Question about Follicle Size and E2 levels...

[MN_SMC]

Does anyone know what the "ideal" mature follicle size is before doing the HCG trigger?

The reason I ask is this, and I'm still a little puzzled... here's why.

I went in on Saturday for my u/s and E2 level b/w. I had lots of follicles. At least 6 were at 15mm and then I had 4 at 14mm. Turns out my e2 level was 675.

So if you figure and e2 level of 150-200 per mature follicle, that means that I had around 3-4 mature follicles. BUT, aren't they supposed to be around 18-20mm in size for them to be mature?

That's where I am a little puzzled. Can I have mature follices based on e2 levels alone without the actual follicle size being 18-20mm in size?

So at my appt on Saturday, they had me do the HCG trigger that night and then insems on Sunday and Monday. When I questioned this, the nurse said "they will grow 1-2mm overnight. By the time you ovulate you will be at 17-18mm in size. And with having 6 at 15mm and at least 4 more at 14mm, they are concerned about multiples."

Would it seem to you that they had me trigger a little to early? Or am I just being parinoid???? It's probably the later due to I'm only 1dpo and already going crazy!

~M

[kwash0880]

I can't really help, but I do have a similar situation going on. I did 5 days of injections and went in for bw and us. I had 2 12mm and 2 11mm follicles. I had bloodwork the next day and my E2 level was 752, so they had me trigger that night. I really think that it was too early, so I hold very little hope for this cycle. I asked the nurse about it being early, and she told me the same thing about them growing 1-2 mm per day. She also told me that my RE wants to see me before I do another cycle if I'm not pg this time. I feel as if I'm not responding well to the meds, and I hope he has something good to tell me. I think he probably wants to discuss my options. If anyone has any input on this, please share. Thanks!

[jan1908]

On my shot day 10 follicles were 3@15, 2@17 on the left and on the right one at 20 (a left over). I had to do two more nights of low dose shots because RE wants follicles to be at least 18. Follicles went to 2@19, 20, 22 on the left and 16, 17 on the right so they did trigger this day. My E2 was somewhere around 1200. Ultrasound a few days after IUI showed 4 follicles released (2 on each side). I had done back to back IUI's this 2nd cycle. On the first cycle I only had to do 6 days of shots. I was worried when I had to keep going this time with injections as my follicles grew slower.

[Aunt2bMomSoon]

Q: At what size are follicles considered mature?

A: Many doctors monitor follicle development during IUI cycles. Most trigger when the dominant follicle is within a certain size range. While there is always some difference in doctor preference, the norms are unmedicated 20-24mm, clomiphene citrate 20-24mm, FSH-only meds 17 or 18mm minimum, and FSH+LH would be 16 or 17mm minimum. It is possible for slightly smaller follicles, 14-15mm, to contain a viable egg. Also, follicles continue to grow until they release, usually at a rate of about 1-2 mm per day. A woman may ovulate more than one follicle in a cycle, but the releases will occur within 24 hours. When hCG is not used, only follicles close in size are likely to release. The use of hCG induces ovulation in about 95 percent of women, and will get most mature follicles to rupture.

Q: What should estradiol (E2) level be at time of hCG trigger?

A: The E2 level should be 200-600pg/ml per 18mm follicle. Some doctors are content with a minimum level of 150, but higher tends to be better.

Hope this helps..

Good luck

[BC-MomZ]

Wow, great info ladies! I hope all of that helped
Julie

[Tia38]

Good thread! I'm new to injectables and starting to have the same questions. Thanks for the info all.

-Tia

[AMF]

Just wanted to say thanks for the info...
I had no idea what all of that stuff meant..and the E2 question, what a relief!
Thx

[Nirmiti27]

Had cd7 u/s today and follicles were 9, 6.5,5 mm in right and 3 @5 mm in left ....
Is this normal on CD 7 ?.....Doctor asked me to increase my dose from 50 iu of puregon pen to 75 iu for next 2 days. he wants to have U/S on 9th day...........wht do u people think....this will be my 1st iui with puregon........

before this 3 cylces of clomid(50,100,100mg)+ BD failed .............

any suggestions before going to IUI and wht should we do tht will have greater no. of success?


Baby dust to all!
Please pray for me!

[BC-MomZ]

That sounds great to me! What day did you start your injections?
GOOD LUCK
Julie

[Nirmiti27]

Originally Posted by BC-MomZ

That sounds great to me! What day did you start your injections?
GOOD LUCK
Julie

CD2-CD7 i started my Injections with puregon pen 50 iu...
now 2 days ie CD8 and CD9 injections 75iu.
Also i am on metformin 2000mg and folic acid 1 tablet perday.........

After injections my weight has increased by 3 kgs approx 6.6 lbs...........
I am already overweight... ..
i can do diet.......as i always fail in it...i try and then suddenly a
strong urge to eat something junky and then cant control...
so diet a waist for me....any solution for this