introduction (TW loss mentioned) and questions after first IUI

harleyquinn0621 · September 2017

Hi Ladies!
I am 35 years old and had my first round of iui with injectables this month
I started seeing my RE last year and spontaneously got pregnant after testing with her before any infertility treatments - unfortunately i lost my son at 19 weeks in April due to ic/chorio

i waited a few months to heal and lose some weight before starting IUIs

this is how my cycle went this month
09/15 CD3 baseline E2 34.2pg/ml ...endo thickness 5.38.... my RE started me on 150ius of gonal f
09/18 CD6 E2 41.1 pg/ml increased gonal f to 225ius
09/20 CD8 E2 42.0 pg/ml follies: 11mm, 10mm, 10mm, 8mm........ endo thickenss 7.13 gonal f 225ius + added femara 5mg for 5 days
09/22 CD10 E2 <25.0 pg/ml follies: 11mm, 10mm, 13mm, 8mm ...endo thickenss 7.27 RE advised drop in E2 was expected due to femara; continued gonal f 225ius + femara
09/25 CD 13 E2 48.6 pg/ml follies 16mm,16mm, 19mm, 15mm endo thickess 8.40 triggered with ovidrel
09/27 IUI day - after IUI they did another ultrasound and found only one 21 mm follie that was getting ready to release, so i had released some of the follies already

a couple of questions, at the last scan one of the follies was 15mm, but it was gone by the time they scanned after the IUI- could that have grown enough to mature?? does ovidrel only release mature follies or would immature follies release too? and finally, my E2: my RE advised high E2 is not needed as long as follies mature and lining is thick enough... she said femara will lower E2 because it works differently... but i'm still super concerned about the E2 numbers and not very hopeful for this cycle.... has anyone seen success even without rising E2?

Labluver2 · September 2017

Welcome it's nice to see a familiar face even tho the reason for being here isn't a good one. I can't really help you with the answers to your question I know when I had a 15 on day of trigger she said it prob wouldn't have time to catch up but I'm also only on 75IU of gonal F so maybe in your case it could on a higher dose. Wishing you the best. Try to relax and stay off Google lol. I seriously drive myself crazy.

harleyquinn0621 · September 2017

@Labluver2 thank you! i try so hard to stay off google but i can't seem to stop myself! lol my RE didn't seem that concerned but everything i've read points to E2 not rising being a bad sign

tosh24 · September 2017

Welcome and I'm so sorry about your loss.

I don't have experience with low estrogen, but have you talked to your RE about starting on the femara first next cycle and adding in the Gonal F either at the same time or starting a few days after the femara? Also, adding in Ganirelix/Orgalutran would suppress ovulation, giving more follicles a chance to mature and prevent premature ovulation. Follicles grow at a rate of 1-2 mm per day and triggering gives them that extra push to maturation, so it is possible that a follicle at 1.5 could be as big as 1.8/1.9 by ovulation and release. If you were Oing without a trigger, generally only those follicles of similar sizes would release their egg, but when triggering, it forces the body to (typically) release everything that is mature, regardless of size. I've heard of women getting pregnant with follicles that were only 1.4 cm at trigger. My RE defines 1.8 cm as being mature, but includes all follicles over 1.5 cm in the total count since a 1.5 cm follicle can certainly contain a mature egg.

harleyquinn0621 · September 2017

@tosh24 thank you for that information!

based on what you said, it sounds like since the 15mm was gone it may have contained and released a mature egg? i'm hoping the little 15mm caught up to the rest and matured, that would give me 4 follies instead of 3 and a slightly better chance

I haven't talked to her yet about starting femara first next cycle. when i asked about doing an injectable/oral combined cycle this cycle she did not want to go that route because, i think, she thought i would respond well to injectables alone..it was only when i didn't that she decided to add femara... if/when i get a BFN i was going to talk to her about doing a cycle with femara first and injectables again since that is when i seemed to respond best ..

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