IUI follicle amount

[shayla1]

Hi Dr.
   I have decided that we are going to try another IUI after all of the genetic testing on our 20 week (in utero) son came back as okay...died of cord accident...cord was tightly wrapped around neck twice..my OB said she'd never seen it so tight in her 15 years.  After talking to both her and you I believe that this will not happen again...you think very unlikely?
  Anyways...the last cycle with IUI I had 5 mature follicles and got pregnant with a singleton.  However, this cycle, starting next week, my doctor upped my dosage.  Wouldnt higher dosage mean more follicles? And what what are the chances of multiples if there are over 5 follicles.  Is it getting "dangerous" to do an IUI with more than 5 in terms of higher order multiples?
  Just wanted to see what you thought. Thanks again for the reasurrance that a cord accident is very unlikely next time around as I know I'll be a nervous wreck!

[Forum-M.D.-SP]

Hi there - this is something that you should discuss with your doctor. We published a paper years ago which demonstrated that pregnancy chances increased with increasing numbers of mature follicles (Plosker SM et al. Predicting and Optimizing Success in an Intrauterine Insemination Program. Hum. Reprod., 9:2014, 1994) with very good pregnancy rates when there were five mature follicles. Five mature follicles for an IUI cycle is more than enough, and I share your concerns about the risk of mulitples, but there may be other reasons why your doctor has upped your dose. This is something that I unfortunately cannot address without knowing the full picture, and truly is best addressed with your physician. Glad to hear you are preparing to try again!