Multiples from Clomid + injects + IUI?

alhal

Hope you don't mind me sneaking in for a question.  Does anyone here have multiples resulting from an IUI injectable cycle?  If so, I'm curious as to how many mature follicles you had at the time of your IUI. 

I am on IUI #2 now.  During IUI #1, I was on Clomid only, and I had 3 mature follicles (which obviously did not result in pregnancy).  Because I responded so well, I'm thinking there is a good chance I'll respond even "better" when injects are added (although I know that there is no way to predict this for sure). 

Basically, I'm hoping for some reassurance that 3 or 4 mature follicles resulting in a BFP does NOT necessarily mean triplets, etc.  So I'd love to hear how many mature follicles you had on your BFP cycle.

TIA!

amamommy

My first pregnancy resulted from inj +IUI, had 4 mature follies, was pregnant with only DD.

This pregnancy same thing, inj + IUI, 4 mature follies, got 3 in there!

We had no luck at all with Clomid, no follies at all. That is why we went on to injectables.

Kristen61607

I did not use clomid (well, I did for another cycle but it didn't work).

My 1st IUI cycle I was on Gonal F, Lupron, triggered and did B2B IUI's with 4 mature follicles. BFN. 

2nd IUI cycle I did Gonal F, Menopur, Lupron, triggered and did B2B IUI's with 3 mature follicles (a 4th may have caught up) and I got pregnant with my twins! 

I should also add that we had NO problem's with DH - he had a beyond wonderful count/motility each and every time, we just needed me to ovulate! lol!

 Good luck!!! 

hunt2005

I'm I'm just curious why you're adding injectibles if the Clomid worked? Are you referring to injectables like Gonal F, etc, or are you just talking about an HCG trigger to make sure that you actually ovulate all mature follies?

We had 2 follies that we saw on the scan and ended up with triplets from Clomid+HCG+IUI.

Remember if you do HCG that EVERY mature follie will go, and that every follicle that goes is an opportunity for a pregnancy, so if you have 4 follies that could mean 4 babies (or more if one of them splits), so keep that in mind that you could have to face those results down the line. Many docs won't do an IUI if you have more than 3 for that reason (I know mine wouldn't have).

kafunder

I can't remember from our first cycle but on our second cycle we did follistim injectables plus ovridel trigger and IUI. I had 2 mature follies and 1 that was borderline, and got my BFP with twins. My RE wouldn't have done it with more than 3 mature follies, and even with 2 mature plus one borderline, they took a long time to explain the risks to us.

alhal

hunt2005:

I'm I'm just curious why you're adding injectibles if the Clomid worked? Are you referring to injectables like Gonal F, etc, or are you just talking about an HCG trigger to make sure that you actually ovulate all mature follies?

We had 2 follies that we saw on the scan and ended up with triplets from Clomid+HCG+IUI.

Remember if you do HCG that EVERY mature follie will go, and that every follicle that goes is an opportunity for a pregnancy, so if you have 4 follies that could mean 4 babies (or more if one of them splits), so keep that in mind that you could have to face those results down the line. Many docs won't do an IUI if you have more than 3 for that reason (I know mine wouldn't have).

I will be on Clomid + Follistim + Ovidrel trigger.  It was hard for me to understand why my RE suggested that I move on to the injects despite having such a good response on Clomid.  Basically he says that the choice is mine (whether I want to do Clomid again or move on to injects) but that my odds will increase if the injects are added and decrease if I repeat the same protocol from last cycle.  I struggled with the decision, but I trust my RE and decided to move forward with the injects.  Feedback from the TTTC board has also made me very wary of my RE's suggestions, especially since he has specifically said that he does not consider 4 or 5 mature follicles to be too many. 

kafunder

alhal:

hunt2005:

I'm I'm just curious why you're adding injectibles if the Clomid worked? Are you referring to injectables like Gonal F, etc, or are you just talking about an HCG trigger to make sure that you actually ovulate all mature follies?

We had 2 follies that we saw on the scan and ended up with triplets from Clomid+HCG+IUI.

Remember if you do HCG that EVERY mature follie will go, and that every follicle that goes is an opportunity for a pregnancy, so if you have 4 follies that could mean 4 babies (or more if one of them splits), so keep that in mind that you could have to face those results down the line. Many docs won't do an IUI if you have more than 3 for that reason (I know mine wouldn't have).

