Thursday, April 21, 2011

Cancelled IVF Cycle: Australian Wonders If She Can Risk Conceiving Naturally

Dear Doctor,

I found out today that my IVF (in vitro fertilization) cycle was cancelled due to not enough follicles stimulated. I was day 11 of my cycle and had 6 follicles in total but only 3 measuring over 10 - at 16, 14 and 11. Another was 9. This is my first cycle - I have an AMH level of 3 and DH has a low sperm count and motility. I have been taking 400iu of FSH (puregon) and an antagonist. What are the risks if we were to have intercourse? Would I need to take my HCG injection prior to intercourse?

Given our history, I don't see why we couldn't try to conceive naturally? Thank you! C. From Australia


Hello C. from Australia,

I don't understand why your cycle was cancelled because it only takes 1-2 good embryos to get pregnant. Although you did not have a large response, you did have a sufficient one. Also, your doctor could have increased your medication up to 600IU of FSH or have added Menopur (FSH/LH).

In any case, you could convert your cycle to an IUI (intrauterine insemination) cycle or intercourse at this point. IUI would probably be the better choice. You would continue on the medication until the lead follicle is at least 18-20 mms, visible with ultrasound. The goal would be to have 3 ovulatory sized follicles (greater than 16 mms) at the trigger, then you would take the HCG and have the IUI's at 24 and 48 hrs after the trigger or have intercourse for the next four consecutive days.

I am in agreement with you that you should not give up this cycle so easily.

Good Luck,

Edward J. Ramirez, M.D., FACOG
Executive Medical DirectorThe Fertility and Gynecology Center
Monterey Bay IVF Program
Monterey, California, U.S.A.

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