TTC after 35

Just got an US done, a little pissed and need advice!

Just got done with my follicular US. One big cyst (she said probably left over from last cycle) and a 19mm follie right next to it. My regular RE was out today, so an ARNP I haven't met before did my US. She said this 19mm wasn't big enough to trigger and I asked how big do you like them to be and her answer was 22mm. Then I told her my other RE has been triggering me when my follies have been 18-20. I've never waited for my follies to be 22 to trigger. Now I am questioning if they have been triggering me too early. I've done a lot of reading beforehand and read some REs don't trigger until they're about this size and others wait until they are atleast 18mm. I also told her I wanted to do the IUI 36 post trigger since I didn't have much success with the 24hr protocol. She said she would consult with another doctor at another clinic and will have an answer for me this afternoon, whether or not I should trigger today or wait. The problem is if I don't trigger by tonight this IUI cycle will be a bust because we leave for Hawaii on Monday morning.

If she calls back and says trigger tonight, should I do it even when she said she doesn't trigger until 22mm and my follicle was 19mm. This follicle next to this 40mm cyst looked a little funny to me too. It was not round like I'm used to seeing on US, it was more oblong shaped, I'm guessing because it was sitting right next to the cyst. I'm not really feeling warm and fuzzy about this cycle because this new gal put doubt into my head. Ugh!!! Why don't these providers use the same protocols especially if they are in the same clinic!
Me: 37 DH: 37, married since Sept. 2013. "actively" TTC for a total of 13 months (after 7 months of TTC, took a 1 1/2 year hiatus due to work scheduling and wedding planning. Started up again after our wedding in Sept.) First evaluation by an RE November 2013

HSG-normal
OH-tiny polyp found, but RE assured me she doesn't think it's contributing to infertility and doesn't recommend me to remove it because it's so small.
DH's SA-normal
Hormones all within normal levels
Ovarian Reserve-RE says "is great" she's not concerned about my egg quantity (which I was until I saw her and results came back good!) 

04/2012 50mg Clomid=BFN (prescribed by OBGYN, not monitored)
06/2012 50mg Clomid=BFN (prescribed by OBGYN, not monitored)
11/2013 100mg Clomid, with HCG trigger=BFN (prescribed by RE, monitored with US (2 dominant follicles) and baseline bloodwork done)
01/2014 100mg Clomid, with HCG trigger-(prescribed by RE, monitored with US-1 dominant follicle)=BFN
06/2014 7.5mg Letrozole, HCG trigger (prescribed by RE, monitored with US-2 dominant follicles), IUI #1 on 7/3/14=BFN
07/2014 7.5mg Letrozole, benched for IUI#2 this cycle, because I ovulated on my own before my follicular US. Progesterone suppositories=BFN Diagnosed with PCOS this month too. Testosterone levels high at 76. =( 
08/2014 7.5mg Letrozole, HCG trigger with 19mm follicle. IUI#2 on 8/31 cancelled last minute due to family emergency. 
09/2014 Taking a 3 month break starting this month. If not pregnant in 3 months, will start up again with medicated cycles and IUIs. Had all my labs and AFC re-evaluated this month also. RE says nothing much has changed since my eval last November, okay for me to take a little break. =) 




Re: Just got an US done, a little pissed and need advice!

  • Hmm, I don't have much advice, except I did a trigger this past month and I had one maturing follicle and I am 99% sure I remember her saying it was 19mm and she went ahead and gave me the trigger. It worked and I got my BFP this cycle. 
    BabyFruit Ticker
    Me: 37 DH: 38 
    BFP #1 3/17/11 - DS born 12/4/11
    TFAS Dec 2013
    BFP #2 - 3/23/14 - CP 3/26/14
    BFP #3 - 8/20/14 - Natural Miscarriage 9/22/14
    BFP #4 - 1/28/15 - DS2 born 10/13/15
    Surprise BFP# 5 - 9/2/16 - Due 5/13/17

  • Awesome @katie0919‌ ! Congrats! Did you do IUI too or TI?
    Me: 37 DH: 37, married since Sept. 2013. "actively" TTC for a total of 13 months (after 7 months of TTC, took a 1 1/2 year hiatus due to work scheduling and wedding planning. Started up again after our wedding in Sept.) First evaluation by an RE November 2013

    HSG-normal
    OH-tiny polyp found, but RE assured me she doesn't think it's contributing to infertility and doesn't recommend me to remove it because it's so small.
    DH's SA-normal
    Hormones all within normal levels
    Ovarian Reserve-RE says "is great" she's not concerned about my egg quantity (which I was until I saw her and results came back good!) 

    04/2012 50mg Clomid=BFN (prescribed by OBGYN, not monitored)
    06/2012 50mg Clomid=BFN (prescribed by OBGYN, not monitored)
    11/2013 100mg Clomid, with HCG trigger=BFN (prescribed by RE, monitored with US (2 dominant follicles) and baseline bloodwork done)
    01/2014 100mg Clomid, with HCG trigger-(prescribed by RE, monitored with US-1 dominant follicle)=BFN
    06/2014 7.5mg Letrozole, HCG trigger (prescribed by RE, monitored with US-2 dominant follicles), IUI #1 on 7/3/14=BFN
    07/2014 7.5mg Letrozole, benched for IUI#2 this cycle, because I ovulated on my own before my follicular US. Progesterone suppositories=BFN Diagnosed with PCOS this month too. Testosterone levels high at 76. =( 
    08/2014 7.5mg Letrozole, HCG trigger with 19mm follicle. IUI#2 on 8/31 cancelled last minute due to family emergency. 
    09/2014 Taking a 3 month break starting this month. If not pregnant in 3 months, will start up again with medicated cycles and IUIs. Had all my labs and AFC re-evaluated this month also. RE says nothing much has changed since my eval last November, okay for me to take a little break. =) 




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  • MARISAV77! We did TI. :) I had the trigger on 8/7. We had DTD on the night of 8/6 so she told me to wait one night, then to have sex on 8/8 and 8/9. I followed doc's orders!
    BabyFruit Ticker
    Me: 37 DH: 38 
    BFP #1 3/17/11 - DS born 12/4/11
    TFAS Dec 2013
    BFP #2 - 3/23/14 - CP 3/26/14
    BFP #3 - 8/20/14 - Natural Miscarriage 9/22/14
    BFP #4 - 1/28/15 - DS2 born 10/13/15
    Surprise BFP# 5 - 9/2/16 - Due 5/13/17

  • I have heard 18-20 is the norm. Not sure why she told you 22. 
    I don't have any first hand experience, but have friends that got pg when theirs were in the 18-20 range.

    GL!
  • Sorry I don't have any advise. But I would go for it because you will be vacationing on Monday. Go for it, good luck
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