QuestionDear Dr Ramirez,
I am currently going through fertility treatments. We initially went to an RE because I had bleeding throughout my luteal phase, but seemed to ovulate around d14 based on temperature charting, cervical fluid and ovulation tests strips. However, clomid alone or in combination with crinone did not result in pregnancy. Because of an insurance requirement we have been doing IUIs before we can move onto IVF. However, using both Clomid and Follistim my follicles mature very quickly. On my last cycle, I used both Follistim (only 50 units/day) and Ganirelix, but by day 8 I had one follicle/ovary of 25 and 24mm. My RE is concerned by this and even thinks that if my follicles mature so quickly that there is only a slim chance that IVF will work. Do you have any experience with people who respond very early to FSH in either IUI or IVF cycles? Does it mean that I do not produce good quality eggs? Is there any treatment regime that may help?
AnswerHello Anna,
It seems that your ovaries are sensitive to the stimulation, but that should not prevent you from getting pregnant. The two biggest worries would be (1) if the endometrial lining of the uterus has enough time to prime itself and (2) if the egg has enough time to mature. However, I have had patients that are ready to trigger during IVF cycles on CD#8 or 9 and have achieved pregnancy.
In your case, your doc might want to definitely consider the Long Lupron protocol, which will slow down your ovarian reaction. Maybe he should try that with an IUI cycle to see how you respond.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf
