Uneven follicle growth during IVF stimulation

[Northern Jane]

Hi ladies,

I am currently in the stimulation phase of my 2nd IVF cycle and am in need of, well, some encouragement hopefully. My 1st IVF cycle (Nov 2013) was unsuccessful. I did an antagonist protocol and got 8 mature sized follicles (<18mm) but during the retrieval, only 4 follicles were found. Apparently there was no fluid in the ovaries to signify ovulation had occurred, but no one seems to have an alternative explanation as to what happened to the other 4 follicles. Anyways, of the 4 follicles that were visible, we got 1 abnormal egg, 2 immature eggs and 1 normal egg. The normal egg fertilized with ICSI and was transferred on day 3, but unfortunately did not stick around. My Dr has since put me on CoQ10 due to a potential egg quality issue (why were 75% of my eggs not viable?) and we're trying again 5 months later, this time with a long downregulation protocol.

Which brings me to my question. I'm on Day 6 and currently have 1 large follicle on my right side (19mm) along with 3 between 7 and 11mm and 6 less than 7mm. On my left side I have 3 less than 7mm. I'm on Lupron and Puregon for the stims. Does anyone have any sense as to why all the follicle growth has been into 1 follicle? There was no large follicle on my day 2 baseline so it's not like it had a head start. Is it common for the others to catch up? Any advice or just support in general would really help - thanks in advance for being awesome!

 

[Coolstar]

I don't have any answer but just wanted to hug you, I could not read and run away. I know what you are going through. I just had ivf and had only 2 lead follicles and my smaller ones could not catch up. Did you talk with your doctor ? You still have time so I guess some smaller follicles might catch up with the lead. And rem you just need one.Wish you all the luck.

 

[Northern Jane]

And all the luck to you too!
I'm waiting for blood work now so I guess we'll see how that plays into it. It's not like you can tell the meds where to go and where not to go (can you imagine you could though?)

 

[Mas1118]

I had a similar scenario this cycle - only one follicle after 4 days of stims and after 7 days - I still only had 3 growing with one dominant so they took me off the lupron. Today which is after 10 stim days - I have 5 - still one that is bigger than the rest but they are catching up!! The lupron over suppressed me. Maybe your RE can take you off that one.

 

[Northern Jane]

Yes that does sound somewhat similar, but if you are off the Lupron, what stops you from ovulating? Given my experience with IVF#1, I'm a bit paranoid about that. I went into the retrieval thinking I had 8 mature follicles, but they only saw 4 so that's all I got - thinking I ovulated away the other 4 (it was an antagonist protocol last time - Centrotide).
Today is day 8 and the dominant follicle is up to 24mm. I also have a 12, 12, 14 and two 7s. Is there any chance that those other ones would have viable eggs inside if they were allowed to grow? I know, wish we had all the answers, right? Thank you

 

[messica]

I'm in a somewhat similar situation. It was explained to me that "dominant" follicles aren't uncommon and that's what's happening when you have one jet up in size while the others lag. I was instructed to stim additional days (total of 11) and continue 5 units of Lupron throughout to prevent losing the lead to ovulation. Mine ranged in size from 12 - 23. I triggered when the late bloomers hit 15 and retrieval is tomorrow.


They told me 15 is considered mature enough to retrieve. I'm looking at 8/9 at that size with several others too small to do anything else with. Your less than 7's may not have time to catch up but your 7-11's sure could. Only being on day 6 you never know so don't lose hope! Keep in mind too that there is no hard rule that each follicle can only contain one egg, sometimes there can be several in each. Even if it appears like you'll only a few you may be surprised with many more.


In general (again this is our only cycle and is based on what I've gathered myself), having one, as in truly ONE, dominant follicle with almost or no other follicles to be seen means proper suppression never occurred. I'm curious what protocol you are currently on if you don't mind sharing?

 

[Northern Jane]

I'm in a somewhat similar situation. It was explained to me that "dominant" follicles aren't uncommon and that's what's happening when you have one jet up in size while the others lag. I was instructed to stim additional days (total of 11) and continue 5 units of Lupron throughout to prevent losing the lead to ovulation. Mine ranged in size from 12 - 23. I triggered when the late bloomers hit 15 and retrieval is tomorrow.


They told me 15 is considered mature enough to retrieve. I'm looking at 8/9 at that size with several others too small to do anything else with. Your less than 7's may not have time to catch up but your 7-11's sure could. Only being on day 6 you never know so don't lose hope! Keep in mind too that there is no hard rule that each follicle can only contain one egg, sometimes there can be several in each. Even if it appears like you'll only a few you may be surprised with many more.


