Dear Squirl1003 - it is possible to ovulate while on lupron; this occurs 1%-1.5% of the time. A progesterone of 4.4 suggests that this may have happened. I don't think anything could have been done to avoid this. Perhaps testing your blood for LH would have been helpful. It is pretty standard to start at lupron 10 units and drop to 5 units when fertility drugs were started. This is one of the most common protocols that we use. You were on high doses of fertility drugs and judging by your response, which was not too much and not too little, it seems to me that your MD picked the correct dose of medication. Canceling a cycle is always upsetting, but I believe was the right thing to do for you; it was not a perfect cycle and you saved thousands of dollars in retrieval, embryo transfer, and lab fees. To give HCG after seven days of stim, when your estradiol plateaued, would not have been a good idea because your uterine lining needs at least 8 days of stimulation to be optimally prepared. Next cycle, your MD might consider using a GnRH antagonist rather than lupron. This response was not expected and could not have been predicted. I hope your next cycle goes better.
Hi. I saw your post and noticed you haven't had any responses yet. I can tell you that early ovulation could have been prevented with Ganirelix and antagon shot taken about 4 days prior to triggering with HCG to prevent ovulation. I was monitored every day on my 2nd IVF cycle and when the lead follicle reached 19mm, they put me on Ganirelix for 4 days. This did impact my estrogen levels so they upped my FSH dosage of Gonal F from 450 to 600 units. As for your other question, I had not heard before that egg quality can be determined by follicle size disparity. My opinion, get the advice of another RE or two before attempting your next IVF cycle.
Yes, I would definitely get a second opinion, it dousn't sound like that doctor knows what he/she is doing. How can you ovulate on your own if your body was supressed before the cycle started? and how did they let your follicles reach 30 mm? you need to have a lead follicle between 16-20 mm and you'd be ready to go. They should have given you ganirelix, it stops ovulation and allows the follicles to mature into the right size before they take them out. But hey, the first cycle is a test for most people. I wasn't given enough follistim during my first cycle. They doubled the dosage in my second cycle and i produced much better follicles. And honestly, they can't tell egg quality by looking at your follicles in an ultrasound, that's bs. They can detect quality by testing your FSH levels and even then, it's not enough. They can not test egg quality until after they've retrieved the eggs, fertilized them, and tested the embryo quality. This is where IVF is best, you can test the quality of your eggs and adjust any changes for the next cycle.
Again, I would see another doctor...and don't go to just anyone. Do some research, visit someone who is established, has great reviews, and look at his/her success rates. My doctor had a 91% success rate when I went to see him with a state of the art lab and clinic all in one place, so I knew I was in good hands.
Good luck, keep trying, and stay positive!
I had my cycle cancelled three hours prior to my first injection because my FSH had gone from 5.8 to 20. I was dropped from the program and was devastated, although I hadn't gotten as far as you did. I found another Dr. and after an agonizing month of waiting for my next period, got an FSH of 6.0. There had been problems with my first center from the start so despite how painful it was to be delayed, I have to believe it was for the best. Maybe your baby just wasn't ready to come down from Heaven yet and he's still up there playing with mine. Can you try again soon? Sounds like your body is just working too well. Are you able to change meds or doctors? Good luck :)
I had my cycle cancelled three hours prior to my first injection because my FSH had gone from 5.8 to 20. I was dropped from the program and was devastated, although I hadn't gotten as far as you did. I found another Dr. and after an agonizing month of waiting for my next period, got an FSH of 6.0. There had been problems with my first center from the start so despite how painful it was to be delayed, I have to believe it was for the best. Maybe your baby just wasn't ready to come down from Heaven yet and he's still up there playing with mine. Can you try again soon? Sounds like your body is just working too well. Are you able to change meds or doctors? Good luck :)