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MS/IUI - did follicles not rupture for BFN cycles?

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11-Nov-08 8:48 pm

I have been reading through lots of posts about MS/IUI and am learning how hard it is to pinpoint when your follicles actually rupture.  I wonder if the IUI is sometimes timed a little too early, just before a follicle ruptures, and then the sperm die before they get to fertilize the egg.  Do sperm have shorter lives after MS?  It would make sense that they would.  Anyway - for those of you that had a BFN with IUI, do you know if your follicle(s) ruptured for sure before the IUI?  It sounds like HRC does not always recommend an u/s the day of IUI, wihch means you're just going by the timeframe of the trigger shot.  Would it make sense to do an u/s right before your husband gives his sample and/or right before your IUI?  If they still haven't ruptured at IUI time what do you do though?  The sperm have a finite life and Kelley probably wants to go home at some point : )

Any thoughts?

 

 

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11-Nov-08 9:07 pm

My follicle had not ruptured at the time of my first IUI (BFN). Two out of three follicles had ruptured at the time of my second IUI (BFP). I did not use a trigger shot the first time, and I question whether that follicle ever ovulated. I think the trigger makes a huge difference. Kelley told me that the trigger forces ovulation within 30-44 hours. That's a pretty narrow window. As long as your IUI is sometime within that timeframe, the sperm should live long enough to fertilize the egg. It does make sense that sperm live shorter after MS, but they also are put directly into your uterus so they have much less distance to travel than they would naturally. Sperm can live for several days naturally, so I would think MS sperm should be able to live for 12 hours, which should be about the longest they would ever need to wait.

I did an u/s before my husband gave his sample the first time. My follicle hadn't ruptured but it looked great and they said to go ahead. I did not do an u/s the morning of my second IUI. Kelley said there was no reason to, and I didn't want to spend another $270 unless there was a really good reason. Even if nothing had ruptured by then there was a really good chance they would have by the time of my IUI seven hours later. If nothing has ruptured early that morning, would you cancel? You still have a really good chance. For me to have had an u/s before my husband gave his sample, it would have been 31 hours after trigger. That is early in the expected ovulation window. My IUI was 38 hours after trigger, so right in the middle of the window, and 2 out of 3 had ruptured. I think it is valuable to request an u/s at the time of IUI so you know what is happening, although by then you have paid for your sort and it is too late to cancel. The sperm have a better chance of survival inside you than in the syringe, so you wouldn't want to delay your IUI at that point. I think you just have to trust that the trigger works.

Mom2RJA Baby Boy R, 2000 Baby Boy J, 2003 Baby Girl A, 2009 MS/IUI 10/2/07 at GIVF, natural cycle, 1 follicle, 94.7% sort purity, BFN MS/IUI 8/25/08 at HRC, Clomid + Ovidrel, 3 follicles, 92.99% sort purity, BFP!!! Beta #1 on 9/9 (15 dpo): 153, Beta #2 on 9/11 (17 dpo): 395 

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RJA Feet

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11-Nov-08 9:26 pm

For my 1st IUI cycle I ovulated about 14 hours before the IUI.  I was on full injectibles and did an hcg trigger.  Totally missed the window on that one.  I know this because I have the same type of crampy discomfort every month with ovulation.  The discomfort started at about 11pm the night before the IUI. For the 2nd and 3rd cycles I did full injectibles and Ovidrel which is a less potent trigger and had an u/s right before the IUI and did not have a ruptured follicle. Obviously all BFN cycles.  The timing thing is the hardest part of it all. I think having a follicle that has just ruptured before the IUI is the most ideal situation.  But I also think the type of trigger makes a difference, at least for me it seemed to. With IVF Dr. Potter had me do 1 hcg shot for my first cycle and 2 Ovidrel for my second.  Incidentally, HRC does not routinely do an u/s right before the IUI but if you request it before hand they will do it free of charge.  I always wanted to know where I was in the ovulation process at the time of the IUI.

Good luck and hope it works out for you!

 Heart  Heart 

3 failed MS/IUI's & 2 failed MS/IVF's                                                                                                   

 

 

                                                                                                       

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12-Nov-08 7:10 am

That is interesting that different triggers can work so differently. I triggered with Ovidrel. It looks like I should be more specific when I write about that. I had no idea Ovidrel worked differently than HCG--I just knew it was easier to use.

