1 follicle on low dose of follistim


#1

I’m been taking 50 ui of follistim starting cd 3 until I have a follicle that is 18 or greater. I’m 28 and have no fertility problems. Since my insurance covers the drugs, my RE went straight to injectables.

For the past two cycles, my RE triggered with only 1 mature follicle. I’m stressing. I thought the point of going through this was to have multiple eggs released. I’m concerned that I’m producing the same amount of follicles that I would be naturally. This is so much stress and money for sperm. I feel like I’m going through all of this while I could be doing this naturally and get the same result.

I realize that follistim can really disrupt my body and that my RE knows what’s best. I don’t want to over stimulate, risk cancellation, or risk having more than twins. I know it only takes one follicle, too. I just want more that one dominant follicle to increase my chances.

I’m wondering why my RE can’t up my dose just a little bit. He said he doesn’t want a Jon and Kate situation, but why does it have to be 1 follicle or 8? Would taking 60 or 75 ui really make me overstimulate etc? I guess that I don’t understand how the drug works, because there must be a real concern with upping my dosage even a little.

Is anyone else in this position? Am I being crazy?

Thank you


#2

IUI, sorry I forgot to say that.


#3

Cheeseburgerlover - If this cycle is not successful I’d ask to increase the follistim dosage. Perhaps to 75 units per day or even 100 units per day. I’m 29 and when I stimmed using 75 units for 3-4 days I always had about 5 follies. When I stimmed using Menopur 150 units for 4 days I had approx 5-6 follies. I really think your dosage needs to be increased. What is your resting follicle count at baseline? Do you know your AMH levels?


#4

Day 3 Baseline:
5 left follicles less than 11 mm in size
8 right follicles less than 11 in size
Not sure of AMH


#5

Not pregnant this past cycle. Today is day 1. I asked for an increase in my dosage and they said no. Very depressed.


#6

did they explain why?

does your insurance restrict quantities for coverage?


#7

They said that they are keeping me on the lowest possible dosage that my body responds well to. I produced one follicle each cycle and they rather that than have me over stimulate and cancel.


#8

how many days do you usually stim for? is there normally a check in between? if you have a u/s in between, after a couple days of stimming, i think you should bring up the topic again. and state that you make one follicle without any drugs already. make your concerns explicit.


#9

Now if this was me and my situtation I’d increase the dosage to 75 units everyday of stims or every other day of stims. Obviously you need the increase if you are only producing one mature follie. Women taking Clomid can produce one follie maybe even two. I dont see why your RE would give you injectable drugs and be on such a low dose. But that’s just my two sense. Have you discussed selective reduction? Not that you will need it but so that your RE is aware you are for or against it? They are being very conservative.


#10

I agree with you.

Yes, we are prepared for a multiples situation. We would be fine with twins and would reduce to two if there were more. Our RE is aware.

I am certainly thinking of increasing my dosage…do many women do that? I’m a bit scared because he won’t budge from 50 even after emails and 2 phone calls to the nurse about my concerns.

Maybe I will try a little increase for a day or two this cycle…


#11

Personally, I’m going to disagree with everyone on here and say that your RE sounds right on track. The goal of my clinic is for everyone to have a healthy, singleton pregnancy. You are responding beautifully to the dose you are on, and are make one, strong lead follicle which is exactly what they are hoping for. The injectables aren’t there to give you tons of eggs, but rather, eggs of excellent quality.

I’m someone who does not respond at all to the low doses you are on. When my meds are raised, I produce a “crop” of follicles that are all around the same size. Ultimately, in the five injectable cycles I did in 2012, three of them ended up a bust due to having too many follicles. They cut back my dose and my E2 plummeted and all the eggs fizzled. In 2010, the cycle that produced my son was a ONE follie situation. I really wanted a cycle just like yours, but my body doesn’t respond ideally like yours does.

Please keep in mind that more eggs does not necessarily yield a huge increase in results. Our brains think that more eggs equals a much higher chances. While the odds would be better if one of the eggs is chromosomally normal and other isn’t, usually the odds raise only slightly with more eggs. Whatever issue is causing the egg not to fertilize or stick is quite likely in the other eggs, as well. Like I said, my first successful cycle was with one egg. This past year, I had two cycles where I had two eggs and both of those were BFNs.

I don’t think you are foolish to want better results…I can see where this is a frustrating situation. But you are not their first patient…they know that raising your dose is going to seriously increase your chance for cancellation and not necessarily your chance for conception. I have been there several times before, and it stinks. At least with one follicle you still get a chance to try for a baby.

I hope whatever you decide works for you. I really think raising your own meds is a bad idea…if not for the fact that you may end up with more than you bargained for, the fact that you may run into insurance issues of not getting more meds fast enough if you need them (my insurance would only fill what the clinic was telling them I needed, and it was hard to get the meds in time sometimes).

Best wishes in whatever you choose. I am living proof, twice over, that slow and steady wins the race!


#12

May I ask your DH’s counts post-wash? If you have a male factor issue, that’s a solid reason to up the dosage. If DH’s counts are great, then I can see why your doctor will be hesitant.

Having said that, I’d definitely think your doctor’s goal should be 2-3 eggs per cycle in your case.

Did you ask your doctor to start at 50iu but increase later on based on u/s and b/w? That’s how my cycles go. If you give in on the starting dose, do you think you can get your Dr. agree on the last few dosages?

If that doesn’t work and if it’s possible at all, I’d find a new doctor. Good luck.


#13

We are using frozen donor sperm which has a lower success rate than fresh.

I’m on CD8 and am still on the same low dose of follistim. I go in for b/w and u/s every two days and they have not advised me to increase iu.

I didn’t increase the dosage on my own either. I was too scared.

It’s taking longer to conceive because he’s so conservative. It’s so much time, money, emotions, stress. I need to be positive, though…


#14

[QUOTE=cheeseburgerlover]We are using frozen donor sperm which has a lower success rate than fresh.

I’m on CD8 and am still on the same low dose of follistim. I go in for b/w and u/s every two days and they have not advised me to increase iu.

I didn’t increase the dosage on my own either. I was too scared.

It’s taking longer to conceive because he’s so conservative. It’s so much time, money, emotions, stress. I need to be positive, though…[/QUOTE]

I don’t even know if you will see this - but I hope you do! Applaud yourself for being patient. Even worse then not having multiple follicles is putting in the time and money and overstimming and having a canceled cycle. Trust your doctor - and if you don’t, find another! Good doctors are not necessarily the ones who tell you what you want to hear. I was frustrated in my journey for #2 because they were low dosing me and after the second round, they had the option of waiting one more day for another follicle or triggering and having just one egg. They decided to have me trigger with one egg only on injectables. I strongly believe that this one egg was of high quality, rather than me having multiple eggs of lesser. It only takes one - as we see in all those women who can get pregnant naturally. Well, the one egg worked. I feel so fortunate. I am happy I listened to my doctor and push my timeline-who knows if I would have had the BFP I got in the end.

Good luck. Be patient. Advocate for yourself but also take care of your body!