# Advice on whether to proceed to another cycle



## katiep

Hi Peter,
This is the first time i have posted so not sure if you can help or not but here goes... it's a bit of a long one -sorry!
I recently (in May) underwent an ivf cycle following a cetrotide protocol. My follicles were slow to develop (only 5mm after 5 days of taking 300iu of puregon and 150 of menopur). I was rescanned on day 8 and they were still small so they didnt administer the cetrotide as normal but carried on with further stimulation in the hope the follicles would grow which they did (I took same dose day 6 and 7 and then 225 IU of menopur day 8-13). By day 14 the 5 follicles had grown to "normal size (18-22mm I think). They did a blood test(E2, LH and Progest) and all seemed well so we went for egg collection with a pre op scan 2 days later. At the pre op scan the follicles were still there (although one large one on the left seemed to have disapppeared). They had explained that there was a danger I may ovulate before they could collect the eggs. However despite lots of looking they couldnt find any eggs in any of the follicles.

The consultant did another blood test and thinks that I did have eggs and unfortunately I had ovulated and the follicles had resealed instead of disappearing. The blood test checked HCG level (297 IU/L) and progesterone (47.3nmol/L)

My lining was also slow to develop (4.6mm on day 5, 5.4 on day 8 and 7.3mm by egg collection day).
the consultant stronfgly recommends another go this time using a short protocol with 600IU - Gonal F (300IU) and Menopure (300IU).

My concerns are that this is a very high dose of drugs and may badly affect the outcome?

Also is it a bad sign that the follicles took a while to grow or is it ok that they caught up?

I also fear that there may have only have been one true follicle with an egg in it and the others were false follicles - not sure how to check this if you can?

My last FSH was 11.3 and I am 39. I have had 2 early miscarriages and 2 ectopics - all naturally. Then had one ivf which was cancelled as I only developed one follicle of the right size (at another clinic on 300IU of puregon). I then went to egg donation as they said I only had < 5% chance of success with my own eggs. The egg donation was unsuccessful. I then changed clinics and they advised to go with my own eggs -very confusing!!! 

My fear is that I seem to struggle to get to the stage of egg collection and wonder if this means my chance of success is really limited with my own eggs.

Sorry for the long burble but would really value some help.

Many thanks

katie


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## peter

katiep said:


> Hi Peter,
> This is the first time i have posted so not sure if you can help or not but here goes... it's a bit of a long one -sorry!
> I recently (in May) underwent an ivf cycle following a cetrotide protocol. My follicles were slow to develop (only 5mm after 5 days of taking 300iu of puregon and 150 of menopur). I was rescanned on day 8 and they were still small so they didnt administer the cetrotide as normal but carried on with further stimulation in the hope the follicles would grow which they did (I took same dose day 6 and 7 and then 225 IU of menopur day 8-13). By day 14 the 5 follicles had grown to "normal size (18-22mm I think). They did a blood test(E2, LH and Progest) and all seemed well so we went for egg collection with a pre op scan 2 days later. At the pre op scan the follicles were still there (although one large one on the left seemed to have disapppeared). They had explained that there was a danger I may ovulate before they could collect the eggs. However despite lots of looking they couldnt find any eggs in any of the follicles.
> 
> The consultant did another blood test and thinks that I did have eggs and unfortunately I had ovulated and the follicles had resealed instead of disappearing. The blood test checked HCG level (297 IU/L) and progesterone (47.3nmol/L)
> 
> My lining was also slow to develop (4.6mm on day 5, 5.4 on day 8 and 7.3mm by egg collection day).
> the consultant stronfgly recommends another go this time using a short protocol with 600IU - Gonal F (300IU) and Menopure (300IU).
> 
> My concerns are that this is a very high dose of drugs and may badly affect the outcome?
> 
> Not at all, these doses sound perfectly OK bearing in mind your previous cycle.
> 
> Also is it a bad sign that the follicles took a while to grow or is it ok that they caught up?
> 
> Steady growth is best, the new protocol should achieve that.
> 
> I also fear that there may have only have been one true follicle with an egg in it and the others were false follicles - not sure how to check this if you can?
> 
> By an E2 level
> 
> My last FSH was 11.3
> 
> This is slightly high but most clinics consider 12 to be the point when problems will arise.
> 
> and I am 39. I have had 2 early miscarriages and 2 ectopics - all naturally. Then had one ivf which was cancelled as I only developed one follicle of the right size (at another clinic on 300IU of puregon). I then went to egg donation as they said I only had < 5% chance of success with my own eggs. The egg donation was unsuccessful. I then changed clinics and they advised to go with my own eggs -very confusing!!!
> 
> I feel very strongly that too many clinics are pushing egg donation onto patients when the do not need it.
> 
> My fear is that I seem to struggle to get to the stage of egg collection and wonder if this means my chance of success is really limited with my own eggs.
> 
> No, it is as good as anyone else.
> 
> Good luck!!
> 
> Peter
> 
> Sorry for the long burble but would really value some help.
> 
> Many thanks
> 
> katie


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