IUI cycle cancelled for too many follicles

[Anonymous]

I've posted before so you may recognize me! I am on a superovulation/IUI protocol with SG, first cycle. They started me at 100mg clomid days 3-7 and 150iu gonal-F (one injection).

Apparently it worked "super" well because I have 5 mature follicles and 2-3 more that are close and have a good chance of making it.

After the U/S, the nurse said she thought there were 4 mature, that is not too many, and they would have me trigger tonight. But on my way out, the doctor caught me and brought me back to his office to tell me my cycle is cancelled because the risk for multiples is way too high. (He said "and I don't mean twins, I mean you could have 8 or more eggs by the time of the IUI and there's a chance 3, 4, 5 of them could fertilize.") We don't even want twins.

I assume there is no way to salvage this cycle??

He did not give me any instructions other than to wait for my regular doctor to call me this afternoon after my bloodwork comes back and she will tell me whether to trigger or not based on how my estrogen is looking. And I assume she will dial down on the meds for next month - but that seems really far away right now. I'm only on cd 11.

Any advice? This REALLY sucks. And I'm old! I can't afford to waste a month!

[Anonymous]

Just to look on the bright side (which may be hard to do at this point) If you ahd this good of a response it is a good sign that IF treatments will eventually work. I don't think there is much they can do. Check out the NY Times series if you want some examples of why your RE is being so conservative about this. Good luck with your treatments!!!

[Anonymous]

When this happened to us, the RE recommended we just have timed intercourse, which is less aggressive than IUI and trigger, therefore decreasing possibility of multiples (although obviously doesn't eliminate the chance). We did and even though it didn't work, I felt much better knowing the cycle wasn't a total waste. Be sure that they adjust your dosages down for the next round.

[Anonymous]

Any chance this cycle could converted to an IVF cycle?

[Anonymous]

This has happened to me and it was crushing. In response to a PP, I wanted to note that my doctor (at SG) told me not to have sex for about week after I went in for my day 11 monitoring because of the risk of multiple fertilizations. So I'd double check with your doctor about that. I have heard of people converting to IVF, but I don't know if SGF does that or not. I didn't ask when my cycle was cancelled because I wasn't interested in doing it. Though it's difficult to see a bright side, as a PP mentioned, it is a good indication that you'll respond well to the meds if you move to IVF. I moved to IVF after my cancelled IUI cycle, which was my second attempt at IUI. Best of luck to you.

[Anonymous]

Thanks everyone.

I don't think there's a way to convert to IVF; it hasn't been mentioned to me. And we're just not ready for that yet.

Trying at home was what I was thinking of when I wondered if there was anything I could do. My thinking was that it would give me a lesser chance than IUI, and maybe none would fertilize, but maybe it would give me a chance of just one fertilizing?? I mean, they were going to do IUI with 3-4 mature, and they didn't think I was at high risk for triplets in that scenario.

What if we tried tonight? It is still pretty early & none of these follies have come off yet (and I'm not sure when they will) so I think that would decrease my odds of multiple eggs fertilizing. I know sperm *can* live for 5 days, but it's not the norm. And the clomid has not helped my cervical mucous any, so I don't think I have the best *environment* for keeping the little guys alive and swimming anyway.

10:02 - how many mature follicles did you have when your RE said you could try TI instead of IUI?

I have been reading the NYT series with interest. I do NOT want to put myself in a position where I am taking huge risks. As I said, we really truly want a singleton. We have no desire for twins (and at this point in time we are not open to selective reduction, so higher order multiples could be disastrous).

Ultimately I will probably follow whatever my dr's advice turns out to be. I think she will be very conservative and tell me to abstain; I believe that is standard at SG when they cancel an IUI cycle for this reason. And I realize it's better for me to lose one month than to take a gamble and end up pregnant with multiples, jeopardize my own health, and risk losing some or all of the babies (and a lot more than one month).

I don't want to be reckless. But if there's a way to mitigate the multiples risk and still give myself a chance (albeit a small one) this cycle, I would consider it.

