Second IUI- Day 11 scan- multiple follicles.

[frpjshortt]

Hi,
We are currently on our second IUI cycle using letrozole 5mg day 2 to day 6 , followed by Gonal-F 75 IU on day 6.
The day 11 scan showed 6 follicles - 2 on the right (14.5 mm and 12mm) and 4 on the left (15.5 mm, 11 mm, 11.5 mm and 13mm). Our RE observed that the larger follicles are growing at a slower pace compared to the day 7 and day 9 scans, and administered 37.5 IU OF Gonal-F today.
I am concerned that the smaller follicles will catch up with this dose of FSH but our RE believes that the larger ones will respond more to the FSH and grow larger. I have another scan scheduled for tomorrow.

Could anyone share what the typical size of a mature follicle is? Has anyone had a similar experience?
Our RE is hoping for 3 mature follicles, but I am worried that I might end up with more.

 

[john025]

@frpjshortt I am not doing IUI but TI. I am on 7.5 mg of letrozole and an ovidrel trigger. I am triggering when they are 20mm. I just had a scan Wednesday and I had one dominant at 22mm so I triggered then. I believe it’s about 20-24mm they look for.

 

[frpjshortt]

@john025 Sure thanks

 

[jazzgirl50]

@frpjshortt It’s assumed a follicle that’s minimum 18 mm contains a mature egg. Follicles grow at a rate of ~1-3 mm/day. Larger lead follicles can often ‘suck up’ injectable FSH. But imo that’s a fairly even cohort you’ve got growing. Anything that’s minimum 15 mm can contain a mature egg.

All this to say, you could very well be looking at being over stimulated for an IUI. You don’t want a john and Kate plus 8 situation. It will all depend on how your scan looks tomorrow.

 

[frpjshortt]

@jazzgirl50 Sure thanks.
No, absolutely don’t want to be in that situation.
RE was hoping to achieve 2-3 follicles but multiple smaller ones appeared on day 7 scan.
If the smaller ones grew to 12 mm each, and the larger ones grew a bit more to 16- 17 mm, would it be safe to proceed with IUI? Or Would the 12 mm ones be considered mature?

 

[tom3]

@frpjshortt My last IUI, I triggered when I had two follicles, one at 17mm and one at 14mm. In the aftermath, it turned out the 17mm was mature by the time of IUI and the 14mm never erupted. Other follicles were 9-12mm and were not mature.

 

[javiercrogs]

@frpjshortt Today was our third IUI.

This cycle I had a follicle that was 16mm (I only have one ovary), and I was told to wait a couple days and then trigger later on. Ideally I think follicles would be between 18-22 mm.

 

[frpjshortt]

@javiercrogs Sure thanks. Good luck

 

[filosofi]

@frpjshortt I was told a mature follicle at CD9 is a follicle 12mm or bigger. I was given 5mg of letrozole from day 4-8 and I ended up with five follicles with 3 mature and I was told I had to cancel the cycle due to the risk of triplets
The nurse said they would give me a trigger shot when follicles get to 20-26mm but obviously not this cycle.

 

[frpjshortt]

@filosofi Got it. I think each clinic has different policies. My clinic says anything over 18 is mature and would trigger at 18.
Good luck with the next cycle

 

[rosencrans]

@frpjshortt I just did my trigger shot on Wednesday when I had a follicle on both sides that measured 22mm. There were multiple follicles but from my research the range they look for is 18-22mm. Good luck on this cycle!

 

[frpjshortt]

@rosencrans Thank you.
Did you mean you had multiple other smaller follicles as well? Would you mind sharing the sizes of the others?
Looks like I will be in a similar situation.

 

[pinkdiva]

@frpjshortt If you have 3 or more follicles iui should be cancelled or converted to an ivf cycle

 

[jobillard]

@pinkdiva I have 3 follicles and my clinic is okay with continuing IUI. I had to sign a multiples consent form.

 

[jobillard]

@frpjshortt Hi, friend! My clinic told me that they look for follicles to be at least 18mm. I was also told that follicles grown an average of 2mm per day.

I took 2.5mg of letrozole days 3-7 and have 3 follicles on the left. They measured 16mm, 12mm, & 12mm on CD13. On CD15 (today) they measured 18mm, 14mm, & 14mm. My clinic is waiting for the smaller ones to get bigger before I take my trigger and am inseminated.

I don't know that your smaller follicles will outgrow the larger ones, but you could end up with multiple mature follicles!

Wishing you luck!

 

[frpjshortt]

@jobillard Hi thanks for your response.
Thanks for sharing your experience and good luck!