Two IUIs with Letrozole, should I up my dose for the next one?

knottie0c1886994ffec556

Hi everyone, I'm 32 & DH 32, been TTC for 2 years with no luck. I have short cycles usually 25-26 day, so typically Ovulate on day 11-12. all tests are fine. DH has low morphology (4% with Kruger strict standard).

Did IUI #1 in February and IUI #2 in March with Letrozole 2.5mg. Now in my TTW but wondering if IUI #2 does not work out, should I up my Letrozole dose for the next round? I actually asked this question to my clinicians (RE did not meet with me after first failed IUI) and they said they don't recommend upping my dose since I am already responding to 2.5mg. Here are my stats, I felt my follicle sizes were too small and some of them shrunk before triggering. 

IUI #1
Started letrozole 2.5mg on CD4 for 5 days.  
Monitoring Day 1(CD8): Right Follicles 23x14(18.5) 11x10; Left several small. E2: 204.03. Lining:5.9mm
Monitoring Day 2(CD9): Right 20x15, 18x13; Left 10x11. E2: 267.03. Lining 7.6mm. Triggered with Ovidrel that evening.


IUI #2
Started letrozole 2.5mg on CD3 for 5 days.  
Monitoring Day 1(CD8): Right Follicles 17x14(15) 12x11(11), 12x8 (10); Left 19x17 (18). E2: 170.83. Lining 5.6mm.
Monitoring Day 2(CD9): Right 14x13(13.5), 18x14(16); Left 21x21 (21). E2: 231.01 Lining 6.9mm
Monitoring Day 3(CD10): Right 15x16, 15x8; Left 18x20 (19) E2: 369.16. Lining 7.9mm  -- how come my lead follicle (left) shrunk on the last day? Triggerred with Ovidrel that evening.

Thank you!

inthewoods23

I believe most clinics will say the same thing. That if you're responding to the medication they won't up it. Especially since you're having multiple follicles grow - too many and they might cancel the IUI. I only ever had 1 dominate follicle grow except for the first IUI when I had 2 growing, the at the 2nd US we found only 1 continued to grow larger.  My clinic had me trigger once a follicle was at least 20mm on average.

Not sure what to think about the shrinking follicle. That is very strange!