Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Took 5 Days Fertomid 100 Mg, 6 Injections Of Menopur 75 IU And Follicle Size 10. Drop The Cycle Or Wait For Follicle To Grow?
Question: hello doctor,
I am on my second cycle of ovulation induction and IUI
Now i took 5 days fertomid 100 mg and 6 injections of menopur 75 IU and my follicle size was 10 mm on day 14th so my doctor stopped giving me menopur and told to cancel the cycle as follicles are not growing.
today is my 19th day of cycle and i did ultrasound and it shows same size of follicle i.e 10 mm with endometrium of 9 mm .
now should i drop the cycle or should i wait for follicle to grow ?
and if i drop the cycle should i take progestrone for getting my period as i have Poly cystic ovaries as i think that i will not get periods withour progestrone?
also was it right for my doctor to stop the injection on day 14 as i think it was too early to decide whether the follicles will grow or not? also i would like to tell u that mostly my cycles are delayed and i use progestrone to get periods?
I am on my second cycle of ovulation induction and IUI
Now i took 5 days fertomid 100 mg and 6 injections of menopur 75 IU and my follicle size was 10 mm on day 14th so my doctor stopped giving me menopur and told to cancel the cycle as follicles are not growing.
today is my 19th day of cycle and i did ultrasound and it shows same size of follicle i.e 10 mm with endometrium of 9 mm .
now should i drop the cycle or should i wait for follicle to grow ?
and if i drop the cycle should i take progestrone for getting my period as i have Poly cystic ovaries as i think that i will not get periods withour progestrone?
also was it right for my doctor to stop the injection on day 14 as i think it was too early to decide whether the follicles will grow or not? also i would like to tell u that mostly my cycles are delayed and i use progestrone to get periods?
Hello
Thanks for your query.
Would you let me know what is your normal cycle duration ?
That will help me to guide you better.
Also, what was the outcome of the previous cycle of ovulation induction and IUI - what was the follicle size, did ovulation occur ?
Looking forward to hearing from you again.
Take care.
Thanks for your query.
Would you let me know what is your normal cycle duration ?
That will help me to guide you better.
Also, what was the outcome of the previous cycle of ovulation induction and IUI - what was the follicle size, did ovulation occur ?
Looking forward to hearing from you again.
Take care.
Above answer was peer-reviewed by :
Dr. Prasad
hello doctor,
MY FIRST IUI IN FEBRUARY
had my 1st IUI with gonal F (no clomid) 100 iu to 125 iu i had at least 15 injections and my eggs developed after 23 rd day of cycle but since i had too many follicles suddenly so it turned out to be hyper stimulation so i was given decapeptyl instead of HCG and IUI was performed
BREAK OF 1 MONTH
2ND IUI in may
my second iui was also not successful i had clomid 5 days and 2 injections menogon 75 iu and 4 injections 75 iu and i had 4 follicles on 15th cycle day size between 18 19 20 good size ( no hyper stimulation) they gave me hcg 0000 iu trigger shot .
my third cycle is going on and i have given details in my Question
thats my history for two cycles
MY FIRST IUI IN FEBRUARY
had my 1st IUI with gonal F (no clomid) 100 iu to 125 iu i had at least 15 injections and my eggs developed after 23 rd day of cycle but since i had too many follicles suddenly so it turned out to be hyper stimulation so i was given decapeptyl instead of HCG and IUI was performed
BREAK OF 1 MONTH
2ND IUI in may
my second iui was also not successful i had clomid 5 days and 2 injections menogon 75 iu and 4 injections 75 iu and i had 4 follicles on 15th cycle day size between 18 19 20 good size ( no hyper stimulation) they gave me hcg 0000 iu trigger shot .
my third cycle is going on and i have given details in my Question
thats my history for two cycles
Hello
In the first IUI you had egg development after 23rd day of cycle, hence you could have had delayed development in this cycle also.
However, it is pointless to give injections for stimulation after day 14 of the cycle, hence your doctor was right in that regard.
If there was delayed development, it would have occurred in response to the injections given until day 14.
Right now, there is very little chance of development as on the 19th day , follicle size is still 10 mm.
You can have one more follow up ultrasound after 4 - 5 days, as earlier development was observed till day 23, however do not have much hope in this cycle.
You can take progesterone for withdrawal bleed, if you do not menstruate without medication regularly.