I will be on Clomid + Follistim + Ovidrel trigger.  It was hard for me to understand why my RE suggested that I move on to the injects despite having such a good response on Clomid.  Basically he says that the choice is mine (whether I want to do Clomid again or move on to injects) but that my odds will increase if the injects are added and decrease if I repeat the same protocol from last cycle.  I struggled with the decision, but I trust my RE and decided to move forward with the injects.  Feedback from the TTTC board has also made me very wary of my RE's suggestions, especially since he has specifically said that he does not consider 4 or 5 mature follicles to be too many. 

Yikes! I'd definitely be wary and would probably change REs. You could end up the next Octomom or Jon and Kate. If I remember correctly, follistim already increases your chance of multipes by quite a bit, and the additional clomid would just be too much, IMHO. You should REALLY understand everything your RE says before doing anything.

SLPMel

alhal:

hunt2005:

I'm I'm just curious why you're adding injectibles if the Clomid worked? Are you referring to injectables like Gonal F, etc, or are you just talking about an HCG trigger to make sure that you actually ovulate all mature follies?

We had 2 follies that we saw on the scan and ended up with triplets from Clomid+HCG+IUI.

Remember if you do HCG that EVERY mature follie will go, and that every follicle that goes is an opportunity for a pregnancy, so if you have 4 follies that could mean 4 babies (or more if one of them splits), so keep that in mind that you could have to face those results down the line. Many docs won't do an IUI if you have more than 3 for that reason (I know mine wouldn't have).

I will be on Clomid + Follistim + Ovidrel trigger.  It was hard for me to understand why my RE suggested that I move on to the injects despite having such a good response on Clomid.  Basically he says that the choice is mine (whether I want to do Clomid again or move on to injects) but that my odds will increase if the injects are added and decrease if I repeat the same protocol from last cycle.  I struggled with the decision, but I trust my RE and decided to move forward with the injects.  Feedback from the TTTC board has also made me very wary of my RE's suggestions, especially since he has specifically said that he does not consider 4 or 5 mature follicles to be too many. 

I would be extremely wary of a RE that would trigger you with 4 or 5 mature follies.  I, like hunt, triggered with only 2 mature follies on *just* Clomid.  We saw 3 sacs, and as of today only two have heart beats.  I could only imagine if I had 4 or 5 follies-how many would I have wound up with?  When it works, and you have to hope it does, you have to think that every egg could be a baby.  

Our first 2 IUI's were a BFN with 1 mature follie-and we had originally thought about moving on to injects to try to get one more.  I would have canceled if we had 3 or more follies.  And as someone who thought I was being "safe" with triggering with 2, and thinking we'd have three-it's scary to be having a triplet pregnancy.  The increased risks are high-to both me *and* the babies.  We wouldn't have done anything about 3, but I am somewhat relieved that we now only have two-financially, emotionally, physically it will be better for me and the babies to only be carrying 2.

Are you willing to do selective reduction?  It's something you have to think about, and your RE should be discussing with you if you are entertaining 3 or more follies.  You may think it won't happen to you (the last time my RE had Clomid triplets was 7 years ago), but it can happen to you, and *will* happen to someone.

cookiemonster03

Our RE discouraged triggering with more than 2, and would not do more than 3. He is pretty conservative, but I think its safer.  We had two mature and a few small ones (gonal-f) and ended up pregnant with triplets. We lost one about 12w and are (duh) having twins.

alhal

Ugh, thanks for all of the input ladies.  I'm definitely wary and not sure what I should do.  At this point, I've paid for the injects, so I suppose I'll move forward with the cycle.  However, if I have more than 3 mature follicles at my monitoring appointment, I'll certainly discuss the risks in depth with my RE, knowing that a canceled cycle might be best.

SLPMel

alhal:

Ugh, thanks for all of the input ladies.  I'm definitely wary and not sure what I should do.  At this point, I've paid for the injects, so I suppose I'll move forward with the cycle.  However, if I have more than 3 mature follicles at my monitoring appointment, I'll certainly discuss the risks in depth with my RE, knowing that a canceled cycle might be best.

