# Had a Harley Street scan today as feeling ill



## MultiMum (Jul 13, 2008)

Oh boy, I seem to be unlucky.

Just cycling directly on the back of a failed cycle. Last Thursday which was *Day 22 after the withdrawal bleed* I was scanned and no activity seen in ovaries or lining. In other words they concluded that coming out of the last cycle I was not going to ovulate this month. I was therefore given Prostap.

As people know if Prostap is given late in the month it's supposed to be _after_ ovulation or when there is no activity at all in ovaries. It is not supposed to be given BEFORE ovulation.

Well.....I felt really really really odd over the weekend. Can't describe it. Couldn't get in to my clinic cos of work so got an urgent scan with a gynaecology consultant in Harley Street.

Turns out there is activity on the left ovary. A follicle is there measuring 10.0 mm and the lining is 4.6mm. It's a follicle not a cyst. She thinks it must have just been missed at the clinic last week.

Does anyone know what happens if you have Prostap inadvertently as I have, before ovulation? I have in my head that this is not a good scenario but I'm not sure why and what happens. 

Thought I was on the home stretch......


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## Mistletoe (Holly) (Jan 1, 2007)

Well if it is active, and secreting oestrogen, then when it gets to 16mm plus you will need to be given pregnyl or ovitrelle to pop it and then have provera to get rid of any lining that has grown as a result of the oestrogen.

After prostap you will not get an LH surge to make it pop so you will have to have it as a jab.


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## mierran (Apr 24, 2009)

Hi,

You may still ovulate on your own depending on when prostap given ( think of all the women who get shock bfps while dr ). Prob is if you do and produce a corpus luteum that causes probs with lining timing. 

How can they say definitely a follicle not a cyst? Just because not huge doesn't mean not an early cyst and as far as i know not easy to tell apart without history, serial scans and bloods unless obviously huge. Follicular cysts are really just sort of overgrown follicles so not exactly 2 completely different things iykwim - just cysts grow quickly and often  dont contain eggs.

I'd talk to original clinic. it is possible ovary was quiet and this has developed since prostap injection. Also pos they missed it first time round. 

Bad news is likely either way will delay cycle.

Good luck with sorting things out.and sorry if i've just confused things further 

X x


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## MultiMum (Jul 13, 2008)

Thanks ladies. Very helpful.


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## Mistletoe (Holly) (Jan 1, 2007)

Sometimes the dr meds cause an initial flare as they make the pituitary secrete any remaining FSH left. If you had been making a little FSH since the last cycle and then you got prostap it is possible that this was released causing a follicle to pop.

This happened to me last year when I was on DR meds for 4 months. I just could not stop making lots of follicles and having my lining grow. I had to come off everything for 3 months to let my cycle settle down. I now have my FET on Friday this week, but I started this treatment in October!


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## somewhere overthe rainbow (May 14, 2012)

I find this information about prostap very interesting.  I have a long cycle and irregular cycle.  I was given prostap on day 21 of 3 of my FET during private treatment.  I would have prostap day 21, the not bleed until upto 2 weeks after, I had to have provera once to bring on af and on 2 occasions I had to have a 2nd prostap inj as i didn't have FET within 4 weeks of having the first one. I am wondering now if this was the right treatment for me.  I have also questioned them missing other things that could have been relevant to my treatment but without the knowledge at the time I couldn't question it.

I honestly feel that I am being better looked after, with regards to treatment being very personalised, on the NHS than I was with private.  Feel I have spent a whole lot of money and wasted valuable time on the wrong treatment plan.


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## MultiMum (Jul 13, 2008)

Very upset today. Had Egg White Cervical Mucus - a true sign of impending ovulation.


So this is the situation.....clinic scan me last week but did a rudimentary scan. Ovaries silent they pronounce and give me the Prostap jab to down regulate. Ill over the weekend so I get a Harley Street scan Monday which shows a 10mm follicle which they say MUST have been present when at the clinic (ie clinic didn't look very hard). 


I told the clinic that I had been using TWO types of home ovulation tests and they had both indicated that ovulation was imminent. 


Now if you add in the mucus then clearly I am/have ovulated. So I SHOULDN'T HAVE HAD THE PROSTAP JAB !!!!!!!!!


