle as soon as they see the us. They can tell by the size of my follicles at cd3 if I can cycle or not. The us tech told me once the resting follicles look different than the cyst and they are much smaller. My us tech is awesome at explaining step by step exactly what she's seeing and why and what it means. I'm also like a 2 yr old asking "but why" all the time and "because I said so" doesn't get it.

Lillovebug79

I have a history of functional cysts (before TTC). My GYN did early cycle monitoring to see if they were still there and if they were shrinking or growing. He explained to me that they do early cycle monitoring (before day 4) because a large follicle AF that point is more than likely a cyst. It makes sense because 3-4 days wouldn't usually be long enough to grow a 12+ follicle.

I think that lining grows about 1 mm per day. My RE wants to see at least 8mm by trigger but more importantly she wants to see a "triple stripe" on the scan. Although I don't know if she would trigger without that because I've always had 10+ lining and a triple stripe prior to trigger.

poohniki

Thanks. At my clinic only REs do u/s so I trust what they are saying and my E2 is high. This is the 3rd time I've had measurable follicles at baseline. But once it was a natural ivf and I triggered cd8. Last time it was a natural iui and triggered cd9. I know from the natural ivf that the follicle was mature at that point and great quality because it went on to a decent grade blastocyst.

BunnyBerry

On my CD2 last month the nurse told me the lining is supposed to be "really, really thin" at that time of the cycle. I don't know what that means in terms of mm's but it looked like a hairthin white line and she said it was good?

Good luck, I hope the 2 follies resolve so you can continue your cycle!

Also, looking at your siggy here...does your doctor think you might be a candidate for mini-IVF?

poohniki

My lining is 2mm, which is right where it should be- but no where near the 6+ they wanted for FET. 

I am not sure about mini-ivf since it would be the same cost as regular IVF for me and I am dx'd DOR. Last time on the highest dosage possible I only got 9 eggs.. With other high dose protocols I've had 4 or 6 eggs.

That's kind of why I was focused on IUI- since why pay that price for 2 or 3 eggs? I have been looking at Donor eggs for the past year, but I don't think I've tried everything yet to make that jump.

poohniki

Just an update:

I'm cancelled this cycle. I still have my period, my lining is 2.6mm and I am ovulating in the next 24 hours based on my scans/blood work. 

We are hoping my timing of the ovaries and uterus line up better next month. Maybe then I can finally start my medicated cycle.

FX for you ladies!