# 3 large follies and EWCM twice! It's never straightforward is it?!!



## hennups (Jun 12, 2009)

HI all!

I'm on day 21 of cycle 4 on clomid. Having had a couple of 'funny' cycles this one has gone pretty well so far!

Had day 12 scan and there were 3 large follies - 18, 22 and 25mm, so they had to warn us about triplets. But with hubby's very low morphology that would be beyond miraculous if all 3 got fertilised! BUT it gave us a huge boost to really 'go for it' this month!!! Feeling really positive overall really!

Then today I woke up with creamy EWCM and read online that it could be the prog/oest levels changing and preparing for AF or it could be an early sign of pregnancy. So it's fingers crossed for next week - I _usually_ have 28 day cycles but have been known to reach 35 days so who knows!!

Well, I'll keep you posted but if anyone knows much about the 3 follies and EWCM things that'd be great to hear!


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## Heluerto (Aug 5, 2008)

Hello!  Glad you got the go-ahead for your three!  We've been told to abstain for our 4, but like you said, it would be beyond miraculous if all 4 got fertilised - knowing my track record (10 years ttc).

Keeping everything crossed for you, my CM has gone very creamy today (CD21) but as you said the signs for pregnancy are pretty much the same as the signs for AF!  Fingers crossed for you!


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hi there

Creamy/thick cervical mucus is completely normal and is due to the higher levels of progesterone following ovulation, especially if you had a couple of good size follicles then hopefully got at least 2 nice mature eggs released.

EWCM is egg white cervical mucus and this is due to the higher levels of oestrogen prior to ovulation...it's when the CM is thin, clear and very stretchy.

Your CM changes throughout your cycle....and this thick, creamy CM is absolutely normal following ovulation.......

Good luck
Natasha


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## slabberkoekje (Jul 6, 2010)

Heluerto said:


> Hello! Glad you got the go-ahead for your three! We've been told to abstain for our 4, but like you said, it would be beyond miraculous if all 4 got fertilised - knowing my track record (10 years ttc).
> 
> Keeping everything crossed for you, my CM has gone very creamy today (CD21) but as you said the signs for pregnancy are pretty much the same as the signs for AF! Fingers crossed for you!


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## slabberkoekje (Jul 6, 2010)

Heluerto said:


> Hello! Glad you got the go-ahead for your three! We've been told to abstain for our 4, but like you said, it would be beyond miraculous if all 4 got fertilised - knowing my track record (10 years ttc).
> 
> Keeping everything crossed for you, my CM has gone very creamy today (CD21) but as you said the signs for pregnancy are pretty much the same as the signs for AF! Fingers crossed for you!


Hi I'm totally new on here, this is my very first post - I am also hoping for three eggs having made their journey down!!! Had three mature follicles at the time of ovulation, actually ovulated myself, used the ovulation kit from chemist five minutes after the nurse had given me the pregnyl shot - just to see if I was ovulating alone (The previous two days it had been no smiley faces just the circle)and there was the lovely smiley face looking me in the face!! I had bad low abdomen pains two days ago (8 dpo) and then they went away. CM is also more scarce now - a bit thick and not much of it - strange colour too. Smells a bit like blood (sorry TMI). Weird. One month I had very creamy CM after ovulation and AF arrived right on cue. Don't know whether to believe my body anymore!!!!!! My test day is in 6 days. Aaaaaagh can't wait!!!! At 18th day of cycle my Oestradiol was 500 andmy progesterone only 9.8 - but Doc said that my progesterone would have probably been higher f I had had my bloods done on day 21 but that I definitely ovulated.


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

slabberkoekje said:


> Heluerto said:
> 
> 
> > Hello! Glad you got the go-ahead for your three! We've been told to abstain for our 4, but like you said, it would be beyond miraculous if all 4 got fertilised - knowing my track record (10 years ttc).
> ...


Hi there slabberkoekje and welcome to FF

If you used an OPK (ovulation predictor kit) after having an HCG trigger injection (Pregnyl / Ovitrelle) then this would have given a false result on the OPK. HCG is very similar in "make up" to LH.....OPKs detect the LH surge prior to ovulation and you'd normally ovulate around 36 hours later.......the HCG injection will actually trigger you to ovulate and that would normally happen around 36 hours following injection. By using an OPK or a pregnancy test too soon after having an HCG trigger injection then it can give false positive results. The HCG injection is basically the same hormone as released from the implanted embryo and it can stay in your system for up to 14 days so try and avoid using pg tests (or OPKs) during that timeframe. The HCG injection can also cause lots of pregnancy like symptoms because of it being same hormone as released from implanted embryo.

