Lupron Flare and Early Follicular Development


#1

Good morning ladies. Usually I am but a lurker on these forums and they have been an excellent resource for me in the past. However I now have a more specific issue/question and I haven’t been able to locate any posts to address it.

This is my very first IVF cycle and my appointment this morning has me a little worried. I’m doing a Lupron Flare protocol and began stims on the 25th (600iu Follistim) and although I had an antral follicle count of 24 at baseline, there was very little activity in the ovaries at my ultrasound this morning - so little I didn’t even have any bloodwork done. The nurse didn’t seem very worried although it also seemed this was not what she expected.

Any of you ladies familiar with Lupron flare protocols know if this could just be the Lupron suppressing follicular growth, as I dropped from 20 cc to 5 just yesterday? I know I should just be patient and sit tight until my next ultrasound on Wednesday but I can’t help but be a bit worried. =s


#2

[quote=SassyMollassy]Good morning ladies. Usually I am but a lurker on these forums and they have been an excellent resource for me in the past. However I now have a more specific issue/question and I haven’t been able to locate any posts to address it.

This is my very first IVF cycle and my appointment this morning has me a little worried. I’m doing a Lupron Flare protocol and began stims on the 25th (600iu Follistim) and although I had an antral follicle count of 24 at baseline, there was very little activity in the ovaries at my ultrasound this morning - so little I didn’t even have any bloodwork done. The nurse didn’t seem very worried although it also seemed this was not what she expected.

Any of you ladies familiar with Lupron flare protocols know if this could just be the Lupron suppressing follicular growth, as I dropped from 20 cc to 5 just yesterday? I know I should just be patient and sit tight until my next ultrasound on Wednesday but I can’t help but be a bit worried. =s[/quote]

They should be starting development. As you know, the Lupron flare is supposed to cause a flare of LH and FSH to get the follicles going. With 24 antrals, you should do well.

If you don’t mind me asking, do you normally have regular periods?


#3

I hope you’re right! Thank you for responding, it certainly is encouraging. My periods have been regular in the sense that I get them every month and on time. However progesterone draws have indicated that I haven’t necessarily been ovulating until about the last six months or so (after having lost about 40 lbs). With temping and charting I’ve been fairly confident that I have in fact been ovulating in recent months, although my luteal phase is only ~10-12 days.


#4

Regular periods suggest normal pituitary function, so I suspect you had a decent surge of FSH from the Lupron flare. Now you should just need a little time to watch those follicles grow.


#5

Thanks again. Will update after the ultrasound tomorrow! :cross:


#6

The news wasn’t much better this morning. After six days of stims, looks like I have a handful (~10 or so) measuring at 4-5mm and one at 7mm. The nurse said we’d most likely be upping my meds pending today’s bloodwork. But is it too late? I’ve responded fairly well to injectable cycles in the past, I have no idea where what my follicles are doing. :frowning:


#7

That is disappointing. Sorry to hear that.

We do flare cycles every now and then, although rarely in a patient with 24 antrals. Most patients do about the same as with a conventional cycle. Once in a while they really take off.