Are you OOP?  Can you switch to a Clomid cycle or have you started the injects already?  The cost difference was significant between a Clomid cycle and an injects cycle for me-almost twice as much.  We had insurance coverage and figured out it made more sense for us to move on to another IVF cycle than it was to move on to injects (because of the OOP costs)

alhal

SLPMel:

alhal:

Ugh, thanks for all of the input ladies.  I'm definitely wary and not sure what I should do.  At this point, I've paid for the injects, so I suppose I'll move forward with the cycle.  However, if I have more than 3 mature follicles at my monitoring appointment, I'll certainly discuss the risks in depth with my RE, knowing that a canceled cycle might be best.

Are you OOP?  Can you switch to a Clomid cycle or have you started the injects already?  The cost difference was significant between a Clomid cycle and an injects cycle for me-almost twice as much.  We had insurance coverage and figured out it made more sense for us to move on to another IVF cycle than it was to move on to injects (because of the OOP costs)

I am doing Clomid + IUI (and am picking up my prescription for the Clomid tonight), so technically I suppose I could convert to a Clomid cycle.  However, I have already paid for the injects and they are being over-nighted to me.  I"m supposed to start the injections on Thursday night.  The fee at my RE's office was the same (and yes, I'm OOP) for Clomid + injects as it was for a Clomid-only IUI.  The only additional expense is the follistim itself (which was around $250).  So it isn't a huge difference.  I dont know that I could stomach tossing the follistim that I already bought at this point...

SLPMel

alhal:

SLPMel:

alhal:

Ugh, thanks for all of the input ladies.  I'm definitely wary and not sure what I should do.  At this point, I've paid for the injects, so I suppose I'll move forward with the cycle.  However, if I have more than 3 mature follicles at my monitoring appointment, I'll certainly discuss the risks in depth with my RE, knowing that a canceled cycle might be best.

Are you OOP?  Can you switch to a Clomid cycle or have you started the injects already?  The cost difference was significant between a Clomid cycle and an injects cycle for me-almost twice as much.  We had insurance coverage and figured out it made more sense for us to move on to another IVF cycle than it was to move on to injects (because of the OOP costs)

I am doing Clomid + IUI (and am picking up my prescription for the Clomid tonight), so technically I suppose I could convert to a Clomid cycle.  However, I have already paid for the injects and they are being over-nighted to me.  I"m supposed to start the injections on Thursday night.  The fee at my RE's office was the same (and yes, I'm OOP) for Clomid + injects as it was for a Clomid-only IUI.  The only additional expense is the follistim itself (which was around $250).  So it isn't a huge difference.  I dont know that I could stomach tossing the follistim that I already bought at this point...

You wouldn't have to toss it-they last for at least 6 months (if not more!)  Which could you stomach more-using the injects and having to lose the whole cycle because there are 4 or 5 follies, or not using the injects and being able to go through?  It's something definitely to think about.  Would you convert to an IVF cycle if needed?

writergirl5786

we did follistim, a trigger and IUI this cycle. i know we had one follie at 21 (right) and one at 17 (left) and i think 2 or 3 around 10 that they weren't sure would go. we are 99% pos each big one went because i had a cyst on each ovary...and we ended up with twins! GL!

alhal

SLPMel:

alhal:

SLPMel:

alhal:

Ugh, thanks for all of the input ladies.  I'm definitely wary and not sure what I should do.  At this point, I've paid for the injects, so I suppose I'll move forward with the cycle.  However, if I have more than 3 mature follicles at my monitoring appointment, I'll certainly discuss the risks in depth with my RE, knowing that a canceled cycle might be best.

Are you OOP?  Can you switch to a Clomid cycle or have you started the injects already?  The cost difference was significant between a Clomid cycle and an injects cycle for me-almost twice as much.  We had insurance coverage and figured out it made more sense for us to move on to another IVF cycle than it was to move on to injects (because of the OOP costs)

I am doing Clomid + IUI (and am picking up my prescription for the Clomid tonight), so technically I suppose I could convert to a Clomid cycle.  However, I have already paid for the injects and they are being over-nighted to me.  I"m supposed to start the injections on Thursday night.  The fee at my RE's office was the same (and yes, I'm OOP) for Clomid + injects as it was for a Clomid-only IUI.  The only additional expense is the follistim itself (which was around $250).  So it isn't a huge difference.  I dont know that I could stomach tossing the follistim that I already bought at this point...