I know what the rational thing to do is, but I am just so disappointed, impatient, and anxious to be 'doing something' rather than sitting out another month, it is hard to stay rational. I feel like I did exactly what I was supposed to do and my body responded perfectly to the drugs (which apparently were too high in dosage). I produced all these eggs, and now we have to waste them all.

[Anonymous]

How old are you?

[Anonymous]

39.

[Anonymous]

Everyone has a story. I know someone 42, IUI with 4 follicles, all 4 were fertilized eggs, only 2 developed into babies with heartbeats. The doctor was shocked to see the possibility of quads. . . . fortunately nature took care of the reduction, and by the time of her first sono it was already clear that 2 weren't going to make it.

[Anonymous]

I know this is really disappointing and not what you expected, but chalk it up to 1) cycles never go how you expect, and 2) it is really great that you make so many eggs easily. I just turned 40 and can't make more than 3 follies even on an aggressive IVF cycle, so my chances for success are extremely low.

[Anonymous]

Just talked to my doctor. She said she's very surprised I had this much of a response and that she has younger patients who don't respond this well. I guess that's the silver lining though it doesn't feel like it right now.

She said don't do the trigger. I can go on the pill (she's worried about me accidentally getting pg with multiples) or I can just wait. My estrogen is pretty high so I should ovulate all of them soon, and finish out the cycle naturally.

I am NOT going on the pill for 28 days. I already put a bunch of drugs in my body (needlessly, it turns out, since I'm now sitting here with ovaries the size of golf balls and my cycle is cancelled) so I am not topping it off with more pills.

Now I just have to hope I ovulate soon and that my ovaries will "calm down" enough to try again next cycle.

Obviously we're adjusting the meds downward to 50mg Clomid instead of 100. Not sure whether we will do the FSH inject at all, but if so, it will be half the current dose. And they will bring me in earlier for u/s to stay ahead of what's going on.

[Anonymous]

This happened to me on my 2nd Cycle of IUI. On my first Cycle, I used 100mg of Clomid, then 150mg of Follistem (day 10) and on Day 12 did the trigger shot. We had about 3 good sized follicles. So, on the 2nd cycle, they changed my medication. I used 50 mg of Clomid, then Day 7 and Day 9 (150 mg each of Follistem). When they checked my bloodwork on Day 11, they said that I had about 7 good sized follicles. They told us the cycle was canceled and to abstain or use protection. I was very upset and felt like we just wasted a month. My husband wanted to try anyway, but I was not willing to take that risk. They also told me that if we were doing IVF, then I would have been a very good candidate. We didn't want to go that route. On my 3rd cylce (but 2nd IUI), we got pregnant! They changed the Meds again. I took 50mg of Clomid, then on Day 8 150mg of Follistem, Day 10 went in for monitoring and took 75mg of Follistem. Trigger shot was on Day 12 and the IUI was performed on Day 14. We had about 4 good sized follicles. We had a singleton. We used SG. So, I know you feel deflated now, but you have to look at it on the bright side. You are responding very well to the medication and the Drs. will figure out the magic formula that will work fo you.

[Anonymous]

I was on the exact same protocol at SG on my first try and I had to cancel my cycle. I had 11 follicles on Day 10! I was switched to clomid 50 mg only and still produced 3 good sized eggs..sadly, I am on to injectables as the Clomid is casuing way too many cysts.. Hang in there.. Im on BCP again! So, I know the waiting can be disappointing.

[Anonymous]

OP here.

Thanks for sharing your stories. I don't know whether it makes me feel better or worse to know this has happened to others, including at SG.

I don't understand why they don't start on lower dosages and work up if this happens frequently. I ovulate on my own anyway, so if they had started me at 50mg clomid, in the worst-case scenario, let's say I didn't respond at all, I would have still had produced one follicle on my own. Even with a poor response, I'd probably have wound up with two. We could have still done the IUI with one or two follicles and had a chance. That would have been so much better than losing the whole cycle. This is so depressing.

[Anonymous]

OP - you never know though. I ovulate on my own but didn't respond well to clomid, the follicles grew but they didn't get big enough to trigger. So you don't know for sure it would have been different on a lower dose. I also had a big set back because of an error SG made when they told me to trigger, and had to wait another month. I think it definitely happens. Hang in there!