Also, if you're being prescribed Progynova (oestrogen) and Utrogestan (progesterone), these may have some effect on your hormone levels plus can cause all manner of side effects and symptoms. Here's just a few...

some of the side effects and symptoms of oestrogen:

breast pain, tenderness or enlargement
headache/migraine
nausea
abdominal pain
bloating
windiness
indigestion
tiredness
anxiety
dizziness
swelling of the ankles due to to fluid retention
skin reactions such as rash and itch
PMS like symptoms

here's just a few side effects of progesterone:

headache 
breast tenderness or pain 
upset stomach and/or vomiting and nausea
diarrhea and/or constipation
bloatedness
windiness
urinary problems
tiredness 
muscle, joint, or bone pain 
mood swings/irritability/excessive worrying 
sneezing/coughing/runny nose 
vaginal discharge/increase in cervical mucus
PMS like symptoms

What unit measurements were your progesterone and oestradiol tested in eg was your progesterone 9.8 nmol/l or 9.8 ng/ml ? When comparing any hormone levels then need to consider the unit measurement used otherwise takes out of context. Ideally you should have progesterone tested 7 days following ovulation as this is when it peaks. Having it tested on cycle day (cd) 21 assumes you ovulated on cd14.....so if you ovulated earlier or later than cd14 then need to get tested accordingly eg if ovulate on cd16 then get progesterone tested on cd23 etc etc......they like to see a level of 30 nmol/l or over to indicate ovulation of a mature egg (this is approx 10 ng/ml). I'm assuming your progesterone was 9.8 ng/ml which would mean you were tested just a day or so too early as the progesterone had not peaked.

What cycle day were you on when you had your scan and HCG injection ? Do you know the sizes of the mature follicles ? It sounds like you had some good ones there. If you ovulate more than one egg then they will all be released within a single 24 hour period eg one egg could be released at 10am on a Wednesday and another egg at 9am the next day, Thursday......you don't release one egg over a longer period of time, only within 24 hours....this is due to the varying levels of hormones, such as higher progesterone released following ovulation which prevents further eggs from being released.

What cycle day are you on now ?

Anyway, good luck to you 

Take care
Natasha


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## slabberkoekje (Jul 6, 2010)

Thanks for you comments Minxy - it is the first time I have been able to talk to someone else who knows all the terms and knows about this strange fertility planet we all live on!!!

Ok this month:-

Day 3,4,5 took 100 clomid (then got really suicidally depressed and decided to go bk down to 50)
Day6,7 - 50 clomid
Day 9 went for scan - endometrium a bit thin so started taking Progynova immediately - she saw four follicles - 11,13, 18,22
She then told me to buy an OPK and test myself - usually I have the pregnyl to make me ovulate - she said because I have four follicles I may ovulate myself as the oestragen levels would be high enough.  She did say though that if after two das of negative OPK then I should call the nurs to come and give me my Pregnyl shot. 
I tested the following day - so cycle day 10 - negative
cycle day 11 - OPK negative
and then I called the nurse to come the next morning.
5 minutes after she had left I went upstairs and did another test just to see if I wasn't ovulating myself - an lo and behold a smiley face. (My Gynaecologist/Fertility Specialist said that the Pregnyl could not be in my urine only five minutes after the shot so I must have ovulated myself)
The OPK was positive over thee days - but apparently then that was because of the Pregnyl (as you said )
Five days after the first shot I had my regular 2nd shot of pregnyl (same dose 5,000) so that would be on Day 17.
My blood test for Oestradiol and Progesterone was on Day 16 in fact - actually only 4dpo!!!!!! and my results were 500 oestradiol which sees really high!!! Do u know why? and Progesterone only 9.8.  Don't know what measurements she was speaking in but she says that anything over 12 is good.  She reads me my results over the phone.

Now I am on cycle day 22 - 10 dpo
Voila!! That's my month explained...now it's cross your fingers time........hoping those smaller follies grew 1-2mm per day between days 9 and 12 - not holding my breath though - if they had developed too - I think my progesterone would have been higher at cycle day 16.


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hi again

The HCG shot should be in your system straight away but obviously I'm not medically qualified, just going by what my fertility consultant has told me.

OPKs only detect the LH surge....the don't confirm or show you've ovulated. If you got a definite positive OPK on day 12 then you would've ovulated around cd14....it's usually around 36 hours following the HCG injection. Sorry but that positive OPK wouldn't have shown you've actually ovulated.

So your blood tests on cd16 would've been 2dpo. If you're on cd22 then you'd be 8dpo today.

