Erratic ovulation outside 36-42hr HCG trigger

[Marietta2000]

I gave birth to a son, Dec 05 at age 33.  He was conceived during my 1st ever natural IUI, no meds.  I then had a daughter July 08.  I had 2 failed natural IUI's before that & it was found I was ovulating too quickly at day 9, so my RE used meds to create a controlled cycle.  1st IUI using puregon & buserelin, I conceived & was overjoyed.  I created around 3 mature follies, plus smaller ones. There was a risk of multiples, but a singleton eventuated.  Now, I'm wanting my last child. My 1st cycle using puregon, in June, was cancelled, as I grew about 7 mature follies & smaller  ones.  My clinic is conservative, as I have 2 children, & only want 1 more.  So, my puregon dose was decreased to 50iu.  My second cycle got to IUI, but I'm sure I ovulated before I took the trigger, with 2 follies, it failed.  My second IUI failed with 3 large follies, this time I'm sure I ovulated a day after IUI.  My FSH is 10, with AMH .71, I'm 37.  Do you think IVF will work?  My Mum menopaused at age 42!  I'm very worried that I will ovulate outside the parameters of the 24 - 42 hour window once the HCG is given, as this happened during my IUI cycles.  My RE thinks this did happen, but he is still thinking to do the egg retrieval around 36 hours or so.  Does it matter if ovulation occurs after the egg retrieval?  My RE is only wanted to transfer one embryo (dependent on number and quality of on the day), but I really wonder if I should put two in?  He says I don't want twins, or the complications that can come with having twins - I'm not sure on this.  My clinic is very conservative, and doesn't like mulitple pregnancies.
Any help or advice so welcome!

Marietta :0)

[Marietta2000]

Thanks for all that Heather!!  You've been really helpful!!  My RE is hoping to transfer at day 5 also, so hopefully the highest quality will get transferred and survive until then.  I think my FSH was 6 when I had my son, and 8 when I had my daughter, so I pray the 10 doesn't leave me totally without a chance!  

I read your profile, and see you're expecting a little girl very, very soon!!!  You are in for such a beautiful time!!!  

Good luck, and all the best for the birth!!  Thanks for your posts!!  

Marietta

[Heather5]

Hi again! Yes, I did get pregnant my first cycle. I had two blastocysts transferred (so it was a day 5 transfer). One was graded a 1BB and the other one was an early blast and too soon to grade. 10 days later I got my BFP and was pregnant with one!

As for the stats you mentioned, I guess it makes sense that it would be lower than the 50%. I think that's the ideal success rate (someone in their 20s with no fertility issues other than blocked tubes, for example). I honestly can't remember what my RE told me. He did show me a graph with the clinic's success rates at different ages, but I just can't remember... By the way, I'm 35 (and was 35 when going through my IVF).

I've also heard that fertility meds can affect you FSH blood test, but I'm not sure how long they linger in your system. Maybe you could ask your doctor about that next time. A 10 is not that bad, though. It's in the "fair" category. But of course, the lower the number, the better!

Take care, and good luck with your cycle!

[Marietta2000]

Hi Heather!

Thanks so much for your post, it's really helpful!!  My RE is worried about early ovulation, so he's going to keep it at 36 hours, and like you say, if I ovulate after retrieval, it's not an issue.  Apparently my follicles are responding a bit erratically, possibly due to my FSH being slightly elevated.  Although, a doctor from this site told me something interesting - that FSH can be artifically raised if you are tested after being on fertility drugs - which is when I tested.  My RE reckons my follies are acting like those of a 40 year old instead of those of a 37 year old (my age).  Therefore, he said my chances of actually getting a baby after one IVF cycle is between 20 - 25%, as opposed to 30 - 35% which would have been more in keeping with my actual age.  He did give me some hope though in that my eggs should still be like those of a 37 year old, not older.

You're right in that I should just wait until the day, and see what the embryos are like.  Honestly, I really don't want twins - I already have two small children, and ideally would just love one more.  But my clinic seems very opposed to twins etc.  My RE said that I don't want to take the risk of having premature births, defects etc!!    I read somewhere that transferring two embryos doesn't increase the pregnancy rate by very much, but it does increase the multiple birth rate.  I've signed a form stating pretty much what you've suggested - if there is a high quality embryo, I will just transfer one, but if quality not great, then I shall agree to two being transferred!  It's all such a journey for me, as I've used the drugs for IUI, but haven't done IVF before.  I'm having to pay for this, so really can't afford more than one cycle!!  Can I ask you, did you get pregnant first cycle?  I read so often how many people have countless IVF cycles, some eventually get pregnant, some don't.  Also, do you know what number cell embryo you had?  I'm going to be taking progesterone pesseries and progynova after the transfer.  

Anyway Heather, thanks so much!  Good Luck with everything, and congratulations on your pregnancy!

[Heather5]

Hi Marietta! Ovulation after retrieval is really not an issue, because once the follicles have been collected, there will no longer be any eggs to release. And ovulating early is also extremely rare, since they monitor you so carefully during IVF. I did an IVF cycle this Spring, and I have to admit I was a little worried about ovulating earlier than the 36 hours too...but I didn't. All the follicles were still there when I went in for the retrieval. It is kinda interesting, though, that they can pinpoint it that closely.

As for your chances, it's hard to say. Generally, IVF success rates tend to be around 50%, but I'm not sure how much your FSH number affects that. Plus, the success rates can differ quite a bit from clinic to clinic. Your RE should be able to help you get a better idea of your chances, though.

And lastly, whether to transfer one or two is a personal choice. I did two and ended up pregnant with one...but of course, there's always a chance that both take. And on the flip side, there's a chance of not getting pregnant with just one, while transferring two can help improve your chances. What you could do is wait until you see how the embryos develop, and then base your decision on their quality (if super high, transfer one, and if lower-quality, maybe transfer two instead). Just an idea...

Best of luck with everything!