Follistim Dosing/ Response/ Monitoring question *loss mentioned*

Marissa6609

My apologies in advance - this is a long post. I am not sure if I officially intro'd on this board yet either, so I will post that separately  

Last cycle (medicated IUI) I was on 225 IU follistim and by my first monitoring appt (4 days of stims complete) I had 5 follicles between 10-12mm and 4 between 8-10mm, with other smaller ones. At this point I started Ganirelix and things progressed well, triggering with two lead follicles (ended in ectopic).  

This cycle (IVF) I started on 300 IU follistim (Monday). Today was my first monitoring appt (4 days of stims complete) and I had 4 follicles between 8-10mm. Clearly I am responding differently to the follistim this time around. Is this normal? Is my body used to Follistim from only one previous cycle? For this cycle, I am also on low dose HCG, would that impact my response? 

Separate question, but related- My dr increased my follistim dose to 450 IUs. I do not have another monitoring apt until Tuesday morning (4 more nights of stims since todays monitoring appt) and he does not have me on ganirelix yet. I am concerned that with the increased dosage I may ovulate before Tuesday. Is this a reasonable concern? I want to trust his decisions, but I am somewhat concerned about the amount of time between appointments considering the increase in medicine.

I appreciate any thoughts/feedback, as right now I am somewhat worried about certain aspects of this cycle already, and I am still pretty early in the process.

przemosbabe

Are you on any other medications that could be affecting the way you respond to follisim? I am on metformin and I know that is affecting my response. A lot of ladies get few eggs when on metformin but you apparently get better quality. I had one IUI with 100IU of follistim and I had 35 follices. Obviously the cycle was cancled. Then my second Ivf with follistim I had 18 eggs ( I think it was 18). So for me the metformin is clearly making a difference, but I would of course rather have 18 good eggs than 35 crappy eggs. If I were you I would ask to be monitored sooner. I would be worried about premature ovulation too. Sometimes those eggs can grow very quickly especially with a high dose. My nurse told me that the meds only make the eggs that are already there grow more, although I personally did see an increase on numbers with every monitoring appointment my second Ivf cycle.

Marissa6609

Thanks for the info! My dr doesn't use menopor but I think the low dose hcg is in place of that (I could be wrong though). I am going to call this morning to see if I can get in for monitoring. The ganirelix just gives me piece of mind... Although I read it also slows egg growth.

kittenmittens9

I always responded quickly, and well, to gonal-f for my IUI's and then with my first IVF at a higher dose...I responded so slowly (11 days of stims I think).  No one knew why.  I didn't add menopur until several days in.  I used BCP at the beginning and I've always been sensitive to it so I wonder if that's what did it for me?  

you could always call and ask about the next monitoring appt.  Your blood work that they did at your first appointment matters too though in regards to ovulating too soon.  It doesn't hurt to call and ask.  Hopefully they can either fix it or give you piece of mind.  There's so much to worry about with these cycles and so much on the line.  GL!