Ultrasound showed mature follicle but....

[Stephanie76]

I am so confused and going in and out of crying spells. I am hoping one of you can elaborate for me.

Not so short summary -

Hubby and I have been TTC for some time now. After not having my period for a few months post birth control pill, I decided it was a good idea to see an ob/gyn. My ob/gyn was suspect of PCOS and wanted to do an ultrasound (and blood work) at a later appt but in the meantime prescribed me the wonderful Prometrium (haaaate that med!!!!!) to induce AF. I promptly started the med as directed and scheduled my ultrasound around the time of completing the Prometrium. Timeline: finished 10 day cycle of 200mg on Tuesday April 17th.

Wednesday April 18th morning temp 97.0 (which is normal for me).

Timeline : Thursday April 19th (morning temp shot up 1 whole degree! Morning temp was 98.0!)- I stroll into her office and get the ultrasound done ---here is where it gets confusing----- which shows I have a 20mm follicle in my left ovary!! Blood was concentrated on flowing to this bad boy and she let us hear it!!!! The tech stated that it looks like I should be ovulating any time and that we should be BDing every day for the next few days. Discussing the further with my actual ob/gyn, we confirmed the size and the ovulating hypothesis.... She stated that my blood work came back normal and that she would surmise that I just have a bad case of the post pill amenorrhea. She said that a mature follicle releases the egg at about 20-24mm so I could be ovulating any day! I was delighted to hear this! She asked me where I was with my Prometrium and I told her I had just finished it. She didn't elaborate on what that could potentially do at this point and sent me out the door smiling thinking I was Miss Fertile.

Morning temp Friday April 20th - 97.9 -still elevated.


Timeline : April 21st - (morning temp plummeted... 96.9 ...lowest reading i have ever seen).While using the little girls room mid-afternoon, I notice brown spotting in my underwear. I thought maybe it is that ovulation bleeding since there was a little CM mixed in (very small amount), so, of course, this furthers my excitement. I carry on with my evening and have a 3 margaritas to celebrate belated birthday with friends... I use the restroom again and there is more blood this time. This time... I can see it in my undies and in the toilet...notice cramping too.

Timeline: This morning - I use the restroom....and there is still blood. It isn't heavy but isnt spotty either. I am having to wear a tampon.

My question..... What the heck is going on?!?!!?? Did my mature follicle completely disappear? Is it possible for it to just stay put and not actually ovulate? Could it be possible that i am ovulating still or is this Prometrium winning the battle here?!?! I am so confused on what is happening because I was just told by a professional that I should be ovulating and now it would seem like I might have jumped straight to my period!?!?! What about the temp readings?! Anyone have anything similar to this?!

Thank you so much in advance.

Emotional train wreck here!

 

[mammag]

I always thought that Prometrium was to bring on AF?? It raises your progesterone level while you are on it, and then when you stop taking it, your progesterone level drops and signals AF to come? So I'm not sure why you would be given prometrium at the beginning of your cycle?

So I would assume, and I hate to say this, and keep in mind I'm not a dr or fertility expert, that even though you were about to ovulate that the rapid decrease in progesterone after ending the prometrium was enough to signal AF no matter where you were in your cycle. I'm sorry hun. But I would count this as CD 2 Good Luck.

 

[seabean]

I agree w/ mam.

Prometrium is progesterone and after 10 days of use you will get AF in a few days from the end of it. It raises your temp, so that's probably why your temp shot up. Mine stays up for a few days after the last pill, then plummets, and AF comes basically that day the temp goes down.

She probably prescribed it to end your long anovulatory post-BCP cycle, not knowing that you might actually be ovulating any day now.

It is still possible that you can ovulate! If you are comfortable w/ the idea, I would say keep BD-ing (even if AF is still around)!

 

[Stephanie76]

Thank you both so much. And you got it right Seabean! When I went and saw the ob/gyn initially, and told her of how long it had been since my last AF, she was concerned and wanted me to shed that lining. Upon giving the Prometrium on that first visit, she said she wanted to see me when I finished it for an ultrasound to rule out the possibility of ovarian cysts or any abnormalities. Upon doing that ultrasound, she saw my mature follicle and my "fluffy" uterine lining and said it was great conditions for an egg to potentially implant and suggested BDing every day the next few days.

Thanks again for all your words of wisdom. I am trying to think positively about this.. but after getting so excited seeing that follicle and watching the husbands face light up.. But at the same time, it is good that Prometrium worked I suppose.


So... you said it is actually possible to still ovulate while this is all going on??? I am confused on how to track this.. if I do indeed call it CD2.. ? I have the ClearBlue Easy Fertility Monitor... so, I would need to know for programming that in.

 

[mammag]

I'm not completely sure, but I don't think you will ovulate with the progesterone drop, estrogen is needed to signal Lh and then the release of your egg. Chances are the egg will stop growing and not release and your body will see this as a new cycle, and since you started bleeding yesterday, along with a temp drop, I would count yesterday as CD1, there's nothing wrong with BD'ing just in case, but at the same time, treat this like a new cycle.