Without knowing what unit measurements were used then it's hard to say anything about your blood tests results. If you were only 2dpo when you had the progesterone blood test then that's way too early....it needs to be tested at 7dpo...which would be around cd21 for you (ie yesterday). If it was only tested on 2dpo then it could well be that it was actually 9.8 nmol/l because it's just too early and progesterone wouldn't have peaked, but if your consultant is saying anything over 12 means ovulation then I think she's far more likely to be talking about 12 ng/ml.......12 nmol/l would not mean ovulation.....you would need to double check the measurement. Also, the HCG injection will have effected your progesterone levels. Basically when HCG is released from the implanted embryo it sends a message to your ovaries to continue to produce progesterone as it's this that supports early pregnancy until the placenta takes over. With having the HCG injection, it tricks your body into thinking it's already pregnant and this in turn encourages your ovaries to release progesterone....so since you had the HCG injection on cd12 which then triggered you to ovulate on cd14 and you had progesterone tested on cd16, this is why it may have been higher (at 9.8 ng/ml, approx 30 nmol/l) so early after ovulation.

Oestradiol (E2/oestrogen) is measured in pg/ml or pmol/l

1 pg/ml = 3.67 pmol/l

100 pg/ml = 367 pmol/l (pg/ml to pmol/l = 3.67)
100 pmol/l = 27 pg/ml (pmol/l to pg/ml = 0.272)

Having Oestradiol tested at 2dpo doesn't really give much indication....oestrogen is produced by the developing follicles before ovulation and it's this that thickens the womb lining and is usually tested at the beginning of your cycle eg cd3 (unless you're having IVF then that's completely different)...since you were prescribed Progynova this would explain why your Oestradiol levels are higher.

Here's some info on hormone levels (note the different unit measurements)....

http://www.fertilityplus.org/faq/hormonelevels.html#female

and here's some info about OPKs...

http://www.fertilityplus.org/faq/opk.html

http://www.ovulation-calculator.com/ovulation-tests/ovulation-tests.htm

http://www.ovulation-calculator.com/ovulation-tests/opk-faq.htm

and some info about how LH and HCG hormones are similar so by using an OPK following an HCG injection it can cause false positive results...

http://www.peeonastick.com/opkhpt.html

If you had another dose of Pregnyl (HCG hormone) on cd17 then you need to be careful about when you do any pregnancy test because it can cause false positive results for up to 14 days later, although if you only had 5000 IU of Pregnyl then this should be less time...around 10 days.....

10,000 IU of Pregnyl and 250mcg/6500IU Ovitrelle can take up to 14 days to leave your system.

Pregnyl has an approx elimination half life of around 33 hrs, Ovitrelle is around half life of about 30 hrs (but again, approximations).....

It's approx 10 days after a 5,000 IU injection or 7 days after a 2,500 IU injection

Have a read of this...

http://www.babyhopes.com/articles/hcgshot.html

Finally, it's likely that the smaller follicles wouldn't have caught up in time to mature enough before the more dominant ones (18mm and 22mm) ruptured and released eggs. They like a follicle to be minimum of 18mm before it pops to ensure egg inside is mature. Once ovulation of those dominant follicles happened, the hormones released (progesterone) prevent any further maturation of follicles or ovulation. I think your progesterone level at only 2dpo (cd16) is fine for that stage.....you're actually having it tested 5 days before it should ideally be done !! If you had it tested today (cd22, 8dpo) you should notice a rise as it should've peaked yesterday.....remember you're only 8dpo today as you didn't actually ovulate on cd12 when you had the HCG injection and did the OPK....OPKs do not detect ovulation, only LH surge beforehand.

Hope that helps

Good luck  
Natasha

/links


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## hennups (Jun 12, 2009)

Well I'm spotting now. Having got to day 25, which is the longest I've gone in 6 years with No spotting, I did start spotting yesterday. Gutted as we really thought this was our month! I'm gonna do a pg test anyway cos I had a scare in month 3 so need to be 100% sure I'm not before I take the clomid  again. 

Thanks for the messages.


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## slabberkoekje (Jul 6, 2010)

Thanks Minxy - for such a detailed reply!!! You certainly know your stuff!! What amazes me though is the conflicting info our docs give us though some time - when I hear abt how my Doc works and others.  Mine said the Pregnyl shot wouldn't be in my sysyem  only 5 mins after test - but yours did. !!! I hope I have at least one good egg this time and it implants well - fingers crossed!!! My blood test is on Monday - that will have the final word on all these levels.!!!!  

Going to check out some of those sites you gav me now!!!!! 


Louise xxxxx


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