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Undergoing cycle of fertility treatment using fertyl. Follicular scan done. HSG normal. Suggestion

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Hello Doctor,
I am undergoing fertility treatment , for 2 nd baby. This is 2nd cycle. My 14 th day folical scan says 11mm. Will the size increase and wil i ovulate ? i had fertyl 50 mg . HSG was normal. Pls advise
Posted Mon, 1 Apr 2013 in Women's Health
 
 
Answered by Dr. Timothy Raichle 7 hours later
Hello, I would be happy to help you with your question. Thank you for being patient for an answer.

So you are a 30 year old with one prior child, who has been attempting pregnancy for 10 months and undergoing your second cycle of fertility treatment using ovulation induction using Fertyl50. I have some questions for you first:

1. What were your cycles like before starting fertility medications?
2. Has your husband ever had a semen analysis?
3. Besides the follicular scans, are you using ovulation kits?
4. Did you ovulate last month?

Let me know and I will get back to you sooner!
Above answer was peer-reviewed by
 
Follow-up: Undergoing cycle of fertility treatment using fertyl. Follicular scan done. HSG normal. Suggestion 8 hours later
What were your cycles like before starting fertility medications?-- it used to be 45-50 days2. Has your husband ever had a semen analysis? --No 3. Besides the follicular scans, are you using ovulation kits? No 4. Did you ovulate last month?- I wa not sure. Last cycle , i took fertyl and asked to have intercoure on 16-18-20 day. But UPT was negative after 40 days , then had devoiry and had my periodson 24 th FEB
 
 
Answered by Dr. Timothy Raichle 6 hours later
Last question and I will get you a much quicker answer- did you need fertility treatment with your first child and how old are they now?
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Follow-up: Undergoing cycle of fertility treatment using fertyl. Follicular scan done. HSG normal. Suggestion 48 minutes later
No .i dint take any treatment for 1st child. She is 4 now.
 
 
Answered by Dr. Timothy Raichle 22 minutes later
Well, I am sorry that this is taking you so much longer this time. First, I want to start by stating that of those couples that have been trying to get pregnant for 12 months, about 40% have a 'male factor' problem. That is why it is important for your husband to have a semen analysis performed before you get too much further along in this process.

Second, it seems that there is a problem with your cycles. It is not normal to have a cycle that lasts 40+ days. This means that you are not ovulating regularly. There are common causes for this, and you have probably had a workup. You could spend a fortune on ultrasounds and never know if or when you actually ovulate. Here is what I would do:

1. Husband needs a semen analysis, and assuming that is normal, then...
2. Review your cycles with your doctor. Ask about lab testing for thyroid disease, diabetes, prolactin, and a condition called PCOS
3. If you did not get a period or conceive with the first cycle after 40 days, then you need to increase the dose to 100mg for 5 days with the next cycle
4. You need to use some form of ovulation detection kit. This is a lot simpler than an ultrasound and can be done in your home (peeing on a stick)
5. In a women with a normal cycle, they are most fertile on cycle day#14. So intercourse on days 10/12/14/16 is probably more effective once you are ovulating.

So, I would back up slightly, review what labs have not been done, ask about an increased dose of fertility medication, and use the ovulation kits. The main thing going for you is that you have had a child before. I am certain that this will happen again.

I hope that this helps and good luck!!
Above answer was peer-reviewed by
 
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