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What Do These Follicle Monitoring Test Results Indicate?
Question: Hi,
We are planning for baby since XXXXXXX 2015 and seriously from April 2015.
I did FM monitoring with following result:
April 2015
Day 13 Left Ovary (-), ET thickness- 10 mm, Single follicle from Left Ovary raptured.
May 2015
Day 13 Left Ovary (-), ET thickness -11 mm, Single follicle from Left Ovary raptured.
XXXXXXX – Didn’t try
July 2015
Day 15 and 16 Left Ovary 15mm .Follicle didn’t rapture naturally for this month.
As natural rapture didn’t happen in this month so treatment plan was initiated for next cycle.
Aug 2015 (Under Treatment)
Day -2 : Visited Doctor and she prescribed below
Tb Clomipure Day 3 to Day 7 ( After Dinner)
Cap Ovaries SR 75 1 OD * 30 days
Tab Folvite 1 OD
Day-4 : Injection FSH 150 IU
Day-14 : Injection HCG 5000 IU in stat
Tab Dubagest 300 mg vaginally* 15 days Day 16 onwards
Follicle monitoring result :
Day-4 : Injection FSH 150 IU
Day 7 : RT OVRY (17 mm) LT OVRY(11 mm) ENDO (3.7mm)
Day 8 : RT OVRY (18 mm) LT OVRY(12 mm) ENDO (5.4 mm)
Day 10 : RT OVRY (22 mm) LT OVRY(14 mm, 17mm) ENDO (6 mm)
(We had relationship in evening)
Day 11 : RT OVRY (26 mm) LT OVRY(19 mm, 18 mm ) ENDO (6 mm)
Day 12 : RT OVRY (29 mm) LT OVRY(20 mm, 21 mm) ENDO (7.6 mm)
(We had relationship in evening)
Day 13 : RT OVRY (31 mm, 23 mm) LT OVRY(22 mm,23 mm) ENDO (7.6 mm)
Day 14 : RT OVRY (32 mm, 23 mm) LT OVRY(22 mm, 23 mm) ENDO (8 mm)
Evening Injection HCG 5000 IU in stat given
(We had relationship in evening)
Day 15 : RT OVRY (Not Seen) LT OVRY(Not Seen) ENDO (9 mm)
RT (Another 16mm DF seen); LT(15mm irregular sized DF seen)
Minimal Free Fluid + in P.O.D
(We had relationship in evening)
Doc asked us to make relationship for Day 14, 15 ( Rapture happened after Injection HCG 5000IUI) and Day 16. On Day 15 radiologist said all 4 follicle (Right 32,23 mm) and Left (22,23mm) are not visible and POD is seen so all four are rupture. However 2 new follicle one at each ovary were visible.
Below are my questions:
1. What are the chances of complication in case of 4 follicles released?
2. Is there chances of multiple pregnancy and how many?
3. Is there any way to avoid complication & multiple pregnancies?
4. Will this treatment impact my next cycle? Do I need to take injections again for Follicle growth (FSH) and Rapture (HCG) every month?
5. As per last 3 months FM monitoring; follicle use to grow naturally; However this month my doc gave injection FSH 150 IU which caused 4 follicle released. Was this injection required for me?
6. What will happen to the 2 new follicles which were seen on Day 15 when previous 4 were not visible?
My Age is 34 and I think it might be difficult to carry multiple pregnancies at this age.
Both of our parents have diabetes ; I have heard now a days gestational diabetes is very common so bit concerned.
I know I have given too much information and many questions but I am very tensed and I need your advice soon to take immediate actions. Please help.
Thanks
XXXX
We are planning for baby since XXXXXXX 2015 and seriously from April 2015.
I did FM monitoring with following result:
April 2015
Day 13 Left Ovary (-), ET thickness- 10 mm, Single follicle from Left Ovary raptured.
May 2015
Day 13 Left Ovary (-), ET thickness -11 mm, Single follicle from Left Ovary raptured.
