Infertility

How to Proceed? - IUI with 10 follicles

Hello everyone!  I wrote about this in the February IUI thread, but I wanted to see if I can get some input from the wider community here regarding my current situation.  In short, I've been taking 125 iu of follistim since CD 3, and I went to the RE yesterday for an ultrasound (on CD 7).  I found out that I have 10 growing follicles between 10-14mm.  6 in my left ovary, and 4 in my right.  The doctors at my clinic decided to consult with one another before telling me how to proceed.  My RE decided to keep me on 125 iu on CD 7 and 8, adding in ganirelix injections both nights so I don't ovulate early.  I go back tomorrow morning for another ultrasound to see how things are going.  I'm worried my RE might decide to cancel my IUI, but I really don't want to.  We are diagnosed with MFI and the chances of success with IUI are only 10-12% according to my RE.  That makes me want to go for it, as I feel our chances of fertilization of even one egg are pretty low.  Any advice, stories, or suggestions?  Thank you!!
***BFP & Child Warning***

Me: 34, DH: 38 ~ TTC since 2014
IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs
IVF ER (July 2016) = 7 PGS normal embryos
FET #1 (Sept 2016) = BFP! DD born 5/30/17
FET #2 (April 2019) = BFN
FET #3 (July 2019) = BFP! DS born 3/27/20

Re: How to Proceed? - IUI with 10 follicles

  • Our clinic would not even trigger us if we had 4 or more follicles that were ready to go. They said that the risk is so high with multiples that they won't risk it. I'm not sure how yours will differ, and there may be some that don't fully develop past where they are now, so you'll be in good shape come trigger time.

    FX for you! Sorry I can't be more helpful!

    ---Trigger warning---

    Me: 31 DH: 27
    TTC since April 2013
    Two cancelled IUIs in Aug and Sept '15 due to low motility/count
    IVF round 1: January 2016
    ER: February 17, 2016; 9 retrieved, 7 mature, 7 fertilized
    Day 5 Blastocysts: 5 BB, 1 AB, all normal from PGS
    FET date: May 11, '16; transferred 1 AB embryo
    First beta: May 23, '16: 998!!  Second: May 25, '16: 1648
    EDD: January 27, 2017
    BabyFruit Ticker
  • @wifeinraleigh28 do they think that they will all mature ? I have pcos and i have lots and lots of 10-11 mm follicles but they never grow. I hope you get only few numbers of mature follies and continue for iui, and the rest would stay behind. I am sorry for the confusion during your cycle and i hope you make the right decision for yourself. Sorry i couldnt be very helpful but just wanted to show support :)
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  • I agree with @ZoeFer do they think they will all mature?  It would seem unlikely, but I guess it's possible.  I would probably move forward also, but I also think of the stories we have seen on here of people getting pregnant with quads.

    Good luck!
  • This is a hard thing to bring up, but this is really the point of the decision you're facing:

    How do you feel about selective reduction?

    It's a very personal decision, and I don't have any judgment about the choices anyone makes.  But the risk you face is a high-level multiple pregnancy, where you either choose selective reduction or you choose to try to carry, facing a very high risk of loss, as well as a risk of severe disabilities.  There are no good choices there.  (I'm as pro-choice as they come so I don't mean to say it's a bad choice, but for someone struggling to TTC, to face selective reduction, it has got to be incredibly difficult.) 

    I had an IVF convert to IUI for poor response, but I had about 4-5 possible follicles.  I went for it, thinking that I'd be okay with selective reduction.  But then I was really, really scared of it-- it made for a very rough TWW, and the BFN was not the worst thing that could have happened.

    So I don't mean to be all scary-- it's not the thing that's the most likely to happen.  But since that's the risk, the reason you might choose not to do it, take some time to really think about what would happen.

    I'm sorry things aren't going as you expected.
    Me- 39 (turning 40 in April), TTC for the first time ever (since Jan 2015), low ovarian reserve
    Married 3/14/14 to my wonderful wife, but her sperm count is rather low
    TTC with frozen donor sperm and science

    7 IUIs, 7 BFNs.
    2 IVF attempts, both cancelled and converted to IUI, both BFNs.
    Decided that my tired old ovaries are ready to retire.
    Next step- reciprocal IVF, using my wife's eggs, my uterus!  
    fresh 5 day transfer (2 embryos) 4/17/17- BFP! 
    Identical twins "due" 1/2/17 (but anticipated arrival sometime December)

  • Thank you for responding everyone! @dragonfaerie @ZoeFer @smdrodgers

    I know there is always a concern about multiples, but my husband's sperm is not normal. I feel hopeless that even 1 will fertilize even with so many follies. I have no idea what to expect in terms of growth though. During my last IUI when I was on the exact same medication (follistim 125 iu) I only had 4 above 10 mm at this point and they all matured. The IUI was still unsuccessful though. We have made improvements in sperm count since then but my RE says our chances are still low.
    ***BFP & Child Warning***

