Overstim on 50 iu Follistim?

mdtokar

Hi all, This is my first time posting. I just don't know where to turn and have been googling like crazy the last day (which just scares me even more). A little background- I was diagnosed with hypothalamic amenorrhea after not getting my periods back after stopping BCP. I did ovulate once and got pregnant but sadly ended in MC. Clomid did nothing for me, which RE figured but we tried it anyway. Since the beginning, RE has been very positive about me doing injectables and having success with just timed intercourse. After what seemed like forever, we got the okay to start provera, bring on a period, and start Follistim. I got tested for AMH which was great (nice and high) and went for all the instruction on Follistim with the usual warnings of ovarian hyperstim and having to cancel a cycle (though the NP doing my training said that didn't happen very often and they'd be monitoring me closely).

So all is good and then I go for my baseline US a few days ago and I (I can't remember which), either 25-35 little follicles. So I go see the NP who reviews the US with me and she says that it's great that I have so many follicles (yay!) BUT (of course) it puts me at high risk for overstimulating and having to cancel the cycle. Then she just freaked me out (because I've never thought of it- the RE was so optimistic with us about just the meds and timed intercourse) and said I'd be the perfect candidate for IVF (because I have so many follicles) and it'd be something to consider at some point. So of course all I heard was "cancel cycle, IVF." She did say that they'd go very slow and low with dose with me and monitor me very closely and that everyone's body responds different to the meds so they'll just wait and see. Called me that night and said the RE wanted me to start 50 iu for next 3 days (I'm on night 2) and then US Monday.

Anyways I was hoping for some feedback and stories of experience (could use positive ones!) with having lots of follicles at baseline and not overstiming. Could I really overstim on 50 iu (though they may change it as we go...)?

Thank you so much!

przemosbabe

It depends on how sensitive you are to the meds. If you over stim all they have to do is coast you or trigger you with lupron. You should ask about that if you are concerned.

MagicMikki

50iu of Follistim sounds like a relatively low dose, but I am speaking from my own personal experience, so please take my experience with a grain of salt!

We're still going through IUI cycles and have not yet converted to IVF. For my first cycle, I started with 24 follies, which is normal. I was prescribed 150iu for 3 days, to which 3 follies started to respond, then dropped to 125iu for remaining 9 days, 12 total days of stim. I got one follicle out of the deal (frustrating). The next cycle, I maintained 150iu (Bravelle) for 11 days, to which 3 follicles responded.

So, as PP said, it really does depend on how sensitive you are to the meds. Some people will overstim with a little, others may not get one out of a high dose.

That being said, it was totally my understanding that most women start with a ton of small follicles under 10mm. My last 3 IUI cycles have started with 24, 22, and 25 follicles. Again, this is my experience so I can't speak for anyone else! But, the information I've been provided by my clinic had me assuming all this was completely normal. It seems odd that your RE is concerned with overstimming on 50iu, but then again, there might be something regarding your treatment plan that has them thinking this way.

Good luck! :-)

przemosbabe

I personally have made 35 eggs on 100 IU of follistim for 3 days, then 75 IU for the following 3 days. This was for an IUI February 2014. That IUI was canceled of course. You can definitely overstimulate on 50iu depending on how sensitive your ovaries are to the meds.