XXXXXXX – Didn’t try
July 2015
Day 15 and 16 Left Ovary 15mm .Follicle didn’t rapture naturally for this month.
As natural rapture didn’t happen in this month so treatment plan was initiated for next cycle.
Aug 2015 (Under Treatment)
Day -2 : Visited Doctor and she prescribed below
Tb Clomipure Day 3 to Day 7 ( After Dinner)
Cap Ovaries SR 75 1 OD * 30 days
Tab Folvite 1 OD
Day-4 : Injection FSH 150 IU
Day-14 : Injection HCG 5000 IU in stat
Tab Dubagest 300 mg vaginally* 15 days Day 16 onwards
Follicle monitoring result :
Day-4 : Injection FSH 150 IU
Day 7 : RT OVRY (17 mm) LT OVRY(11 mm) ENDO (3.7mm)
Day 8 : RT OVRY (18 mm) LT OVRY(12 mm) ENDO (5.4 mm)
Day 10 : RT OVRY (22 mm) LT OVRY(14 mm, 17mm) ENDO (6 mm)
(We had relationship in evening)
Day 11 : RT OVRY (26 mm) LT OVRY(19 mm, 18 mm ) ENDO (6 mm)
Day 12 : RT OVRY (29 mm) LT OVRY(20 mm, 21 mm) ENDO (7.6 mm)
(We had relationship in evening)
Day 13 : RT OVRY (31 mm, 23 mm) LT OVRY(22 mm,23 mm) ENDO (7.6 mm)
Day 14 : RT OVRY (32 mm, 23 mm) LT OVRY(22 mm, 23 mm) ENDO (8 mm)
Evening Injection HCG 5000 IU in stat given
(We had relationship in evening)
Day 15 : RT OVRY (Not Seen) LT OVRY(Not Seen) ENDO (9 mm)
RT (Another 16mm DF seen); LT(15mm irregular sized DF seen)
Minimal Free Fluid + in P.O.D
(We had relationship in evening)
Doc asked us to make relationship for Day 14, 15 ( Rapture happened after Injection HCG 5000IUI) and Day 16. On Day 15 radiologist said all 4 follicle (Right 32,23 mm) and Left (22,23mm) are not visible and POD is seen so all four are rupture. However 2 new follicle one at each ovary were visible.
Below are my questions:
1. What are the chances of complication in case of 4 follicles released?
2. Is there chances of multiple pregnancy and how many?
3. Is there any way to avoid complication & multiple pregnancies?
4. Will this treatment impact my next cycle? Do I need to take injections again for Follicle growth (FSH) and Rapture (HCG) every month?
5. As per last 3 months FM monitoring; follicle use to grow naturally; However this month my doc gave injection FSH 150 IU which caused 4 follicle released. Was this injection required for me?
6. What will happen to the 2 new follicles which were seen on Day 15 when previous 4 were not visible?
My Age is 34 and I think it might be difficult to carry multiple pregnancies at this age.
Both of our parents have diabetes ; I have heard now a days gestational diabetes is very common so bit concerned.
I know I have given too much information and many questions but I am very tensed and I need your advice soon to take immediate actions. Please help.
Thanks
XXXX
Brief Answer:
You are taking the right treatment
Detailed Answer:
Hello XXXXXXX thanks for trusting health care magic.
I understand your anxiety related to the issue.
There is practically no complication with 4 follicles rupturing simultaneously except multiple pregnancy which occurs in only 5% of the clomiphene induced cycles.
This rate cannot be reduced further.
Yes FSH is a better way to mature the follicle as it helps in increasing the endometrial thickness as well and suppresses the bad hormones in body.
It will be better if you take FSH in next cycle too.
The failure of spontaneous ovulation is just because of excessive anxiety and at times clomiphene failure occurs but can be easily managed so don't be anxious about the rupture of follicle as that can be easily manipulated from outside via various drugs.
Remaining two follicles will atrophy as you will start gestofit now which will halt their growth and thus they are not of much significance and are usually seen in most of clomiphene induced cycles.
