Trigger shot and IUI same day

[qwirty1]

In all the reading everyone seems like they are getting their trigger shot and then waiting for the IUI the next day or two. My RE gave me the trigger shot today (tues)  and then about an hour or two later the IUI. I am so confused right now. Yesterday (monday) they told me based on u/s I wasn't ready follies needed a little more time so they did bloodwork, LH 15.4, progesterone 4.0 and Estradiol 452, they called and told me it looks like I am about to ovulate. So to come back today (tues). I come back today (tues) have another u/s and then she said well your blood work looks like you are ovulating but the follies haven't broke thru yet so we trigger today and do IUI today, come back for second IUI tomorrow (wed). Is this right? I know they say sperm can last 3-5 days but I thought that was for fresh and not frozen/washed sperm. I read those last only ~12-24 hours.

I am 45 doing medicated cycles (450 Follistim and 75 Menopur), I dont mind the cost I am paying as long as it makes sense for timing the trigger and iui.

Does anyone have any insight?  Thanks and I am hoping one and done!  I try and tell my ovaries and uterus to just work this one time and we will be done, LOL

[qwirty1]

Thank you for your reply Dr B.
My R ovary was quiet for the most part, when we triggered there were 2 follies about 3mm, the L ovary had 4 follies 2 at ~15mm. They triggered me on CD19 as the CD18 bw showed I was about to ovulate. CD 19 uls showed still no breakthrough so trigger shot then the IUI an hour later. Unfortunately that round didn't take :(
My RE upped my dose to 300 iu Follistim and 75 iu Menopur twice a day, he said that was teh max and what they give IVF patients. I am guessing I am a poor responder and they are hoping to see more follies? My REs run in and out of the room so fast it is hard to ask questions at times.
But I was really concerned about the IUI and washing sperm and reading washed sperm live 12 hours and if they did the IUI right after the trigger shot, those guys would die before I ovulated.  This is so confusing and I know reading online confuses me more and I should just have faith they know what they are doing. I like they do the back to back IUIs...I call it insurance even though even my RE says there really isn't a big difference statistically, I think it puts my mind at ease to have more chance of hitting the mark  :)  So you dont think I should be concerned with same day IUI even though everyone says its 36 hours after the trigger that you ovulate so the first IUI round of swimmers may potentially be dead? :( Awww thats a sad thought now that I wrote it.  This is all new and I am wondering if IVF is more effective for my age or if I just have crappy old hard bitchy eggs, LOL
Thanks for any thoughts/advice!

[Elaine Brown, MD]

HI!
If you were my patient, I would advise you that we hope to see follicles of about 1.9 to 2.0 cm on ultrasound when we trigger ovulation.  Sperm last about 3-7 days isn the female reproductive tract whether or not they are fresh or frozen, so it isn't necessarily incorrect to do the IUI so soon. Some doctors tend to do two IUIs per cycle, although I have read that there is no difference in pregnancy rates.  Your RE may have newer data..
It may be that there was some concern about you ovulating on your own and missing the event.  Don't hesitate to ask your doctor.  That is part of what you are paying for!
Good luck!
Dr B