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What does the follicular studies indicate?

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Posted on Mon, 19 Jan 2015
Question: Hi! I am gonna be 31 yrs, height - 5.2 inches & weight - 68 kgs. I have got my FSH, LH, Insulin & AMH tested. My AMH is 1.29 and rest all 3 are normal. I have also done fallopian tube testing and thats normal too. My husbands sperm count is really good. We are trying to conceive since 5 months now but have failed. Today is my 17th day but eggs have still not ruptured. I was been given HCG 10000 injection on 14th day and had done IUI 3 hrs post taking the injection. Why have my eggs not ruptured? and can i still conceive this month? what are the chances. I had taken Goodova from day 3 to day 7. Did follicular studies from day 9 to till date. What medications should i do? Reports are normal then why am i not conceiving? Pls help. Is this an empty follicle. THe follicle are sized 29 X 25 and 23 X 16 on left ovary. Right Ovary is MSF and ET is 9.9 mm
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Answered by Dr. Manisha Jain (6 minutes later)
Brief Answer:
You have good chances to conceive.

Detailed Answer:
Hello mam,

The reason for unruptured follicle in your case is because of PCOD probably.
But at times follicles take time to mature so nothing to worry.
HCG injections are helpful and most probably you have good chances of conception with IUI.

All the best and in case, you have any questions I will be happy to help.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Follow up: Dr. Manisha Jain (56 minutes later)
IUI was done on the 14th day and today is my 17th Day and follicle has not ruptured. Still do i have a good chance to conceive.
doctor
Answered by Dr. Manisha Jain (21 minutes later)
Brief Answer:
follicular study tomorrow

Detailed Answer:
Yes, because you have good ET and had an IUI procedure. After IUI when good motility sperms are infused, sperms have a fertility potential for 72 hours to 5 days. So don't be worried.

Get a repeat scan tomorrow. I hope your doctor must have advised this to you. In case you still have unruptured follicle then HCG injection and IUI can be repeated.

The fact that size of follicles is good and sperm quality is also good, it favors your chances.
Just wait till follicular study tomorrow and then we can discuss further management.

Take care.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Manisha Jain (50 minutes later)
Thank you Dr. XXXXXXX XXXXXXX .. I shall do my follicular tomorrow and let you know. Can these 2 follicles be empty ?
doctor
Answered by Dr. Manisha Jain (24 minutes later)
Brief Answer:
less chance of both follicles being empty

Detailed Answer:
You are welcome.
PCOD affected women definitely have higher chances of unruptured follicles.
The diagnosis of empty follicle is one of the possibility when patient fails to conceive but in your case you have two follicles so chances of both being empty are less as your FSH and LH levels are normal (as you said).
Wait for your follicular study tomorrow which will decide our further management and prognosis.
Waiting for your response

Regards
Dr Manisha.
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Manisha Jain (22 hours later)
Hi Dr. XXXXXXX XXXXXXX .. I had been for a follicular today. One follicle sized 26 X 25mm is still visible but the other one sized 29 X 25 mm has not ruptured but has formed a cyst. The lab Dr says the other follicle will also not rupture and form a cyst instead. She has commented the following 29 X 25 mm follicle shows multiple septa s/o hemorhgic cyst and 26 X 25 mm shows few septa within s/o formation of cyst. Can u pls explain what does this mean and why has this occured. Is this the reason behind me not conceiving even after trials of 5 months. If yes then what is the solution to cure it?Will i ever be able to concieve naturally? Pls advice. Can this also happen as i had taken Goodova. Cause in past all 4 months my follicles had ruptured.
doctor
Answered by Dr. Manisha Jain (2 hours later)
Brief Answer:
cyst probability increases with goodova

Detailed Answer:
Hello mam, its sad to know the ultrasound report and this cycle is a waste now.
We will have start afresh with controlled ovarian stimulation.
Goodova can cause cyst formation (known complication).
So best option for you now is to opt for a fresh cycle of follicular study with an infertility specialist and supplement goodova with FSH injections to help in formation of good follicles.
In my practice I usually prefer to do In utero insemination along with follicular study in this situation.
You have normal hormones and good semen quality so chances of pregnancy are good with specialist care.
All the best and hope you will be blessed with a healthy baby soon.
In future you can contact me directly on health care magic.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Manisha Jain (16 minutes later)
I had done IUI and follicular study in this cycle but it did not help. Will this cyst something serious. when will it be cleared and does it create an hurdle for conceiving. earlier i had taken siphene 50 mg and this month i took goodova... which of these medicine is better? As i had mentioned m AMH is 1.29, is this too low fetility count? what are the reasons for this cyst formation and remedies for the same. Just to inform you i also take folic acid tablets everyday
doctor
Answered by Dr. Manisha Jain (57 minutes later)
Brief Answer:
repeat scan on day 2 of periods

Detailed Answer:
Folic acid is good and keep taking it.
Cyst formation is not a serious thing but not a good sign and can interfere with conception.
Induction drugs (clomiphene and FSH)are withheld till the cysts subside.
These cysts disappear on their own most of the times and just need regular follow up in the form of ultrasound.
Goodova is better than siphene as it contains enclomiphene which is the good isomer.
AMH is definitely in lower side but as dominant follicles are developing the inference from low AMH in your case is just that you need to actively participate in assisted reproduction (as you are already doing) and don't sit and rest in hope of spontaneous conception.
Cyst formation is common in patients taking ovulation induction I.e. clomiphene and those with PCOD (polycystic ovary disease).
Cysts usually disappear themselves.
Wait for your periods now and get a repeat scan on day 2 to see for the disappearance of the cysts.
All the best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Manisha Jain

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What does the follicular studies indicate?

Brief Answer: You have good chances to conceive. Detailed Answer: Hello mam, The reason for unruptured follicle in your case is because of PCOD probably. But at times follicles take time to mature so nothing to worry. HCG injections are helpful and most probably you have good chances of conception with IUI. All the best and in case, you have any questions I will be happy to help.