Multiple pregnancy can be easily managed if you take as much rest as told by your doctor with regular antenatal visits.
Right now just pray for pregnancy, as fetal reduction can also be done in case you guys are very much against multiple pregnancy.
Diabetes firstly is not the thumb rule that it will happen only and in case it does show up then also can be taken care of by insulin and other drugs.
You can ask as many questions as you want, as I will be glad to comfort you by telling you all the technical points related to the issue.
Take care
Regards
Dr Manisha
You are taking the right treatment
Detailed Answer:
Hello XXXXXXX thanks for trusting health care magic.
I understand your anxiety related to the issue.
There is practically no complication with 4 follicles rupturing simultaneously except multiple pregnancy which occurs in only 5% of the clomiphene induced cycles.
This rate cannot be reduced further.
Yes FSH is a better way to mature the follicle as it helps in increasing the endometrial thickness as well and suppresses the bad hormones in body.
It will be better if you take FSH in next cycle too.
The failure of spontaneous ovulation is just because of excessive anxiety and at times clomiphene failure occurs but can be easily managed so don't be anxious about the rupture of follicle as that can be easily manipulated from outside via various drugs.
Remaining two follicles will atrophy as you will start gestofit now which will halt their growth and thus they are not of much significance and are usually seen in most of clomiphene induced cycles.
Multiple pregnancy can be easily managed if you take as much rest as told by your doctor with regular antenatal visits.
Right now just pray for pregnancy, as fetal reduction can also be done in case you guys are very much against multiple pregnancy.
Diabetes firstly is not the thumb rule that it will happen only and in case it does show up then also can be taken care of by insulin and other drugs.
You can ask as many questions as you want, as I will be glad to comfort you by telling you all the technical points related to the issue.
Take care
Regards
Dr Manisha
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Thanks Mam for the clarification,
My doc asked me to start Tab Dubagest 300 mg/ Susten 300mg vaginally* 15 days from Day 16 onwards. I started taking it vaginally from Yesterday Night.
However, found discharge happening whole night through vagina.
My question:
--Does Susten 300mg has any side Effect?
--This is First time I am taking Susten tablet through Vagina,3 Months back I had taken Gestofit orally,that time I didn't had any discharge through Vagina.
Is Susten 300mg high dose for me?
Can I shift to a lower dose like Susten 200mg or instead of vaginally orally?
--Can this impact my next cycle.
--I had observed increase in my Body weight once I started the treatment plan this month.Does body weight has any relation with these tablets.
My doc asked me to start Tab Dubagest 300 mg/ Susten 300mg vaginally* 15 days from Day 16 onwards. I started taking it vaginally from Yesterday Night.
However, found discharge happening whole night through vagina.
My question:
--Does Susten 300mg has any side Effect?
--This is First time I am taking Susten tablet through Vagina,3 Months back I had taken Gestofit orally,that time I didn't had any discharge through Vagina.
Is Susten 300mg high dose for me?
Can I shift to a lower dose like Susten 200mg or instead of vaginally orally?
--Can this impact my next cycle.
--I had observed increase in my Body weight once I started the treatment plan this month.Does body weight has any relation with these tablets.
Brief Answer:
Take it as advised
Detailed Answer:
Susten tablet has very good results when taken vaginally and 300 is the right dose to be given in sustained release form.
The discharge you had from vagina is because of the drug delivery substance which is there in capsule which is released out and drug is absorbed into the vagina.
This is the reason there is vaginal discharge when you have taken it via vagina and not there when taken orally as you did 3 months back.
So take it as advised and you will have improved chances of a successful pregnancy.
Take care
Take it as advised
Detailed Answer:
Susten tablet has very good results when taken vaginally and 300 is the right dose to be given in sustained release form.
The discharge you had from vagina is because of the drug delivery substance which is there in capsule which is released out and drug is absorbed into the vagina.
This is the reason there is vaginal discharge when you have taken it via vagina and not there when taken orally as you did 3 months back.
So take it as advised and you will have improved chances of a successful pregnancy.
Take care
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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