I'm really upset about this. Clinic are going to re scan me Friday by which time I predict the follicle will then be a corpus luteum but the clinic will just see that there's something smaller than a 10mm follicle and no doubt conclude that the 'follicle' has got 'smaller'. 


So can anyone help with these two questions (and yes you detect I'm losing faith in the clinic so want to go with my own clear plan)


Is there any certain way of determining whether I have ovulated? 


If I have ovulated given that the donor is on the pill and 'waiting' for me, am I going to be able to continue with her. Surely I'm now going to have to wait an entire month for Prostap to leave my body?


Really upset about all of this. I react very badly (mood swings) to all fertility meds and I can't believe I might have now had a jab for nothing.


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## Mistletoe (Holly) (Jan 1, 2007)

As I said before, when you had the prostap it might have caused an initial flare and the follicle popped up at that moment and reached 10 mm by this week.

If it is producing oestrogen then you will get cervical mucus. 

If you have had prostap then it is unlikely that you will have an LH surge which is what is needed for ovulation and normally happens 36 hours before ovulation, so why you were getting positive tests before the prostap is a mystery.

Are you definitely not pregnant from the previous cycle? HCG and LH are chemically very similar and an Ovulation test will pick up HCG from a pregnancy. If you were getting positive ovulation tests then I would want to know why. It could be a pregnancy.


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## MultiMum (Jul 13, 2008)

Holly...gonna buy a test on the way back from work!


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## Mistletoe (Holly) (Jan 1, 2007)

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

/links


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## MultiMum (Jul 13, 2008)

Found one - negative. Couldn't be anyway with a really really thin lining.


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## MultiMum (Jul 13, 2008)

Bottom line 99% I've ovulated cos keeping it really simple I was out of treatment so body a bit slow to get going on its own again, I start testing with two ovulation kits and they go from negative to positive about a week after I would normally ovulated. Then the London scan finds a follicle.


So I have or am about to ovulate.


The key question therefore is whether treatment will have to be abandoned. 


If clinic can't pull any tricks out of a hat then I guess we have to let Prostap get out of my system - that would be 4 weeks and then go again on Day 21 of that next cycle. Bummer....that is ages away! The donor can't hang on that long. 


Anyone think the clinic might have a treatment plan they can use in this situation to prevent a massive delay?


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## Mistletoe (Holly) (Jan 1, 2007)

You need a scan to see what is happening with this follicle and the lining. Then go from there.

As I said the prostap is supposed to STOP you having an LH surge, that is the whole point.

If you have managed to pop a follicle with the prostap causing a flare, then you will have to have a trigger shot to get rid of it and a course of provera to bleed the lining down again.


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## mierran (Apr 24, 2009)

If you ask for bloods on friday as well.they will be able to tell if you have ovulated from your hormone profile. You want oestrogen and progesterone levels as a minimum. 

If you have an oestrogen secreting follicle it may need triggered. If it is a cyst they may ignore it, keep you down regulated on prostap to see if it shrinks, surgically drain it like egg collection, or prospone the cycle to let your body deal with it itself.

Was the prostap given into the muscle or under the skin? If under the skin it may not all have been absorbed so it's not working properly. 

You can do deivf without down regulating. I dont respond well to prostap and tend to develop cysts among other issues so i am starting prognova day 2 of my cycle scan day 10. Worth discussing with your clinic if they want to let the prostap get out your system.

Mistletoe - good luck.

X x


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## Puglover1980 (Mar 7, 2013)

As mierran has said, your progesterone level is the only reliable/guaranteed way to know if you've ovulated. That said, it's best to have blood drawn for this 5-8 days after ovulation, as that's the time progesterone peaks. As you don't know if/when you ovulated, it could be tricky to know the best day to draw the blood. But either way, a day or two after ovulation your progesterone level will be high enough to confirm ovulation, so it doesn't really matter when you have the blood drawn.

I hope your clinic is keeping you informed about how they are going to manage this. It doesn't sound like they're giving you many answers.


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## MultiMum (Jul 13, 2008)

actually no, I'm not happy with the clinic.


