Ovarian cysts after failed injectibles cycle. Failed trigger?

ytterp

Hi, I  am 30 and have PCOS. We have been ttc for just over 3 years. We did our first injectibles cycle in Dec. It failed b/c my body forced ovulation before the follicles were big enough (normally, I NEVER ovulate on my own!)  I took January off b/c of a large cyst.  

We just did another injectible cycle (added ganirelix), and it also failed. This time, the scans showed lots of left over cysts, with 6 being fairly large. My ovaries are so large right now, that they are touching each other. They tested to make sure that I had blood flow through my ovaries, but warned me that I was at high risk for Ovarian Torsion.  I am not in much pain right now, but I had tons of terrible pain during my 2ww. I assumed this was from the meds, but now I'm worried that I'm not actually ovulating with the trigger shot. How do you know if you have ovulated, and are the large cysts due to continued follicle growth instead of ovulation?  

So frustrating.  

MelleTX

If you have cysts, I would think it would indicate you ovulated. The cysts are what happens when the follicle releases an egg and then collapses on itself with fluid still trapped inside. 

What size were your follicles at trigger? There is such a large range for follicle size and success, I wouldn't necessarily say that is why your cycle failed. Are you doing IUI or TI? 

BzeetyD

All 3 times I've done injectables (follistim) I've had a cyst or two afterwards - but also know I ovulated. I think the PP is right about the cyst is the excess fluid trapped after release. Sorry yours are so big. Are they going to put you on BCP to control them or just let them fade on their own.

Mine always faded within a month on their own.

Good luck.

nycitygirl1

MelleTX:

If you have cysts, I would think it would indicate you ovulated. The cysts are what happens when the follicle releases an egg and then collapses on itself with fluid still trapped inside. 

What size were your follicles at trigger? There is such a large range for follicle size and success, I wouldn't necessarily say that is why your cycle failed. Are you doing IUI or TI? 

This is how I understand it too. I used injectables for both of my IUI cycles and after the first one, also got a really big cyst.

This is common for women with PCOS, unfortunately. Like OP said, failing an IUI cycle is common even if you have a "perfect" cycle. The chances are still only around 25% that it will work.

Why do you think you did not ovulate? I haven't heard of a trigger shot not working and normally doctors don't tell you to use it until your follies are mature. They are usually only looking for 1 or 2 dominant/mature follicles rather than tons of small ones.

ytterp

Thank you for replying! You ladies made me feel so much better. I assumed, ignorantly, that the cysts were left over follicles that simply continued to grow. I did not realize that they were the left overs after ovulation. The doctor had me do the trigger when I had a 16.5, a three 14's.  The nurse told me that I had the cysts b/c I had gotten so many follicles. I just didn't understand. Phew.

 I guess I've just been worried b/c of the pain during the 2ww, and the warnings I've been given now for the torsion risk.  I know that injectibles do not have a high success rate. We did timed intercourse the first 2 rounds, and we are now moving on the IUI.  We will do three rounds with IUI and if we still do not get a positive we will have to decide whether or not to continue treatment. Our insurance covers injectibles, but not IVF.  

We are also currently going through an international adoption, so if it looks like we have to do IVF, I may just put it on hold and focus on the adoption.