    Me: 34, DH: 38 ~ TTC since 2014
    IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs
    IVF ER (July 2016) = 7 PGS normal embryos
    FET #1 (Sept 2016) = BFP! DD born 5/30/17
    FET #2 (April 2019) = BFN
    FET #3 (July 2019) = BFP! DS born 3/27/20
  • @KLake42 - I appreciate what you wrote.  I think right now it's easy for me to say I'd be okay with selective reduction, but I know it's the type of thing that will probably be much more difficult when facing it head on.  And it also doesn't sound like something I'd want to put my body through either.  If my husband's sperm was normal though it would be a much higher risk.  At it stands right now though, it seems like we have a better chance at winning the lottery than having more than 1 egg fertilize.  I know I'm being dramatic, but our odds aren't good.  I really don't know what to do, but I appreciate the input you all have made.
    ***BFP & Child Warning***

    Me: 34, DH: 38 ~ TTC since 2014
    IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs
    IVF ER (July 2016) = 7 PGS normal embryos
    FET #1 (Sept 2016) = BFP! DD born 5/30/17
    FET #2 (April 2019) = BFN
    FET #3 (July 2019) = BFP! DS born 3/27/20
  • I say go for it!! I had 5 mature at one point and wound up with an ectopic. So it sort of worked but not really. My Re wanted to cancel my IUI twice because of high number of follicles. I said no and glad I did because it didn't work anyway. At the same time it COULD work. I thought I was ok with selective reduction first but then my RE told me how and when they do it and now I'm not so sure I could go through with it. Selective reduction sounds easy and I wish it was for me. 
  • What is the MFI? If it's severe enough I would probably go ahead with the IUI. We have MFI- morphology, but we went straight to IVF. Definitely talk it out with your doctor. It's really important to trust them on this. Best of luck hun!
  • greengypsygreengypsy member
    edited February 2016
    hello, back in sept/oct i had a similar situation. 1st attempt at our 3rd iui was canceled bec follis stopped growing so they increased my meds for 2nd attempt. i ended up over stim & like you, developed many follis early. my re would not go thru w iui so we either cancelled again, convert to ivf or i could have follicles aspirated (pretty much same process as egg retrieval in ivf except your completely awake, it was so painful!) we didnt want to cancel again bec the cost of cancellation at that point was almost same as going thru w iui. that cycle was BFN. i have recently read that if follis mature to early & you trigger early (for me it was cd9) the egg quality is most likely low. looking back, i wish my re would have let us go thru w iui as normal but i dont know if i could do selective reduction if it did work & was multiples. but we have been ttc for 4 yrs, never pregnant & low morph (& possible pcos) so i felt like our chances of conceiving was low even with alot of follis. good luck to you! almost forgot to mention, i got mild ohss after trigger & my re's office said they had never seen that happen in an iui cycle : / 
  • I would wait and see. There's always a chance that many of them won't mature. I always have over 20 follies and only get 1-3 mature and 1 is usually the most mature/largest. 

    Me: Endo, PCOS, septated uterus (mostly removed)

    DH: perfect

    Started TTC in June 2011

    Baby boy born 3/17/2014

  • edited February 2016
    @Drove2u - I didn't know you had an eptopic :cry: Sorry you went through that! And I agree with you, I had 4 mature follies last time and BFN. I want better chances!

    @akcrowe - His latest SA on 1/28 was 43 million, 35% motility, 4.5% morphology. RE said we have 10-12% chance of success with IUI with those results. What made you decide to go straight to IVF? I've heard mixed things about morphology.

    @greengypsy - I had no idea that triggering early could result in poor egg quality! I think I'll ask about that at my appointment tomorrow. Last IUI I was triggered on CD 9 and IUI was on CD 11. I thought that was pretty early but I never questioned anything.

    @EML2011 - I sure hope you're right! I will find out more tomorrow 
    ***BFP & Child Warning***

    Me: 34, DH: 38 ~ TTC since 2014
    IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs
    IVF ER (July 2016) = 7 PGS normal embryos
    FET #1 (Sept 2016) = BFP! DD born 5/30/17
    FET #2 (April 2019) = BFN
    FET #3 (July 2019) = BFP! DS born 3/27/20
  • @wifeinraleigh28I'm wondering if converting to IVF is a possibility at this point. If I were in your shoes, I would definitely inquire about that.
    *******
    Married Jan. 2014
    Me:36 DH: 39
    TTC since August 2014, Mild PCOS + uterine fibroids
    Myomectomy June 2015- 18 fibroids removed
    IVF #1, May 2016 = 32 eggs retrieved, 12 fertilized, 7 frozen, 3 PGS normal
    FET#2, July 2016 = one embryo transferred 
    TRIGGER
    BFP! Beta = 617
    Due date = 4/9/17
    Delivery date = 3/20/17
  • edited February 2016
    I just had my ultrasound... I have 2 mature follies and 4 measuring 14 mm.  My doctor is having me trigger tonight for IUI on Saturday morning.  I guess there's a possibility that some or all of the 14 mm follies could mature by then?  My doctor said he feels comfortable doing the IUI but he wouldn't want to wait longer than Saturday to do it or I could end up with too many, even though Saturday is only CD 11.