The Harley Street scan I had measured both ovaries and measured what was found inside and the lining and gave pictures on the report of each. I asked my clinic for proof that the ovaries were quiet last week (which is what they are saying) and they categorically won't tell me anything! I asked for confirmation that both ovaries were actually seen - ie did scan lady write down that both were seen and were silent. They won't tell me this.


So me thinks they are being just a tad defensive here. I do know that occasionally an ovary can be missed. However it is far more likely that cos I was Day 22 the assumption was made that I had ovulated and so the scan was not thorough. Okay so even this is forgiveable but I kept telling the scan lady that I was just off the back of treatment and that two home kits had gone positive so and my instinct what that my body was doing the usual stuff but later than usual. But the scan was probably about 2 mins in total! 


When they said they were going to give Prostap I was in tears as I just didn't feel it was right. I begged the donor co-ord to go and find a doctor. AT the very least I expected him to come in and talk to us (has happened at all other clinics). No he didn't. She just came back and saiid that Prostap was being given. Every bone in my body said this was wrong but I so wanted to trust them.


DP and I have discussed and we are concerned that we don't trust the clinic to help us. I've already emailed in asking for bloods and they've said no. I've asked again this morning and more sternly. 


If DP and I were to walk away from the clinic (and I'm not saying we will do this) but IF we did - would my body just sort itself out? I guess it would if I have ovulated but not if there's a developing follicle.


I am so sorry to be essentially criticising the clinic. I really don't want to do that. I want to have confidence in them. I've been through so many times with other clinics though and I know that scans are usually REALLY thorough and on the only other one occasion where a clinic wasn't sure if I'd ovulated or not they would NOT give prostap and made me keep coming back to be sure.


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## Mistletoe (Holly) (Jan 1, 2007)

The thing is MM the prostap can mean your natural cycle does not get back to normal for up to 8 weeks, or at least this is what it says in the data sheet for Buserelin which is a similar drug. It varies depending on the individual.

So I would say ''day 22'' in your situation is somewhat meaningless.


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## MultiMum (Jul 13, 2008)

Hi 


Well been to the clinic and there's a whopping big follicle on the left ovary. So this ties up precisely with what was seen on scan in Harley Street on Monday and, well, let's just say that this time last week the clinic just somehow missed it! 


So no wonder I have felt terrible as the Prostap was given when it shouldn't have and so this was fighting my body's own hormones.


Anyway this morning the lining was 6.6mm, and the follicle in the left ovary was 17.5. I've had ovitrelle this morning and also have got 5 days of provera.


What can I hope to happen from this point then? And if I've got ovitrelle and provera on board as well as prostap will I feel better or crap....


Thanks for all your help ladies!


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## MultiMum (Jul 13, 2008)

PS Clinic didn't do bloods.....! However given all other info it would be very unusual if this was NOT a follicle


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## Mistletoe (Holly) (Jan 1, 2007)

Like I said before MM the Prostap can cause an FSH flare as it works by pushing all of the FSH out of the pituitary really quickly to get rid of it. Occasionally this can cause a follicle to grow. So it is perfectly possible that this follicle was not visible at the clinic before the jab was given and the jab has CAUSED the follicle to grow.

I had the flare effect from Buserelin last year for 3 months trying to DR.
I was making *16* follicles every month when there should not have been ANY! Not just ONE!


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## MultiMum (Jul 13, 2008)

I could cry I really could....can you believe this - 


Left clinic. Both DP and I heard the nurse say TWO Provera TWICE a day  - ie 4 tablets PER DAY.


So as soon as I left the clinic I took two and then early evening took two. Felt off but then I'd had Ovitrelle at the clinic on the back of Prostap last week and the body trying to ovulated.


Then we noticed as we were eating that there isn't the right number of tablets in the box for 2 TWICE a day....


Just called the emergency line. Was given wrong instructions. This is the maximum dose of Provera (10 (mg) so it's one twice a day.


Can it get any worse.....


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## Mistletoe (Holly) (Jan 1, 2007)

Don't worry too much. It is given in MUCH higher doses for other conditions. 10mg is the max for inducing a bleed according to the data sheet, but you won't be poisoned. Check with the doctor what to do next, whether what you have taken will be enough for today and tomorrow or just have a shorter course.


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