 

[seabean]

Thank you both so much. And you got it right Seabean! When I went and saw the ob/gyn initially, and told her of how long it had been since my last AF, she was concerned and wanted me to shed that lining. Upon giving the Prometrium on that first visit, she said she wanted to see me when I finished it for an ultrasound to rule out the possibility of ovarian cysts or any abnormalities. Upon doing that ultrasound, she saw my mature follicle and my "fluffy" uterine lining and said it was great conditions for an egg to potentially implant and suggested BDing every day the next few days.

Thanks again for all your words of wisdom. I am trying to think positively about this.. but after getting so excited seeing that follicle and watching the husbands face light up.. But at the same time, it is good that Prometrium worked I suppose.


So... you said it is actually possible to still ovulate while this is all going on??? I am confused on how to track this.. if I do indeed call it CD2.. ? I have the ClearBlue Easy Fertility Monitor... so, I would need to know for programming that in.

I think it is possible that you can Ovulate. The progesterone actually prevents ovulation, but once it is out of your system (when AF starts), then you still have that maturing follicle. Your hormonal cycle starts over again with CD1 (first day of AF flow) , but since you already have a very mature follicle, it might release sooner in your cycle. I would BD earlier than usual just in case, for that reason! Good luck!!!

 

[Stephanie76]

So cycle day 2.. Now comes the discussion of Clomid, I am sure (the ob/gyn already brought that up). Would that aide in this situation? So when AF leaves and we hope the mature follicle hangs around... would the Clomid make the follicle drop the egg?

Sorry for all the questions. You all are terrific and helpful. Means so much to me.

 

[mammag]

I would say you are in a perfect position to take clomid! But you need to speak with your doctor SOON, within the next day or two, so that you can start it on time! My only advice would be to not put all your hopes into the first month on. I took clomid for the first time this month and still didn't O till CD 24, and a CD 22 ultrasound only showed one follicle at 15mm, that's not even technically "mature" hoping next month proves more fruitful for me

 

[Stephanie76]

Wonderful! Will call the doc tomorrow.

Good luck mammag!!!!!

 

[Stephanie76]

Well, this is odd (but possibly normal)... It would seem my period is coming to an end now. Is this common for Prometrium induced periods to be short?? Also, the color isn't quite what I remember my periods being either. On Saturday, CD1, it was a light brown... then yesterday (CD2) and today (CD3), it is a bright pink.... It is light, but enough that I am wearing a "light" version tampon.

Thoughts on this or does this typically happen with induced periods?

 

[sparklythings]

Very interesting thread. I agree with the ladies that previously posted. It makes sense but who knows what's really going on inside there. I have no idea about lighter periods after having it induced. Sounds like you were actually about to do things on your own and maybe the prometrium may have messed things up for you. No idea about the bleeding but ill be checking back. I wouldn't count this as a cycle of ttc at all.

 

[seabean]

Well, this is odd (but possibly normal)... It would seem my period is coming to an end now. Is this common for Prometrium induced periods to be short?? Also, the color isn't quite what I remember my periods being either. On Saturday, CD1, it was a light brown... then yesterday (CD2) and today (CD3), it is a bright pink.... It is light, but enough that I am wearing a "light" version tampon.

Thoughts on this or does this typically happen with induced periods?

I've used progesterone to bring on AF twice now. The first time it was a regular period for me. The second, it was super light, kind of like you are describing. The fact that it came at all is a good sign. I would treat this like a regular cycle, but I'm not sure if that mature follicle will make things weird or not? Keep us posted

 

[Stephanie76]

Well, not much to report now. I had one day of medium AF (which was Sunday... CD2). Monday (CD3) AF was bright pink and light.. I stopped using a tampon later that day because of how light it was. Tuesday (CD4) was spotting and didn't even require a pantyliner. Wednesday (CD5) was essentially the end of it all. So that would put me at a very odd, light 5 day cycle I guess?!?! I am a bit cautious in even calling it that! Haha!

Regardless, I do think you are all right in that my body was gearing up to do something and the Prometrium won that battle. I will tell you, I HATED taking that stuff!

I called my doc to discuss Clomid and she said we could do a round if we want, or just wait and see if my body got a little kick start from the Prometrium round. With my husband being nervous about Clomid twins as they run in our family as is, I don't think he wanted to perpetuate that risk more-so. Clomid this round was not in the cards. So, I am on CD 7, and am using my ClearBlue Easy Fertility Monitor to see if helps.. as well as tracking my BBT.

 

[Ksquared648]

I know this post is old, but I was curious what happened that cycle? I thought I was on Day 3 after a round of prometrium and went in for a baseline ultrasound. I was expecting no follicles and was going to start follistim injections tonight, however we were surprised to find two large follicles! On the right ovary, I have a 28 mm (maybe a cyst) and on the left I have an 18 mm. The doctor said she will wait to see what my bw comes back at, but these might be actual mature follicles.

 

[Hopeful456]

Did you ever hear an update? I recently found myself in similar situation. Went in for day 3 baseline us to start meds for iui and they found what they thought was a cyst. Went back cd5 and it turned out to be a mature follicle 20 mm and my E2 went up to 360. They advised us to BD that night and next day. I'm just perplexed that i could have a mature follicle on day5, but af was short and lighter than normal...still hopeful