# of failed IUI cycles = increase # of follies to try with?

KdgTeacher · February 2012

So, I know my question is confusing, so bear with me and I'll see if I can make more sense.

As you have more failed IUI cycles behind you, does your RE allow you to go ahead with an IUI if you have more follies?

My first IUI cycle I had 3 follies and the nurse had to call and go over the whole multiple pregnancy thing. My 2nd IUI cycle (reduced meds) I had 2 follies and was fine--no multiples conversation.

If I let's say this cycle I end up with 4 follies, would the fact that I've had 2 IUI cycles fail (3 IUIs total) mean I could proceed with the 4 follies? (No issues with MH (20-30 million count each time), all my levels and u/s always look good.

What has been your experience?

DebateThis · February 2012

I haven't started IUIs yet (waiting on CD1), but I don't think I personally could cycle with 4 follies.

Also, I just found this study which might be helpful? https://humupd.oxfordjournals.org/content/14/6/563.full

KdgTeacher · February 2012

DebateThis:

I haven't started IUIs yet (waiting on CD1), but I don't think I personally could cycle with 4 follies.

Also, I just found this study which might be helpful? https://humupd.oxfordjournals.org/content/14/6/563.full

Thanks. That article said what my RE/nurses have said. More follies doesn't necessarily inclrease your chances of getting KU...just your chances of having multiples. Which I kinda makes sense and kinda doesn't. ::shrugs::

I guess I was wondering that since multiple follies didn't get me KU before...would they allow more follies since the previous multiple follie cycle didn't work.

tapnpsych · February 2012

I've had 3 failed IUI's with up to 3 follies each time. I'm working with a new RE this cycle, but he is trying to get 4 of my follies to mature. I'm assuming since I've failed 3 other times he wants more follies. IDK for sure though. I was surprised that he wants 4 this time.

Native+Girl · February 2012

Hmm...interesting question and interesting article. You'd think that with more targets, one would have an increased chance of pregnancy. I guess if something is wrong, other than sperm finding egg, the number of targets wouldn't matter. I'm not suggesting something deeper is wrong in your case, that's just where my brain went with the logic.

matthewsbride05 · February 2012

I'm glad you posed this question. When we initially met with my RE, (We have unexplained IF.) she said that Clomid increases the chance for twins but nothing else...Meaning, it is very rare to get pregnant with more than twins on Clomid. Our first cycle of Clomid with TI, I had 3-4 mature follicles. Again, I asked if I had an increased risk of anything higher than twins and was told that anything higher than twins was extremely unlikely. I didn't get pregnant. Our second cycle of Clomid and TI, I had 1-2 mature follicles. Again, I didn't get pregnant and am now moving on to Clomid and IUI. Even though my RE is renowned in the field, I still got a little nervous the cycle I had 3-4, but we went ahead with TI.

KdgTeacher · February 2012

matthewsbride05:
I'm glad you posed this question. When we initially met with my RE, (We have unexplained IF.) she said that Clomid increases the chance for twins but nothing else...Meaning, it is very rare to get pregnant with more than twins on Clomid. Our first cycle of Clomid with TI, I had 3-4 mature follicles. Again, I asked if I had an increased risk of anything higher than twins and was told that anything higher than twins was extremely unlikely. I didn't get pregnant. Our second cycle of Clomid and TI, I had 1-2 mature follicles. Again, I didn't get pregnant and am now moving on to Clomid and IUI. Even though my RE is renowned in the field, I still got a little nervous the cycle I had 3-4, but we went ahead with TI.

When I did Clomid only, I only had 1 follie each time. I didn't get more follies until we added an inject (Follistim) to the mix did I get 3 then 2. I go in Saturday for u/s and b/w...I won't lie. I'm hoping for at least 3 follies.

keelmic · February 2012

By the time I was on my 6th IUI (three were femara + IUI, three were follistim + IUI), I had a response of 4 mature follicles. Because I had never been pregnant before in nearly 2 years and the fact that I was on my 6th IUI, the RE was okay with letting me proceed with the four mature follicles. We are currently pregnant with one baby.

I agree with what you said. I don't think my RE would have wanted me to proceed with 4 mature if it was one of my first IUI's but after several attempts, I think they do start to become more flexible with the numbers, as long as you are okay with the possibility of having multiples.

genmalone · February 2012

My Re initially said 2-3 was my max but by my last few cycles (I've done 7) she was fine with 4 and even once with 5. It scared to sh!t out of me but I still didn't get KU.

Good luck!

KdgTeacher · February 2012

genmalone:

My Re initially said 2-3 was my max but by my last few cycles (I've done 7) she was fine with 4 and even once with 5. It scared to sh!t out of me but I still didn't get KU.

Good luck!

