Premature Ovulation even before hcg trigger

Itztrish7

Hi all, I am new to this board. I've generally tried to stay away from forums but I'm now pretty much looking to see if anyone has had a similar experience.

I'm soon to be 37yo and tried to conceive naturally with my husband for several months. Our fertility workup came back all normal. We did a "just in case" egg retrieval in the middle and it did not go so well. My follicles did not grow synchronized and ultimately only 4 eggs were retrieved with 2 mature enough to be frozen. Once we decided to proceed with IVF a few months after that, my doctor put me on an approx 3 week priming protocol of estradiol, testosterone patches, and progesterone which was supposed to synchronize follicle growth.

Due to bad timing and Memorial Day Weekend (fertility clinic closed for the whole 3 day weekend), I baselined on day 5. I started Omnitrope, Gonal-F, and Menopur that same evening. Yesterday was day 7 of injections and on labs/US monitoring, it was found that I was having an LH surge (plus progesterone level of 2, estradiol>1000) and 2 follicles around 20-24mm plus a whole bunch of smaller ones. I started Ganirelex that afternoon. Today, my LH/progesterone/estradiol are all downtrending and the 2 large follicles were nowhere to be found, hence I ovulated likely last night. I still have a total of 18 follicles with at least 8 in the 10-15mm range. Instead of canceling the cycle all together, my doctor suggested that I continue with the cycle since I have a decent cohort of follicles. My next monitoring is in 3 days, and she is predicting that I will trigger 2 days after that. Hopefully will fertilize, then freeze embryos for a transfer in a month or two.

Has anyone ever been in a situation where you had premature ovulation even before triggering and continued with the cycle? If so, what was the ultimate outcome? Thanks!

optimistgardener

*lurking from the TTGP board*

@Itztrish7 wow that's kind of a fascinating situation. I've never heard of that particular thing, but I think you should be reassured that many clinics now regularly do what are known as "mid-luteal start" stimulation protocols in which they wait for the body to naturally ovulate and then begin the stimulation protocol. The takeaway here, i guess, is that eggs retrieved from a luteal-start retrieval cycle where the eggs being recruited were already present and kinda hanging around by the time the body naturally ovulated are statistically as likely to mature and become euploid embryos as from a standard (~cd3) start. I know it's been a few days since you posted this question, but would love to hear about your outcome!