You wouldn't have to toss it-they last for at least 6 months (if not more!)  Which could you stomach more-using the injects and having to lose the whole cycle because there are 4 or 5 follies, or not using the injects and being able to go through?  It's something definitely to think about.  Would you convert to an IVF cycle if needed?

I really appreciate all of your input.  I have a lot to think about!

KDC1014

My last IUI, I did Follistim, Femura, and Ovidrel Trigger.  I had 4 follicles and I'm pregnant with triplets.  I would be wary about starting Follistim, because you responded so well to Clomid.  I responded well to Clomid, but it thinned my lining and I wanted to up my chances, so my RE gave me a choice to move forward with Injections.  I took the chance, but I had so many issues after becoming pregnant with OHSS, due to too many injections.  I wish you the best of luck!!! 

SLPMel

alhal:

SLPMel:

alhal:

SLPMel:

alhal:

Ugh, thanks for all of the input ladies.  I'm definitely wary and not sure what I should do.  At this point, I've paid for the injects, so I suppose I'll move forward with the cycle.  However, if I have more than 3 mature follicles at my monitoring appointment, I'll certainly discuss the risks in depth with my RE, knowing that a canceled cycle might be best.

Are you OOP?  Can you switch to a Clomid cycle or have you started the injects already?  The cost difference was significant between a Clomid cycle and an injects cycle for me-almost twice as much.  We had insurance coverage and figured out it made more sense for us to move on to another IVF cycle than it was to move on to injects (because of the OOP costs)

I am doing Clomid + IUI (and am picking up my prescription for the Clomid tonight), so technically I suppose I could convert to a Clomid cycle.  However, I have already paid for the injects and they are being over-nighted to me.  I"m supposed to start the injections on Thursday night.  The fee at my RE's office was the same (and yes, I'm OOP) for Clomid + injects as it was for a Clomid-only IUI.  The only additional expense is the follistim itself (which was around $250).  So it isn't a huge difference.  I dont know that I could stomach tossing the follistim that I already bought at this point...

You wouldn't have to toss it-they last for at least 6 months (if not more!)  Which could you stomach more-using the injects and having to lose the whole cycle because there are 4 or 5 follies, or not using the injects and being able to go through?  It's something definitely to think about.  Would you convert to an IVF cycle if needed?

I really appreciate all of your input.  I have a lot to think about!

I know how hard it is to make the decision.  We want so badly to get pregnant, and we want to give yourself the best chances for success.  But we also want healthy babies-and it's a balance between increasing success and making sure that you can have a healthy pregnancy, and healthy baby/babies.  I honestly would give Clomid a good three tries before moving on-because you have had such great number.  After 3 tries, that is when success really goes down.  I had success on #3 myself-even though everything looked the exact same #1 and 2. 

"Quints By Surprise" was always the case that came to mind-they did IUI with 5 follies and got 1 baby the first time.  They did IUI with 5 follies for #2, and got 5. 

leslie13510

I did Clomid + Bravelle injects + IUI, after 3 failed Clomid IUIs, and ended up with twins.  I had 2 really good follies, one that would definitely trigger but that wasn't all that great, and another that my RE gave maybe a 50% chance of triggering and a less than 10% chance of fertilizing even if it did trigger (I forget the exact measurements now, but basically I had 3 follies).  That, and the slight possibility of a fourth one, had us talking pretty in depth about cancelling the cycle, and the idea of selective reduction if there were more than 3, and maybe even more than 2 because I'm such a small person, and that combined with my wonky uterus (had a septum removed a few months before that) made him think my body wouldn't tolerate more than twins.  Turns out he was absolutely right since my body barely tolerated carrying two babies, and even that required several medical interventions.

Anyway, we decided to go ahead with the cycle, after discussing everything, and I'm glad we did (obviously).  That said, even though "only" two of the eggs fertilized and implanted, I also ended up with a raging case of OHSS 3-4 days after my IUI.  It was awful, but thankfully resolved itself pretty quickly.  Just one more thing to add to your list of things to contemplate though.