Mom2RJA Baby Boy R, 2000 Baby Boy J, 2003 Baby Girl A, 2009 MS/IUI 10/2/07 at GIVF, natural cycle, 1 follicle, 94.7% sort purity, BFN MS/IUI 8/25/08 at HRC, Clomid + Ovidrel, 3 follicles, 92.99% sort purity, BFP!!! Beta #1 on 9/9 (15 dpo): 153, Beta #2 on 9/11 (17 dpo): 395 

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RJA Feet

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12-Nov-08 7:31 am

I had the crampiness you mentioned before each MS/IUI and had I not known better would have thought it was O, but also had u/s every time right before MS/IUI which was timed for 42 hours post trigger.  The follies were either rupturing or about to rupture.  The crampiness I felt the nights before was just my body gearing up for O and not actual O,  based on u/s confirmation. 

 If the docs catch your LH surge in time (before it starts), the hcg trigger (which Ovidrel is one type of), then with almost  full certainty, your Ovulation will be timed to be about 40-48 hours after trigger.  If the LH surge has started (based on bloodwork), that timing is moved up 12-24 hours because you will O sooner.

I took both generic hcg and Ovidrel brand subq and had the same results with each....I triggered before my surge and had the IUI about 42 hours after the trigger with rupturing or about to rupture follicles. 

 

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12-Nov-08 7:32 am

Mom2RJ:

. My IUI was 38 hours after trigger,

 Did you detect your surge through OPK before hcg trigger?

 

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12-Nov-08 7:48 am

katescubs"]

[quote user="Mom2RJ:

. My IUI was 38 hours after trigger, [/quote]

 Did you detect your surge through OPK before hcg trigger?

 

Yes, I relied pretty much exclusively on OPKs for the trigger timing. My last ultrasound was three days before I got my +OPK and triggered.

Mom2RJA Baby Boy R, 2000 Baby Boy J, 2003 Baby Girl A, 2009 MS/IUI 10/2/07 at GIVF, natural cycle, 1 follicle, 94.7% sort purity, BFN MS/IUI 8/25/08 at HRC, Clomid + Ovidrel, 3 follicles, 92.99% sort purity, BFP!!! Beta #1 on 9/9 (15 dpo): 153, Beta #2 on 9/11 (17 dpo): 395 

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12-Nov-08 8:13 am

I was at my 2nd u/s at my OB's office, and he was mentioning how HUGE my follies were and they were actually bigger than they usually let them get when they do IUI for infertility purposes.  I got a little discouraged.  I did my lab work and was walking out to my car when my cell phone rang... It was Nachet.  She said, "Carey, I don't even need to get your blood work back.  You're about to pop.  You need to fly out tomorrow and be here the next morning at 7:30."  My heart sank.  We weren't supposed to even LEAVE for 2 more days!  I just knew we were screwed.  And we only had one chance at this.  I cried and cried as Bill and I frantically changed all of our plans.  I triggered that night at 10:00 with Ovidrel, I think.  I was cramping on one side horribly that night, and I just knew one of the follies was rupturing.  My hopes were diminishing quickly.  We flew out the next morning (Wed), tried to relax, went in for MS at 7:30 the next morning (Thurs), and I had my IUI at 2:00.  By mid-morning that morning I was cramping terribly on my other side, so I figured the other follie was rupturing.  I mentioned it to Nachet, and she said that was PERFECT timing.  So, my IUI was about 36 - 39 hours after trigger (factoring in time zone differences).  However, the clomid actually made my follies grow faster and get "ready" sooner, which caused the frantic travel changes...

But... it worked for us!  IUI OHW!!!  And, I have to tell you... I was NOT dilligent about OPK's, timing cycles prior to that one, "knowing" my body well.  I just prayed, went in with the mentality of peace and that it work if it was meant to be.  It was the strangest thing... because that is SO not my personality.  I'm a worrier!


 

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12-Nov-08 8:32 am

I am sure the hcg and ovidrel work the same for most everyone else.  Leave it to me to be different, lol.  But that is par for the course with my whole high tech disaster of an experience.  I still wonder if I ever had a follicle rupture for my 2nd and 3rd cycles.  I just know that based on the u/s right before the IUI nothing was ruptured.  I also never had any of the crampiness I usually feel with O.

