HCG Shot & IUI After LH Surge: A Fertility Journey

Question
My husband (30) and myself (33) are trying to conceive our first child together.  I have had a successful pregnancy 10 years ago.  I was diagnosed with mild PCOS and was having irregular ovulation and anovulation.  I am on my 3-4 th round of clomid.  I took 50 mgs on days 5-9, the Ultras sound on day 18 didn't show much response so my Dr. prescibed 100mgs of clomid for the next five days 18-22.  I had blood work done on day 29 ( day 16 if you count from the second round of clomid) and i had not yet ovulated and my E2 levels was 599.   I was scheduled for ultrasound the next morning, but I took an OPK the evening before and detected the LH surge.  My ultras sound was done at 10:30 in the moring and I had not yet ovulated. I had 2 good follicles, one on each overy.  they measured at 20mm and 18 mm.  We scheduled the IUI for later that same day and at the time of the IUI, I was given the HCG shot just to ensure I popped those Eggs out.  I am concerned that we did the IUI too early.  I had some AWESOME pain the evening of the IUI, it felt like there was a gremlin using my overies as drums or something.  It has subsided today.  Did we do the IUI too early?  Should I be concerned?  My husband was wiped out after the IUI so we could not have relations last night.  I can't find any information on taking the HCG shot after detecting the LH surge.  

Thank you
I am writing from New Mexico, USA.

Answer
Hello,

I don't think the IUI was done too early.  It has been shown that the sperm needs to be present prior to ovulation so you may have timed it perfectly.  The HCG shot at the time of IUI was a little unorthodox, although of no harm.

The way that I do the protocol, I would have given the HCG at the time of the ultrasound detecting the 20 and 18 mm follicles.  Then I would have done the first IUI the next day and a second the following day.  Since we can't know exactly when ovulation would occur, the two day method covers the possible times.

Sincerely,

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.