Oh, and I also would run far away from an RE who would go through with an IUI cycle with 4-5 mature follies present, without seeming at all concerned about it.  Any cycle resulting in more than 2 (maybe even 3 depending on your IF history) mature follies should be discussed in serious detail before going through with the IUI.  In my opinion, anyway.

Good luck!

leslie13510

And I totally missed the fact that this is only your second IUI cycle (and I'm assuming second medicated cycle as well?).  I would be questioning the fact that your RE wants to make the jump to injects so soon.  Most want you to try 3 Clomid cycles first, assuming that your body responds well to the Clomid, and it sounds like yours did. 

ebrooke

Not to freak you out, but we only had 1 mature follie that was a contender.  Not sure where the 2nd came from but voila! Twins! The RE was kind of scratching his heads about that one....

alhal

leslie13510:

I did Clomid + Bravelle injects + IUI, after 3 failed Clomid IUIs, and ended up with twins.  I had 2 really good follies, one that would definitely trigger but that wasn't all that great, and another that my RE gave maybe a 50% chance of triggering and a less than 10% chance of fertilizing even if it did trigger (I forget the exact measurements now, but basically I had 3 follies).  That, and the slight possibility of a fourth one, had us talking pretty in depth about cancelling the cycle, and the idea of selective reduction if there were more than 3, and maybe even more than 2 because I'm such a small person, and that combined with my wonky uterus (had a septum removed a few months before that) made him think my body wouldn't tolerate more than twins.  Turns out he was absolutely right since my body barely tolerated carrying two babies, and even that required several medical interventions.

Anyway, we decided to go ahead with the cycle, after discussing everything, and I'm glad we did (obviously).  That said, even though "only" two of the eggs fertilized and implanted, I also ended up with a raging case of OHSS 3-4 days after my IUI.  It was awful, but thankfully resolved itself pretty quickly.  Just one more thing to add to your list of things to contemplate though.

Oh, and I also would run far away from an RE who would go through with an IUI cycle with 4-5 mature follies present, without seeming at all concerned about it.  Any cycle resulting in more than 2 (maybe even 3 depending on your IF history) mature follies should be discussed in serious detail before going through with the IUI.  In my opinion, anyway.

Good luck!

I'm just so confused.  My RE is extremely reputable in my city.  I just can't figure out why he would be so well-regarded if his suggested protocols are so wonky.  I feel so torn between trusting my doctor and trusting all of the Bump feedback that I've gotten (and I don't take advice from Bumpies lightly... I really trust the information that I get here).

Chickandtaco

I was on Clomid 100mg.  I had the HCG trigger shot after seeing 3 mature folicals on u/s.  I ended up pregnant with twins on the first cycle!

hunt2005

I'm wondering, when you said you had 4 follies, were they all mature, or were there 4 total? I ask because most of us using the drugs have way more actual follicles than the "mature" ones, but it's only the mature follies that "count." So, for me, I had 8-9 TOTAL follicles, but only 2 that were above 20mm when I triggered, and no others (That we could see) that were close to that. So maybe you had 4 TOTAL follies, but only one or two  mature and that's why he's willing to go forward?

CrazeyJaneyR

My daughter was the result of IUI + injectables. We did 4 rounds of IUIs using clomid, one with clomid and injectable and 2 with just injectables. I was pregnant 4 times and only the last one stuck. Using the injectable appeared to help the quality of my eggs.

 

I would trust your Dr. over bump feedback for sure. I would also ask him the same questions and voice the same concerns with him that you have here and see what he has to say. 

 

Good luck! 

E&RMommy

If you end up with numerous mature follicles, instead of cancelling the cycle completely your RE should give you the option of converting to IVF.

Looks like our very own cocojack posted about this in 8/10/09....she has twins now (not sure if from that cycle or not).  Perhaps you can ask her!

Best of luck!

ougrad1

I had three IUI's-

#1-Clomid + IUI=BFN (two follies)

#2-Clomid+trigger+IUI=BFN (two follies)

#3-12 days of injects+trigger+IUI=BFP (two follies)  I WAS SHOCKED!!!

 

It seems the injects only improved the quality of my follies-not the quantity.  

 

Kristen61607

I already posted my 'stats' but I don't think your RE sounds THAT bad....so long as he's not forcing anything on you and letting YOU make the choice.

