How many follicles on follistim

The biggest follicle had no egg, the second largest had a degenerative cell and the third an immature egg. I took iu's of follistim and 1 vial of menopur increased to two mid cycle. We are trying a gentler dose and using follistim instead of gonal f. My first few cycles I was taking iu's of gonal f and iu;s of menopur. They had me doing this protocol for months and I started to respond poorly to it.

I insisted on changing the meds or trying a gentler dose. We interviewed with a new doctor here and his approach is less is more, less meds and get better quality vs. And is it true that the smaller follicles esp.

My last cycle debunked that whole theory because the dominant follicle or the two largest didn't have any eggs. The smallest follicle did have an egg but it was immature.

I know that on the average I produce follicles per cycle. I think it's important to save as many of the follicles we can, we can't afford not to even if they have bad eggs in them. I am not young and producing 20 follicles. The new doctor wanted to put me on iu's of follistim every other day or maybe everyday? That did not seem enough? He only wants to stimulate the dominant follicle or larger follicles.

I don't want to take so little that it doesn't stimulate enough or take too much that I can get overstimulated and not respond well. I know my body and I am very sensitive to the drugs. I have also used micro-dose lupron and I responded poorly to it. What protocol do you at your clinic use on women my age? My recent baseline fsh is 8. It started low and increased up to 0. Usually, OHSS resolves spontaneously with the onset of menses. Cases of OHSS are more common, more severe, and more protracted if pregnancy occurs; therefore, women should be assessed for the development of OHSS for at least 2 weeks after hCG administration.

If serious OHSS occurs, gonadotropins, including hCG, should be stopped and consideration should be given as to whether the patient needs to be hospitalized. Pulmonary and Vascular Complications Serious pulmonary conditions eg, atelectasis, acute respiratory distress syndrome have been reported in women treated with gonadotropins.

In addition, thromboembolic reactions, both in association with and separate from OHSS, have been reported following gonadotropin therapy. Women with generally recognized risk factors for thrombosis, such as a personal or family history, severe obesity, or thrombophilia, may have an increased risk of venous or arterial thromboembolic events during or following treatment with gonadotropins. Sequelae of such reactions have included venous thrombophlebitis, pulmonary embolism, pulmonary infarction, cerebral vascular occlusion stroke , and arterial occlusion resulting in loss of limb, and rarely, in myocardial infarction.

It should be noted that pregnancy itself also carries an increased risk of thrombosis. The ability of the ovaries to stimulate well and give us numerous eggs can be predicted fairly well by an ultrasound test — the antral follicle count. The minimum number of follicles needed to proceed with in vitro fertilization treatment depends on several factors, including their sizes, age of the woman, results of previous stimulations and the willingness of the couple and the doctor to proceed with egg retrieval when there will be a low number of eggs obtained.

In our experience, IVF success rates are very low with less than 3 mature follicles. Some doctors will say that you should have at least 5 that measure 14mm or greater while others might do the egg retrieval with only one follicle. Women that are more likely to be low responders to ovarian stimulation would be those that have low antral counts, those women who are older than about 37, women with elevated FSH levels , and women with other signs of reduced ovarian reserve.

Patient Resource Center. Patient Portal. Request a Consult. In order to maximize success rates with in vitro fertilization we want a good number of high quality eggs from the woman. We generally try to get about eggs at the egg retrieval procedure.

IVF success rates correlate with the number of eggs retrieved. Without stimulating medications, the ovaries make and release only 1 mature egg per menstrual cycle month. The commonly used stimulation regimens include injections of follicle stimulating hormone — FSH.

There are 2 classes of drug used for this: GnRH-agonist gonadotropin releasing hormone agonist such as Lupron GnRH-antagonist such as Ganirelix or Cetrotide FSH product follicle stimulating hormone to stimulate development of multiple eggs Gonal-F, Follistim, Bravelle, Menopur HCG human chorionic gonadotropin to cause final maturation of the eggs The ovaries are stimulated with the injectable FSH medications for about days until multiple mature size follicles have developed.

Many doctors will cancel if more than three follicles develop or if estradiol levels are very high. The risk of ectopic pregnancy and miscarriage is also higher with gonadotropin-conceived pregnancies. Surgery is necessary to untwist or possibly remove the affected ovary. Your risk of pregnancy complications—like pregnancy-induced high blood pressure and placental abruption —may be also slightly increased compared to a naturally conceived pregnancy.

Whether this increased risk is caused by the gonadotropins or the infertility is unclear. Because gonadotropins are injectable medications, you may also experience soreness near the injection sites. If you suspect an infection, be sure to alert your doctor right away. Your potential for pregnancy success with gonadotropins will depend on a variety of factors, including your age and the cause of infertility.

A study by The Jones Institute for Reproductive Medicine looked at 1, gonadotropin treatment cycles. Younger patients had higher live birth rates. Older studies have found higher pregnancy rates with gonadotropins than this study. However, it's possible the higher success rate came at the expense of higher risk for OHSS and multiple pregnancy. The higher price takes into account the required blood work and ultrasound monitoring.

The also price varies because different women will need different amounts of drugs. Your insurance company may pay for part of the treatment. Or, they may pay for all of it You may need to pay your fertility clinic in full first. Then, you may need to file for a reimbursement from your insurance yourself, or the clinic may handle the insurance claims for you. Be sure to clarify all of this with your fertility clinic before you start treatment.

You don't want to be surprised by a high bill at the end. Get diet and wellness tips to help your kids stay healthy and happy. Recombinant versus urinary gonadotrophin for ovarian stimulation in assisted reproductive technology cycles. Hum Reprod Update. Homburg R, Howles CM. Low-dose FSH therapy for anovulatory infertility associated with polycystic ovary syndrome: Rational, results, reflections refinements.

Human Reproduction Update. Maternal human chorionic gonadotrophin concentrations in very early pregnancy and risk of hyperemesis gravidarum: A retrospective cohort study of pregnancies after in vitro fertilization. American Society for Reproductive Medicine. Gonadotrophin ovulation induction and enhancement outcomes: Analysis of more than cycles. Reprod Biomed Online. Your Privacy Rights.