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Dr. Andrew Rynne

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What are the chances of conceiving twins while having two mature follicles?

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Dr. Nishikant Shrotri

OBGYN

Practicing since :1968

Answered : 2916 Questions

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Posted on Thu, 5 Nov 2015 in Women's Health
Question: Previously I have had 3 children that are 12, 11, and 5 years old with no issues from a previous marriage, I am now remarried and have been TTC for 2.5 years. My husband has been tested and he has no issues with sperm. My tubes have been checked a year ago and they are open. I have been diagnoised with a very minor level of PCOS....previously we tried the 1st round 2.5mg femara no response, 2nd cycle dose doubled to 5.mg 3-7 -and it resulted in one mature follicle measuring 18mm..Progesterone was checked then checked 7 days after Ovulation and progesterone result was 18, Dr. said I likely ovulated on my own based on progesterone result and due to having no known ovulation problems.... I am currently on my 3Rd cycle on femara with timed intercourse, This cycle I took Femara CD 3-8, of 5 mg and resulted in 2 mature follicles seen in ultrasound that was taken 10/19/2015..which measured 18.2 & 18.7 one on the left and one on the right, I am on CD 13 today, . ....I want to know if a trigger shot would give me any benefit for conceiving or makes of better quality egg?
I also want to know since I have 2 follicles that are mature does that mean there is a chance of them to both release and possibility of twins?
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Answered by Dr. Nishikant Shrotri 44 minutes later
Brief Answer:
Hormonal assays needed.

Detailed Answer:
Dear Adeodato,

I am not sure whether I have spelt your name correctly or not. If I am wrong, please correct me.

Femara you are taking is Letrozole, which is basically a medicine for cancer of the breast. Some doctors do use this medicine for treating infertility. It acts by suppressing a hormone released by Pituitory gland which is supposed to stimulate Oestrogen production.

I would have preferred to know the details of your investigations instead of just 'normal'. Particularly, if you have got your blood reports of FSH, LH, Oestrogen, Progesterone and Prolactin, please upload them for me to review them. I would not go for Letrozole without having these reports reviewed.

However, since you are showing good response to Letrozole, you may try it this month. Try to plan your intercourse on the day of egg release. Fortunately your eggs are getting released at or around 18 mm diameter which is a good size for healthy fertilization. Follicles more than 21 mm size are not good for the good quality of egg.

I believe your reference to 'Trigger shot' is towards hCG injection. This injection does help initiate the egg release from the follicle. That is the only advantage of this injection. Further more, if fertilization takes place, it helps settling down of the fertilized ovum since hCG is needed in the early stages for supporting the pregnancy.

Yes, you have got a very valid question! If both the follicles rupture, there is a possibility of both of them getting fertilized resulting into a twin pregnancy.

At this juncture, based on the information provided by you, I can guide you this much. If you provide me with detailed information, your medical history and the reports and images, I can study them, based on which I can advice you further.

I hope this information is also quite useful to you. For any more information, I am always available for you.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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