# Follicles not rupturing properly whilst on Clomid?



## skybluesarah (Nov 15, 2006)

Life FertilityCare who are treating me have spoken to me today and asked me to arrange 3 follicle tracking scans next month. (Privately as they can't do them...it's going to cost me about £200).

I asked why, and they said it's because I've had a few months now on their combination of Clomid and Cyclogest, with excellent blood test results and well-timed sex, and I'm still not pregnant. So they are starting to think there must be yet another thing wrong, and perhaps my follicles aren't rupturing properly when it comes to ovulation. I never can get a positive OPK, even on Clomid, even though my CM does change once I've passed what should be ovulation time.

So...does anyone have any experience of the follicles not rupturing properly, and if so, do you know what can be done about it? I'm up to my limit on Clomid next month, so am really running out of time.  I don't really see what these scans can show that they don't already know.  How can they tell if a follicle has ruptured properly or not, other than by blood tests, whic have so far all come back fine?

Thanks!


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hi

They like a follicle to be around a minimum of 18mm before rupturing to ensure that the egg released is healthy & mature enough for good fertilisation.  If the follicle is too small (below 18mm) or too big (above about 26+ mm) then it may mean the egg is either not mature enough or too old for good fertilisation.

When they scan you they'll be able to see the size of the dominant follicle(s)...when a ovulation occurs and an egg is released it ruptures from the follicle and the area where the egg released becomes the corpus luteum (which literally means "yellow body" or "yellow matter").  Progesterone is released from the corpus luteum which is what the blood test checks for...a good level to indicate ovulation happened is 30 nmol/l (some say over 40nmol/l).  If they scan you after ovulation they should also be able to see the corpus luteum.

They will also be able to measure the thickness of the womb lining which they like to see minimum of 8mm.

There could be any number of reasons why you've not conceived on clomid yet.  I ovulate absolutely fine naturally & have always had good healthy eggs released, good womb lining and high progesterone levels.  I was prescribed 6mths of clomid to boost (and regulate cycles which had gone a bit erratic following 2 early mc's - naturally conceived).  I had follicle tracking for first 3 months of the clomid and then more progesterone blood tests...I released 2 or 3 eggs each cycle but sadly I didnt conceive...I do have other problems effecting my fertility though and have moved on to ivf.

Hope your scans go well.

Good luck
Natasha


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## skybluesarah (Nov 15, 2006)

Thanks Natasha.  They are pretty sure I do ovulate naturally, but they think that the egg gets too old for decent fertilisation, but they are only basing this on the fact that I have fertile cervical fluid literally from the day my period ends until ovulation date.....so the theory is that my body keeps trying to ovulate, but by the time it gets there, the egg is no good.  My progesterone levels have all been coming back really good, over 60, but I think that might be due to the Cyclogest disguising the position, as I take that in the second half of the cycle, so of course it's going to make my progesterone levels look good.

Thanks for the info though...to be honest I'd convinced myself that the scans were pointless, but I guess any further investigation might confirm/deny what's previously suspected.  This is my 12th month on Clomid though, so if the scans aren't good, I'm not sure what else they can do for me as I've already been discharged from the NHS because I don't want to have IVF and have exhausted everything they could offer me.

Thanks!


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

I wasn't suggesting you didn't ovulate but was suggesting pretty much what you've just said...that your follicles are either too small or too big when rupturing.  If they're too small then it may mean that the egg is too immature for good healty fertilisation...if the follicle is too big when it ruptures then it could mean that the egg is too old/too mature for good healthy fertilisation.

By having the follicle tracking scans they will be able to get an idea of what size the follicle(s) is before it pops...so giving an indication of whether the egg was too small or too old....

Hopefully you'll get some answers from the scans...

Have you considered acupuncture as this can be really beneficial...perhaps another option if you don't want to go down the ivf route ?

Good luck
Natasha


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## skybluesarah (Nov 15, 2006)

Thanks Natasha....sometimes I need someone sensible and knowledgable to talk to me!
I've just started accupuncture, so fingers crossed for that.  I guess I'm just not sure what they are going to do if it shows the follicles do get too big.

Good luck for your IVF...I'm off to watch America's Next Top Model...hurrah for trashy TV!


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## SarahPooh (Nov 7, 2006)

Hi Sarah, just noticed your thread...  last time I had a scan while on clomid I asked the nurse about this and apparently the follies do look different after they have ruptured as well, instead of being like a big black circle on the screen they are a more irregular shape (I think that's what she said, it was a few weeks ago now).

Not sure if I have just basically repeated what Minxy said but thought you might like to know.

Sarah xx


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

SarahPooh said:


> Hi Sarah, just noticed your thread... last time I had a scan while on clomid I asked the nurse about this and apparently the follies do look different after they have ruptured as well, instead of being like a big black circle on the screen they are a more irregular shape (I think that's what she said, it was a few weeks ago now).
> 
> Not sure if I have just basically repeated what Minxy said but thought you might like to know.
> 
> Sarah xx


The follicles will look different because they've ruptured. Basically a follicle is a fluid filled sac (or cyst) that would usually contain an egg. When they rupture they release this fluid and the egg...and the area on the follicle where egg pops out becomes the corpus luteum which can clearly be seen on scan. The corpus luteum is what releases progesterone.


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## skybluesarah (Nov 15, 2006)

Thanks ladies!


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