    @cmm012 - We don't have any IVF coverage but we get a total of 3 IUIs covered.  This is IUI #2.  I'm hesitant to move to IVF before trying our chances with our covered IUIs first!  But I totally understand your logic.  My RE even said today that I'm a great candidate for IVF because I respond so well to the meds, and he said my lining is absolutely perfect.  He said that since MFI is our only issue, IVF has a high chance of working for us.
    ***BFP & Child Warning***

    Me: 34, DH: 38 ~ TTC since 2014
    IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs
    IVF ER (July 2016) = 7 PGS normal embryos
    FET #1 (Sept 2016) = BFP! DD born 5/30/17
    FET #2 (April 2019) = BFN
    FET #3 (July 2019) = BFP! DS born 3/27/20
  • Best of luck @wifeinraleigh28 with your IUI!!
    I cannot believe you are having an IUI already, we were testing together just last week :) 
  • @ZoeFer - I know! It's a little concerning for me that we're doing it so soon... my baseline was just last Friday! But I understand why my RE is triggering me already. Funny how my TWW will be about twice as long as my wait for the IUI was. I'm keeping my fingers crossed for some good sperm now! Thank you for the support! :smiley: 
    ***BFP & Child Warning***

    Me: 34, DH: 38 ~ TTC since 2014
    IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs
    IVF ER (July 2016) = 7 PGS normal embryos
    FET #1 (Sept 2016) = BFP! DD born 5/30/17
    FET #2 (April 2019) = BFN
    FET #3 (July 2019) = BFP! DS born 3/27/20
  • I think it is great, I always have to wait and wait and wait  so I would love to have an IUI this week. I have just started my Letrozole yesterday, we ll try another TI cycle.
    I hope it does not sound too superstitious but I have very good feelings about you. I will be checking for your results. Best of luck !!!!
  • Thank you, @ZoeFer!  I'm definitely feeling better about this cycle than I did about previous cycles.  Definitely hopeful!  Are you still doing monitoring/ultrasounds with your TI cycles?  Hopefully that's all you need and it's just a matter of time before it's successful! :)
    ***BFP & Child Warning***

    Me: 34, DH: 38 ~ TTC since 2014
    IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs
    IVF ER (July 2016) = 7 PGS normal embryos
    FET #1 (Sept 2016) = BFP! DD born 5/30/17
    FET #2 (April 2019) = BFN
    FET #3 (July 2019) = BFP! DS born 3/27/20
  • I'm a bit surprised that with MFI you're RE even suggested trying IUI. I thought MFI was always automatic IVF.
    About us:
    Me - 28, Lean PCOS
    DH - 31
    Married June 2010, TTC since March 2014
    Blog: ourbinarystar.com

    FET cycle #3 Transfer July 28th 2016, Triplets born healthy on February 26th 2017 at 33w1d!

  • edited February 2016
    @AandDM2014 - It depends on the MFI and how severe it is.  IUI has a lower chance of success if you have MFI but it is still often tried first before IVF.  My RE told us the bare minimum for IUI is 1 million motile sperm.  If you have less than that they won't do it.  I've actually connected with quite a few ladies on these forums who also have MFI diagnoses and a few had success with IUI and moved on from here!  It gives me hope!
    ***BFP & Child Warning***

    Me: 34, DH: 38 ~ TTC since 2014
    IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs
    IVF ER (July 2016) = 7 PGS normal embryos
    FET #1 (Sept 2016) = BFP! DD born 5/30/17
    FET #2 (April 2019) = BFN
    FET #3 (July 2019) = BFP! DS born 3/27/20
  • @wifeinraleigh28 - I know you are set for IUI, but just a thought for you and anyone else reading this. My last cycle started as an IUI with high doses of follistim and menopur, when I got to the 9th day of stims my RE decided we were switching to IVF because there were so many mature follies. The good news there - insurance has already paid a lot of the monitoring fees, meds, etc and the clinic charged a significantly reduced rate for the IVF! We don't have IVF coverage so it helped us a lot! Unfortunately, we transferred all 3 embies and it resulted in a chemical :( Good luck this weekend!
  • @amos1417 Wow, that's actually a really good point since all my meds and monitoring had been covered until that point, so I guess it wouldn't be quite as hard of a hit.  I'm sorry about your CP! :(  Are you doing another round of IVF?
    ***BFP & Child Warning***