 Just some trigger facts, an hcg trigger is a dose of 10,000 iu's and ovidrel is 7,000.  Dr. Potter posted about this in the ask the dr. forum a while back.

 Heart  Heart 

3 failed MS/IUI's & 2 failed MS/IVF's                                                                                                   

 

 

                                                                                                       

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12-Nov-08 8:38 am

 In all my MS IUI my follicles were not ruptured so I knew it was going to be a BFN.

I do think MS sperm has a short life spam and that's why you need ICSI if doing IVF.

So MAKE SURE your follicles ruptured BEFORE your DH give his sample and if is not ruptured yet, then WAIT!!!!!!!!!

Baby Boy Baby Boy Baby Boy MS/IVF Dec/2008 Sort Purity 88% for a Baby Girl Lilypie Expecting a baby Ticker

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12-Nov-08 8:48 am

 At the time of my IUI, I had two follicles.  One had just ruptured, and one had not.  I wondered for a long time which follicle was responsible for my BFP... until I found out I was having twins!   So I don't think an unruptured follicle necessarily = BFN, in my case both the ruptured and unruptured follicle made babies.

Mom to And Microsort/IUI twins!



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12-Nov-08 9:17 am
As my MS/IUI is quickly approaching, I am reading each detail of this post over and over again! It is making my head spin to try to wrap my brain around so many things to "make sure of" because I don't want to miss anything! So, it sounds like I should have Kelley do an u/s before my IUI, to see if I have or an just about to rupture? She told me to base my trigger on OPK more than on u/s, so that is my plan.

Baby Boy Eric 2005 Baby Boy Kyle 2007 and Our newest Baby Boy love... Ryan born May 26, 2010

*****I was in and out of the hospital and otherwise at home on bedrest for 12 weeks after bleeding due to complete placenta previa. Gratefully made it to 37 weeks and our strong and healthy baby Ryan finally arrived safe and sound!

 Heartbroken June 2004 Heartbroken January 2009 (my MS/IUI baby) Heartbroken September 2009

Our MS/IUI Journey... 11/16/2008: MS/IUI at HRC 11/27/08: 11dpIUI: BFP!!!!!!! 11/28/08: 12dpIUI: Digital reads "Pregnant" 12/17/08: U/S shows no viable pregnancy- gestational sac only 1/5/09: Natural m/c finally occurred After 9 wks pregnant and a 92% purity sort for Baby Girl, our MS/IUI journey ended Jan. 2009

Cynthia

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12-Nov-08 9:45 am

 YES!!!  This is the only thing I regret not doing because I thought it was more $$ and Kelley did not offer it.  My 3 follies measured 19, 20, 21 on Monday morning (triggered that night) and then I was in severe O pain starting Tuesday night before my IUI and I did not get in until Wednesday at 4:30/5:00 the next day and I have no idea if I had ruptured or not.  Has anyone looked at those who go at 2:30 vs. 4:00 ish to see if there are more BFPs on the early side? Having that info would have been helpful for another cycle but I like Calebzmom was in peace and SURE it worked.  So I say get all the info you can.

DREAM JOURNEY: 28 months 2 failed IUIs, 2 Sway attempts HeartbrokenHeartbroken, 2 IVF cycles = no transfer all abnormals.... Another miscarriage (a girl) .

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12-Nov-08 9:47 am
Maureen, what I think is if one already ruptured it means that the Ovidrel DID WORK and the other one should rupture any time. But is it NOT GOOD NEWS if any of them are ruptured when it's 42 hours after the HCG. I asked Dr. Potter and he told me sometimes people need 2 Ovidel to make sure they will ovulate (I wish I knew that before my MS IUIs) Also, when I cycled at HRC, they didn't use OPKs ..... that's new because I even ask if I could use them and they said: "NO, we go by U/S and bloodwork" but if you see MOM2RJ, if she would go by US her IUI would have been 2 days before.... and she got a BFP. I do recommend OPKs!!!!!!!! I think if you wait until your surge to have the ovidrel, the follicles will be ready.
Baby Boy Baby Boy Baby Boy MS/IVF Dec/2008 Sort Purity 88% for a Baby Girl Lilypie Expecting a baby Ticker

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12-Nov-08 9:52 am

 tzipi, good point.  

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