Next time, before proceeding for IUI, have a complete PCOD workup in the form of -
Day 2 FSH , LH
AMH
Pelvic baseline sonogram
Prolactin, T3, T4, TSH
DHEAS, S. free testosterone
S. fasting insulin, Oral glucose tolerance test.
Sometimes, patients with PCOD have to go for antagonist protocol, where different injections are given . You can discuss this with your doctor. In some protocols, injections are started from the pre menstrual phase also.
Patients with PCOD often have difficulty conceiving, so do not lose hope.
Also, if more IUIs fail inspite of good egg development, you can go for hysterolaparoscopy to check if your fallopian tubes are patent.
Meanwhile, remain stress free, maintain an ideal BMI.
All the best to you.
In the first IUI you had egg development after 23rd day of cycle, hence you could have had delayed development in this cycle also.
However, it is pointless to give injections for stimulation after day 14 of the cycle, hence your doctor was right in that regard.
If there was delayed development, it would have occurred in response to the injections given until day 14.
Right now, there is very little chance of development as on the 19th day , follicle size is still 10 mm.
You can have one more follow up ultrasound after 4 - 5 days, as earlier development was observed till day 23, however do not have much hope in this cycle.
You can take progesterone for withdrawal bleed, if you do not menstruate without medication regularly.
Next time, before proceeding for IUI, have a complete PCOD workup in the form of -
Day 2 FSH , LH
AMH
Pelvic baseline sonogram
Prolactin, T3, T4, TSH
DHEAS, S. free testosterone
S. fasting insulin, Oral glucose tolerance test.
Sometimes, patients with PCOD have to go for antagonist protocol, where different injections are given . You can discuss this with your doctor. In some protocols, injections are started from the pre menstrual phase also.
Patients with PCOD often have difficulty conceiving, so do not lose hope.
Also, if more IUIs fail inspite of good egg development, you can go for hysterolaparoscopy to check if your fallopian tubes are patent.
Meanwhile, remain stress free, maintain an ideal BMI.
All the best to you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks doctor for the reply
In my first iui I was given injections continuously till 23 rd day from the day 2 of my cycle and only then my follicles increased in size suddenly .
However in this cycle I only took 6 injections so don't u think doctor should have continued injections ?
I think my chance this month is very less but if this cycle I don't have good follicle will I make good follicle next cycle ?
I mean does it happen in PCO that one cycle a woman doesn't make dominant follicle n next cycle she makes good follicles ?
Also my Amh is 8.6 and fsh lh are ok
In my first iui I was given injections continuously till 23 rd day from the day 2 of my cycle and only then my follicles increased in size suddenly .
However in this cycle I only took 6 injections so don't u think doctor should have continued injections ?
I think my chance this month is very less but if this cycle I don't have good follicle will I make good follicle next cycle ?
I mean does it happen in PCO that one cycle a woman doesn't make dominant follicle n next cycle she makes good follicles ?
Also my Amh is 8.6 and fsh lh are ok
You mentioned at least 15 injections given from day 2, that would mostly not carry you on injections till day 23.
Normally, stimulation injections are not given till day 23 of the cycle. IT would help if your doctor gave you more details.
Also, last time, the growth might have prompted your doctor to try and continue the stimulation.
However, 10 mm is quite a small size, hence it was a proper decision to stop stimulation, and reduce the risk of side effects.
There is no guarantee that next month you would make good follicles.
There is no rule of thumb in PCOD that every alternate cycle would have good follicles.
Women with PCOD often have difficulty in responding to stimulation, and special protocols have to be tried in them such as - Antagonist protocol as I mentioned.
You might require IVF also, if more IUIs fail.
Please do not lose hope, as the journey to fertility in PCOD is sometimes quite long and frustrating.
Normally, stimulation injections are not given till day 23 of the cycle. IT would help if your doctor gave you more details.
Also, last time, the growth might have prompted your doctor to try and continue the stimulation.
However, 10 mm is quite a small size, hence it was a proper decision to stop stimulation, and reduce the risk of side effects.
There is no guarantee that next month you would make good follicles.
There is no rule of thumb in PCOD that every alternate cycle would have good follicles.
Women with PCOD often have difficulty in responding to stimulation, and special protocols have to be tried in them such as - Antagonist protocol as I mentioned.
You might require IVF also, if more IUIs fail.
Please do not lose hope, as the journey to fertility in PCOD is sometimes quite long and frustrating.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
