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Hello Dr. Roseff,
I would like some feedback from a professional outside of my clinic. I am 34, have PCOS, and have an AMH of 43. I have done 8 cycles of oral meds, only two of ended with triggering. Both were 10 days of high dose femara. Subsequent attempts failed to produce dominant follicles.
This cycle I did 12.5 mg femara days 3-7 and 150 IU follistim days 5-8. At cd 9 I had no dominant follicles and my estrogen was 20. They upped my dose to 175. On cd 12 an ultrasound showed 8 or 9 follicles starting to develop. My estrogen came back at 172. Today, on cd 14, the monitoring doctor had trouble seeing all areas of my ovaries, and they shadowed the image of the uterine lining so that he was not confident but thought my lining was measuring at 6. He could confidently see one follicle at 18, one at 17, and four between 14 and 16, but there were areas he could not get a good visual on.
He told me that they would do my estrogen and if it was above 1500 they would cancel the cycle. My estrogen came back at 785 and they still wanted to cancel because my estrogen tripled in two days. I do not understand the mentality. Having friends who have triggered with estrogen exceeding 1000 and having almost as many follicles as my doctor was able to see on the u/s, each having produced one baby, it's hard for me to believe that I am at such greater risk than they were for HOMs. I don't want to do anything stupid, but this is my third shot at getting pregnant in almost two years, and it's hard to accept this decision, especially considering that the doctor who conferenced with the monitoring doctor was not my regular RE, because my RE is in Haiti right now.
He seemed to believe that without triggering I will still release all of those follicles. Is this true? Or does my risk decrease without triggering? I'm trying to make a decision based on reason over emotion, but it's very difficult after you've poured time and money into all of this.
I would like some feedback from a professional outside of my clinic. I am 34, have PCOS, and have an AMH of 43. I have done 8 cycles of oral meds, only two of ended with triggering. Both were 10 days of high dose femara. Subsequent attempts failed to produce dominant follicles.
This cycle I did 12.5 mg femara days 3-7 and 150 IU follistim days 5-8. At cd 9 I had no dominant follicles and my estrogen was 20. They upped my dose to 175. On cd 12 an ultrasound showed 8 or 9 follicles starting to develop. My estrogen came back at 172. Today, on cd 14, the monitoring doctor had trouble seeing all areas of my ovaries, and they shadowed the image of the uterine lining so that he was not confident but thought my lining was measuring at 6. He could confidently see one follicle at 18, one at 17, and four between 14 and 16, but there were areas he could not get a good visual on.
He told me that they would do my estrogen and if it was above 1500 they would cancel the cycle. My estrogen came back at 785 and they still wanted to cancel because my estrogen tripled in two days. I do not understand the mentality. Having friends who have triggered with estrogen exceeding 1000 and having almost as many follicles as my doctor was able to see on the u/s, each having produced one baby, it's hard for me to believe that I am at such greater risk than they were for HOMs. I don't want to do anything stupid, but this is my third shot at getting pregnant in almost two years, and it's hard to accept this decision, especially considering that the doctor who conferenced with the monitoring doctor was not my regular RE, because my RE is in Haiti right now.
He seemed to believe that without triggering I will still release all of those follicles. Is this true? Or does my risk decrease without triggering? I'm trying to make a decision based on reason over emotion, but it's very difficult after you've poured time and money into all of this.
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