In general (again this is our only cycle and is based on what I've gathered myself), having one, as in truly ONE, dominant follicle with almost or no other follicles to be seen means proper suppression never occurred. I'm curious what protocol you are currently on if you don't mind sharing?

I started 10 units of Lupron on Day 19 of my previous cycle, and have continued with that throughout this cycle. On Day 2 of this cycle, I started Puregon, first 250 now up to 275 (downregulation Long protocol). It's now day 10 and I have about 9 follicles across a broad range of size. I suppose the hard part now is to maximize the number in the ideal size range. We let the dominant follicle go and are now focusing on the others, of which today there were 3 promising ones at 14, 17 and 18mm. There was also a 10, an 8 and some 7s, which may or may not catch up. Fingers crossed!

 

[BBbliss]

I had a similar scenario this cycle - only one follicle after 4 days of stims and after 7 days - I still only had 3 growing with one dominant so they took me off the lupron. Today which is after 10 stim days - I have 5 - still one that is bigger than the rest but they are catching up!! The lupron over suppressed me. Maybe your RE can take you off that one.

Mas, could you tell me what your lining was on your first FET compared to your second? I had a chemical with my first ivf and I believe it was due to a thin lining

 

[candefloss30]

Hi ladies

I am in a similar-ish situation. This is my first IVF attempt and I'm on the short protocol antagonist although it isn't ahort as I am on day 20 of stims!! It's nearly been cancelled about 4 times and was told the other day I had premature ovarian failure then they started to grow! So I have one at 13 and about 4 at 8 so they sis they will check every other day and probably go for the 4 if they keep growing. I have 3 others that are doing nothing.

It is so frustrating and exhausting isn't it?

Wishing you all luck and lots of growth!

 

[BBbliss]

Candefloss, you poor thing! I had a dominant follicle that was 18 and everything else was much smaller and on Monday they talked about canceling. I know how it feels, I went for an acupponture session and I think it helped and I got back on track so I triggered last night and retrieval is tomorrow. I have no idea how many eggs I'm getting because they are all sizes from 8-22mm.

Besides ACU I used a heating pad with the hopes it would help and I think it did. Good luck and I hope they grow enough that you don't cancel

 

[candefloss30]

BBbliss good luck for tomorrow!! What is the thinking behind heating pads? I had acupuncture years ago the last time I was ttc and they said my stomach and kidneys were 'cold'.

Got my e2 results back today and they are rising but it hasn't doubled like the last time it seems to be slowing just hope it continues.

Let me know how many eggs you get, hope it is lots &#128512;

 

[BBbliss]

The heating pad (I use it on low), also people mostly use a hot water bottle, I believe promotes circulation in the area.

I had my retrieval today and I had no idea going in of what was going to happen because of all different follicle sizes but the were able to collect 8 eggs so that's good, at least it's the same as last time.

How are you doing?

 

[candefloss30]

Congrats BBliss 8 is good! Have you heard back from the embryologist yet?

I am feeling pretty up and down tbh. I am in again tomorrow and I am dreading them telling me the growth has stopped again!

 

[BBbliss]

Hi cande, I did hear back and I'm pretty upset today... Only one of eight fertilized, the others were still alive but didn't show sign of fertilization. I'm waiting for tomorrow's report but tbh I'm not feeling very optimistic... Last time I had all my eight eggs fertilize and ended with 5 day blasts, the odds are just so slim now

Good luck tomorrow, I hope you have some progress...

This is so hard isn't it

 

[candefloss30]

Argh I'm so sorry Bbliss that seems so unfair! Have you heard about the other egg? Do you have any frozen from last time?

My scan didn't go well so rather upset myself. 3 are growing but slowly so he more or less said unless they jump up a fair bit by Wednesday it will be cancelled. I'm uk nhs funding, I just hope they let me have another go as I dont think they will grow much by Wednesday which will be day 24 of stims!

 

[BBbliss]

I had 2 5d blasts transferred last time and a chemical pregnancy... I did hear back from them this morning and I had one fert late so I now have 2 2d embryos and if they are still ok tomorrow I think we are going to do a 3dt

I'm so sorry this has gone this long for you, at least you are not paying out of pocket and really hope you get another go if you get cancelled. Maybe you just need another protocol. I can't even imagine what this has done to you emotionally

Hang in there

 

[candefloss30]

Yay 2 is great!! Let me know how it goes you still have a good chance.

I am feeling fed up and emotionally exhausted. I'm 32 and I seem to have the worse stim results on the Internet &#55357;&#56862;