This is what I'm hoping my RE will do....if it is even an issue for me. We'll find out Saturday! Tongue Tied

genmalone · February 2012

KdgTeacher:
genmalone:

My Re initially said 2-3 was my max but by my last few cycles (I've done 7) she was fine with 4 and even once with 5. It scared to sh!t out of me but I still didn't get KU.

Good luck!

This is what I'm hoping my RE will do....if it is even an issue for me. We'll find out Saturday!

Fingers crossed for you!

meganfauer · February 2012

I talked to my RE about this as well. I have been through 2 failed IVF's and now 1 failed IUI's, we are sort of doing things backwards, long story. BUT me and my RE talked about the fact that when I did my first IVF we got 6, 4 were mature and only 2 made it to blayst and BFN. So my point is even if I got 6 follicules for IUI, from my odds of my 3 failed cycles there is no way that all 6 would even be good. I am not saying I would move forward with 6 follicules but I am hoping for more than 2, like last time.

Good luck!

katib77 · February 2012

I think it really depends on your RE and diagnosis. I've heard of girls that the more BFNs the more follies their RE will let them move forward with - but many times it's one's with the Dx of MFI.

I do know they say more targets does not increase your chance - but I have a hard time understanding that. Especially when there are chances that the egg you ovulate is not mature. You'd think with multiple follies there is at least the increased chance because of higher percentage of mature follicles possible. But I'm not a statistician.

DMCKnox · February 2012

DebateThis:
I haven't started IUIs yet (waiting on CD1), but I don't think I personally could cycle with 4 follies.
Also, I just found this study which might be helpful? https://humupd.oxfordjournals.org/content/14/6/563.full

Great article, very interesting. Thanks for sharing that!!

KdgTeacher · February 2012

katib77:

I think it really depends on your RE and diagnosis. I've heard of girls that the more BFNs the more follies their RE will let them move forward with - but many times it's one's with the Dx of MFI.

I do know they say more targets does not increase your chance - but I have a hard time understanding that. Especially when there are chances that the egg you ovulate is not mature. You'd think with multiple follies there is at least the increased chance because of higher percentage of mature follicles possible. But I'm not a statistician.

I'm RIGHT there with ya. I get it....but I don't.

byrne15 · February 2012

***ticker***

I don't know since you guys have good post-wash numbers (our were between 2 and 10 million, average of 4-5 million). My 1st clomid cycle I had one follie, then a couple for the next 2 cycles. On my 1st gonal-f cycle I had 4-5 follies and on the last one I had 6 follies and did a B2B IUI (which didn't work).

Gregermis · February 2012

not for us... since we were MFI, I was always allowed to proceed with 4, and we never had more than that so it wasn't an issue.

maggie2324 · February 2012

I had 3 mature follicles for IUI #1 and there was not a bit of multiples discussion... Probably because of our MFI and our decreased likelihood of getting pg at all.

I read the whole article, full text, and I think it's baloney.

1st, they say your chance of multiples with 3 follies (if you get pg) is 14%. Your chance with 4 follies is 10%. Obviously there is some bias in the data or the sample size is way too small. Your chance of getting pg with 3 follies is only around 15%, so 14% of that is 2%. You have a 2% chance of getting multiples in any given cycle on the high end, and less than a 0.4% chance of trips or more. To me, that's not a crazy risk of multiples period.

2nd, this is not something that can be studied ethically, so all data on this subject is going to have bias. Different doctors are going to have different cancelation criteria that is patient specific. Patients have different diagnoses that influence how they respond to meds and therefore influence the data.

So my conclusion is, do not proceed with 2 or more follies unless you are ok with twins. HOMs are always going to be a risk as well, but the chances are low regardless. After multiple failed IUIs, I would not be concerned about HOMs even though the small risk is there. I'd be much more concerned about not getting pg at all.

katlilvoce1 · February 2012

Kdg-just glad that you posted this because I've been wondering the same thing but we have MFI also I'm going to ask in the morning how many they are thinking to go ahead with.

jessican08 · February 2012

genmalone:
My Re initially said 2-3 was my max but by my last few cycles (I've done 7) she was fine with 4 and even once with 5. It scared to sh!t out of me but I still didn't get KU.

Good luck!

Pretty much this. By my 5th and 6th IUIs, my Re said he'd let me go ahead with up to five. The most I ever had was 4 on my 6th IUI.

Seagull2012 · February 2012

I've had 9 failed IUIs & my doc has always said he would trigger with up to 5 follicles for me. But, at the same time, he said that one big, beautiful one is just as good so i think there is something to say about quality vs. quantity, too.

my first time on 100mg Clomid i had 3mature follicles and he triggered with no discussion of multiples.

also, I think anyone undergoing fertility treatments should be prepared for twins but i really think triplets is a low probability.

and, honestly, at this point in my journey i wouldn't want to cancel a cycle due to too many follicles and would fight that decision with my doctor. But that's just me (and i haven't been in an "over-response" situation, yet)

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# of failed IUI cycles = increase # of follies to try with?

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