    Me: 34, DH: 38 ~ TTC since 2014
    IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs
    IVF ER (July 2016) = 7 PGS normal embryos
    FET #1 (Sept 2016) = BFP! DD born 5/30/17
    FET #2 (April 2019) = BFN
    FET #3 (July 2019) = BFP! DS born 3/27/20
  • Thanks. It was my second chemical since starting fertility treatments :( Yes, we are going to do another round of IVF. It will be OOP though because insurance won't cover it. It'll be in April. I was diagnosed with PCOS which is apparently affecting my egg quality. I have been on a gluten free diet, reducing as many chemicals as I can (organic foods, natural shampoo/conditioner, cleaning with essential oils, homemade body wash, etc), exercising more often, metformin, and taking a whole bunch of vitamins and supplements. I started most of that at the beginning of January and they say it takes about 3 months to work. I wanted to have my period 3 times before starting IVF again. In the mean time, we are hoping and praying for a natural miracle! I have one more refill of letrozole, so we ware going to try that next month on an unmonitored cycle.
  • @amos1417 - Not a bad idea to take a few months off in between... it's good for your body!  Best of luck to you!
    ***BFP & Child Warning***

    Me: 34, DH: 38 ~ TTC since 2014
    IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs
    IVF ER (July 2016) = 7 PGS normal embryos
    FET #1 (Sept 2016) = BFP! DD born 5/30/17
    FET #2 (April 2019) = BFN
    FET #3 (July 2019) = BFP! DS born 3/27/20
  • @amos1417 I'm so sorry for your losses. Does your RE know you are planning on doing an unmonitored cycle? That can be very dangerous and could actually result in loss of fertility. Please do your research and speak to your dr before continuing just because you have a refill on your Rx. 

    Me: Endo, PCOS, septated uterus (mostly removed)

    DH: perfect

    Started TTC in June 2011

    Baby boy born 3/17/2014

  • @EML2011 Yes, they know. It's just for one cycle to try before our last round of IVF. I have heard of other women that are given either clomid or letrozole to try without an IUI or monitoring. Thanks for checking :)
  • @amos1417 I am also doing an unmonitored letrozole cycle. I did few monitored cycles before and now my insurance does not cover fertility this month so my doctor was okay with two unmonitored cycles until I get IUI coverage. Best of luck to you !
  • just lurking here @wifeinraleigh28 - congrats on the IUI and fx for you in this 2ww. I hope all works out for you. Keep us posted. You're in my thoughts. 
    ---
    Started TTC April 2011
    Me: 32, DH: 32
    Diagnosis: Endometriosis

    • 2012 - 3 Rounds clomid - all BFN
    • 2013 - 1 Fresh IVF with 2 day 3 embryos - BFN
    • 2014 - 1 Frozen IVF with 2 day 5 embryos - BFN
    • Took a long break, continuing trying naturally
    • Feb 2016 - Biopsy = Endo, DH sperm improved from 1% to 6% morphology
    • March 2016 - Fresh IVF cycle with acupuncture & intralipids: 20 eggs retrieved (17 mature), 7 ICSI'd fertilized, 9 naturally fertilized. 16 total embryos!
    • April 8th - 2 embryos (1ICSI and 1 Natural) transferred. (7 blastocysts frozen), April 18th - Beta = BFN
    • Sept 23rd - Lupron Depot Injection for Endo control
    • Nov 15th 2016 - Started daily Lupron Injections for upcoming FET
    • Nov 22 - Baseline US/BW - Intralipid Infusion - Start Meds for FET with immune protocol
    • Dec 16th FET transfer of 3 embryos (1 - AA, 2 - BB)
    • TW below
    • Dec 22nd - first ever bfp (very faint lines FRER & cheapie)
    • Dec 27th Beta = 192, Dec 29th Beta = 379
    • EDD - Sept 5th 2017

    - - -
    I'm a YouTube vlogger who talks about Infertility, IVF and Endometriosis. Check it out here!
    Follow along at http://liv4today.blog
    Instagram @liv4todayvlog 


  • Thank you @oxinfree.  I'm not expecting a BFP but of course I'm hoping for one :)
    ***BFP & Child Warning***

    Me: 34, DH: 38 ~ TTC since 2014
    IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs
    IVF ER (July 2016) = 7 PGS normal embryos
    FET #1 (Sept 2016) = BFP! DD born 5/30/17
    FET #2 (April 2019) = BFN
    FET #3 (July 2019) = BFP! DS born 3/27/20
  • Thanks @ZoeFer! Good luck to you too!
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