Infertility

Antral Follicles

Hello ladies. Well my clomid cycle 100mg with metformin did not work. And my RE does not think clomid will work ever for me so we have to go over other options. One of which is IVF. My husband and I are not against it but want to try that as our vary last resort. I know from my blood work and ultrasounds my estrogen was in the 60's, and my lining looks great and I have about 20 antral follicles total between both ovaries. Now my question is have any of you had that many and tried injectables with a IUI? And if so did it work or make you over stimulate? What did you use for injections? I also thought about asking for ferema the other medication that can help to increase ovulation.  Thanks!
Married for 3 years
Me: 28 DH: 33
Together for a total of 6 years
Fur mommy to two rescue dogs
DX: PCOS and Insulin Resistance

History:
Irregular Cycles
2010: Laproscopy with Hystroscopy ablation. Tubes were clear.
1/5/2016 : DH sperm analysis is excellent.
February: Switched to a new RE
Two failed clomid rounds
March 2016: New HSG and found tubes are open
April 2016: Round one Letrozole 2.5 mg. Ultrasounds day 13 &16. No follicle grouth
May 2016: Had to take a month off
June 9th 2016: Started Letrozole again but at 5mg
July 5th: bfp beta 31
July 7th: Beta 97
July 9th: Beta 231
July 11th: Beta 500
July 13: Beta 1400
Beautiful son born 3/16/17 @ 1:38pm




Re: Antral Follicles

  • There are definitely other options before moving on to IVF. I'm assuming you have PCOS? I heard that many women respond better to Femara than Clomid (but then some don't). I've done Femara and TI (3 cycles), and moved on to Femara+ Follistim with IUI after a hysteroscopy anf laparoscopy (my issues were endo and uterus shape). I think the logic behind the combined cycles of oral and injectibles is that you start with the oral (CD3-7, followed by injectibles in my case from day 6), which will stimulate less follies than starting with injectibles right away. It's also supposed to help with egg quality, which is never a bad thing. 
  • Sorry, should have mentionned I had an antral follicule count somewhere between 20-25 on that combined cycle. Only one for sure made it to maturity, with possibly 2-3 more by the time I triggered and got the IUI. 
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  • I don't know how many antral follicles I have but with both my IUIs I did follistim injections only (125 iu CD 3-8), I ended up with a lot of growing follicles, but I was triggered at the point when just 2 reached maturity on CD 9.  My first IUI was unsuccessful and the 2nd was just today so I can't tell you yet if it is successful.  We are dealing with MFI though so our chances of success are lower anyway.  But I can tell you I certainly didn't overstimulate even with a lot of growing follicles!  At my ultrasound on CD 7 I had 10 follicles measuring between 10 and 14 mm.  On CD 9 I had 2 mature and 4 at 14 mm.
    ***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
  • Thank you ladies! I will be talking with my RE about those. It just stinks because at times I feel like he pushes ivf on me. 
    Married for 3 years
    Me: 28 DH: 33
    Together for a total of 6 years
    Fur mommy to two rescue dogs
    DX: PCOS and Insulin Resistance

    History:
    Irregular Cycles
    2010: Laproscopy with Hystroscopy ablation. Tubes were clear.
    1/5/2016 : DH sperm analysis is excellent.
    February: Switched to a new RE
    Two failed clomid rounds
    March 2016: New HSG and found tubes are open
    April 2016: Round one Letrozole 2.5 mg. Ultrasounds day 13 &16. No follicle grouth
    May 2016: Had to take a month off
    June 9th 2016: Started Letrozole again but at 5mg
    July 5th: bfp beta 31
    July 7th: Beta 97
    July 9th: Beta 231
    July 11th: Beta 500
    July 13: Beta 1400
    Beautiful son born 3/16/17 @ 1:38pm




  • I don't know how many antral follicles I had, but based on follicle counts during appointments, it was a lot. I ovulated on my own, but Clomid did nothing extra for me (1 follicle only on 100 + thinned lining). My doctor recommended injects. I took Gonal-F with ganirelix later to prevent LH surge and Pregnyl trigger. I got pregnant on my 3rd try. I did TI instead of IUI because of our great postcoital test results. The cycle of my BFP, I had 3-4 mature follicles. 
    Married to DH 10/6/12
    TTC since 5/14
    Unexplained with (controlled) hypothyroidism and suspected ovulatory dysfunction (but, I do ovulate on my own)
    Clomid 50 mg 3/15 (unmonitored) - BFN
    Clomid 50 mg + metformin 4/15 (unmonitored) - BFN 
    First RE appt. 5/15; Natural cycle 5/15 monitored with 2 mature follicles and Pregnyl Trigger (full dose) + prometrium - BFN
    6/15 HSG - clear tubes & normal uterus; great PCT test results
    TI - 100 mg Clomid + prometrium (AM & PM) + vaginal estrace (AM & PM) 6-7/15 (monitored) --> no additional response and thinned lining - BFN
    TI - Injectables (follistim + Gonal-F, Ganirelix, & 1/2 dose Pregnyl) + prometrium (AM & PM) 9/15 --> 3-7 mature follicles (3 definites and 4+ that could have matured due to trigger) @ O -->BFN + 5 large cysts
    BC for 2 weeks due to cysts
    TI - Injectables (Gonal-F, Ganirelix & full dose Pregnyl) + prometrium (AM & PM) 10/15 --> 1 mature follicle --> BFN 
    TI - Last attempt at injectables (Gonal-F, Ganirelix & 1/2 dose Pregnyl) + crinone (AM only) + vaginal estrace (AM & PM) 11/15 --> 3-4 mature follicles --> BFP!! 11/27/15 @ 13dpo (shockingly, actually waited until then to test)

    Beta #1 @ 16dpo (11/30/15) = 1,075
    Beta #2 @ 19dpo (12/3/15) = 3,150
    One baby: Saw heartbeat @ 5w5d (114 bpm; baby measuring 2.3mm)

    "Great Things are Happening"
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