My RE was comfortable with triggering up to 4 mature follicles max., but they made it VERY clear to me that if I was uncomfortable with the possibility of multiples, then we would either cancel the cycle or convert to IVF. The choice was mine. for me personally, i was very comfortable with the idea of having multiples so I had no problem with proceeding with 4 mature follicles.

Also, i can see why your RE is moving you to injectables. You are supposed to have better egg quality/lining with injectables and as a person who did both (although I didn't give clomid much of a chance - I only did 1 cycle that did make me O but resulted in BFN, then a 2nd that didn't produce any mature follicles that we "saved" with Gonal F), I HIGHLY preferred my injects to stupid clomid.

But one thing I don't think you need is the clomid during your injectable cycle. If you're RE is worried about you o'ing too early he can give you a very low dose of lupron to take with the follistim in order to keep everything in place until they are ready for trigger.  But that being said, it's certainly not unheard of to do combo cycles (clomid or femara with injecatbles). From what I understand it's fairly common.

 Also - this isn't the best place to ask about multiples since we do indeed ALL have multiples!!!!! Like I posted before, my 1st IUI/injects cycle I had 4 mature follies and got a BFN, so you just never know! I'd also take into consideration your DH's sperm count. If you have MFI, that changes things a bit too (in my opinion). But really, I'm sure there are plenty of woman who had similar protocols that ended up with a singleton. Maybe ask the PG after IF board?!

Anyways if you have any other questions let me know - best of luck to you! 

 

ougrad1

alhal:

hunt2005:

I'm I'm just curious why you're adding injectibles if the Clomid worked? Are you referring to injectables like Gonal F, etc, or are you just talking about an HCG trigger to make sure that you actually ovulate all mature follies?

We had 2 follies that we saw on the scan and ended up with triplets from Clomid+HCG+IUI.

Remember if you do HCG that EVERY mature follie will go, and that every follicle that goes is an opportunity for a pregnancy, so if you have 4 follies that could mean 4 babies (or more if one of them splits), so keep that in mind that you could have to face those results down the line. Many docs won't do an IUI if you have more than 3 for that reason (I know mine wouldn't have).

I will be on Clomid + Follistim + Ovidrel trigger.  It was hard for me to understand why my RE suggested that I move on to the injects despite having such a good response on Clomid.  Basically he says that the choice is mine (whether I want to do Clomid again or move on to injects) but that my odds will increase if the injects are added and decrease if I repeat the same protocol from last cycle.  I struggled with the decision, but I trust my RE and decided to move forward with the injects.  Feedback from the TTTC board has also made me very wary of my RE's suggestions, especially since he has specifically said that he does not consider 4 or 5 mature follicles to be too many. 

See I would tell you to do a different protocol as well.  If it's not working, move on-you haven't gotten pregnant on the Clomid and I didn't either.  

If you're worried you need to pick up the phone and talk to him and let him know what you're thinking.  Most women don't know what to ask so, he probably doesn't know how far to get into it with you.  Call him and explain to him your worries and let him give you feedback.   He has reasons for doing what he is doing-just ask him.  : )

ETA-I would completely trust your doctor over a message board.   There are SO MANY factors that go into play with each individual person.  Call your doctor and talk to him.

Please keep us posted on your progress wether you end up with multiples or not and lots and lots of luck to you! 

sunnybrook.

I won't repeat what has already been posted. On Clomid, I had 1-2 good follicles. It caused me to ovulate too soon the first two times and then it caused a huge ovarian cyst and I ended up on BCP for two months.

The cycle I got pg, I was on follistim. I had 3 mature follies and 1 that was pretty darn close. We got twins

My DH and I made it very clear to our RE that we would not do selective reduction and our goal was one healthy baby. Based on my age (35) and the number of failed cycles I had plus some other medical things, my RE was comfortable triggering with up to 4 follicles. However, my DH and I would not have proceeded with more than 3 follicles. 

jcthomas1281

the cycle I got pregnant on I had two HUGE mature follicles. they gave some percentage on chances with two follicles but I don't remember what they were.

GL!

Northof54

Hi.... just skimmed through the responses... but wanted to add:

 

with DS#2.... 8 cycles of Clomid -- many with 3 follicles = BFN.

FIRST inj. cycle (was considered a failure with only 1 follicle) = BFP