# follicle sizes on or before trigger day?



## katkat2014 (Nov 28, 2014)

I really don't know where else to post this so hopefully someone reads this at all. After several failed ICSI cycles with many immature eggs each time,  I wanted to see what sizes the follicles of other ladies were the day before or on the day of trigger?

My follicle growth is sometimes unequal. To give you an idea, at one of my cycles I got 13 follicles, they aspirated 9 of them and found 9 eggs. Just 4 were mature. The size on the day BEFORE trigger were: 25.7, 18.3, 16.8, 16.3, 14 and smaller. So what I am trying to figure out: is the 25.7 too large and the 4 mature ones were the ones btwn 18 and 14 (assuming the 14 grew overnight until trigger day to become a 15 or 16), or does my body need huge follicles to ve mature and good quality? I did have a bit of blood on my last scan so have a feeling I ovulated fhe largest one but just don't know...
The second scenario was Follicle sizes On trigger day of 18.7, 17.3, 16.3, 15.7, 14.3, 10.8, 9.2 and right ovary 20, 19.6, 16.7, 13.2. I only had 5 mature eggs!  And on a long protocol I had 13 eggs and only 2 mature although sizes were mainly between 17-26mm.... but on this particular cycle I stimmed for ages and follicles grew very slowly. As my Dr just says they are always fine then I need to do my own research.


----------



## ladybug8410 (Jan 12, 2015)

Hi Kat

I have had problems with egg maturity in my cycles too. My first 2 clinics used a cut off of 16mm as ready for trigger but this resulted in lower number of mature eggs for me. My last clinic triggered at 18-19mm and that was much better for my egg maturity. Did your clinic ever measure estradiol levels during your cycle? I can't remember but there is a rough estimation of what your estradiol levels should be per mature egg. 

Another thing that can affect final egg maturity is the trigger used. Some people seem to respond to HCG trigger (Pregnyl, Gonasi) better. One clinic tried Buserelin as my trigger and again, I had better maturity then. Its difficult to know what made the difference at the end but I suspect its a combination of waiting for larger sized follicle and a different trigger.

I assume you have not had your positive outcome yet but one of the things I was told in my numerous clinic reviews is sometimes if it is difficult to gets mature eggs despite changing stimulating drugs, more patient stimulation or different trigger, this could point to an underlying egg issue. It could be due to receptors on the follicles that do not respond to stimulation meds as one would expect. 

Looking at yours, your clinic may be using 16mm as a cut off for trigger as if you count all your follicles above 16, that will equate to the number of mature eggs you got. I guess you could ask your clinic if they will consider waiting till your follicles are bigger for next round but I know there is a school of thought who feel your largest/dominant follicle is prob the best and if you wait for smaller ones to catch up, you may risk losing the best one. 

This is just my views and I don't have a BFP to show for it but hopefully it gives you some food for thought.

x


----------



## katkat2014 (Nov 28, 2014)

Hi ladybug, thanks so much for replying. Hm no my clinic never measure estradiol, they don't do any bloods at all. They reckon size is enough.  Maybe I should insist on it.

I am using double trigger since the disaster of 2 our of 13 eggs mature and since had 3-5 mature. I wonder if pregnyl or ovitrelle is the better one. I tried both, cannot tell the difference but using pregnyl now as cheaper. But if there is evidence that 2 x 25mg ovitrelle gives you better or more mature eggs then would go for that one...?

The explanation of Receptors on follicles makes sense and I think I do have an egg quality or maturation problem, I personally think they may not have enough energy to separate chromosomes properly.

Do you or does anyone know if follicles of 25 or 26mm are still good (day of or day before trigger?

Will be interesting to hear how large or small follies were of others too


----------

