Your opinions on US

[Dri-Jim]

Ladies,

My wife was called in today for an ultrasound ahead of the scheduled one tomorrow. The doctor said it was because her estrogen level was higher than he thought it would be, although he didn't say what it was. He said he wanted to be sure the follicles were the right size and that there wasn't a very dominant one.

Anyway, she's been on Menopur 150 (once a day, Follistam 300 (once a day), and just started Ganirelix 250 (this morning). She's been on the first two meds since Monday.

The doctor did the US and said that she has 7 follicles ranging in size from .89 to 1.10 millimeters. 2 of them are over the 1.0 and the other 5 under it. He said he's happy with the progress and she'll have another US on Sunday.

How does this sound to you girls?

Thanks,

Hope you're all doing well.

Jim

[lauradc]

Jim- Sounds to me like your RE is being thorough and that's great! Good luck with the rest of your journey.

Laura

[Samara1]

Hi Jim,

From your post it sounds like your wife has been on stims for five days. I think your Dr has given you measurements in cms eg .89cm and 1.1cm. This would mean she has 7 follies ranging in size from 8.9mm to 11mm.

If yes, I would be very happy. Generally your Dr will want to see follicles measuring around the same size, if there was one in there that was measuring way above the rest he/she would be worried. But all the follies are very close in size. Your Dr will probably wait until they are around 18mm and then he will let you know when you can trigger.

Follicles grow at a rate of approx 2mm per day. At retrieval the follicles will be around 20mm.

Good luck!

[Dri-Jim]

Hi Jim,

From your post it sounds like your wife has been on stims for five days. I think your Dr has given you measurements in cms eg .89cm and 1.1cm. This would mean she has 7 follies ranging in size from 8.9mm to 11mm.

If yes, I would be very happy. Generally your Dr will want to see follicles measuring around the same size, if there was one in there that was measuring way above the rest he/she would be worried. But all the follies are very close in size. Your Dr will probably wait until they are around 18mm and then he will let you know when you can trigger.

Follicles grow at a rate of approx 2mm per day. At retrieval the follicles will be around 20mm.

Good luck!

Samara-

Thanks very much for your input. We're having another US tomorrow morning and I hope to see some growth in the follies as you mentioned. Should we be looking for more to grow at this point, or is seven sufficient? I'm under the impression that they'd like at least four of them to be 18 cms and won't do the et if this isn't the case.

Thanks again.

What is your situation, btw?

[Dri-Jim]

...also, does anyone know what the parameters of a good lining are? I'm going to get her stats at tomorrow's US and post them.

Thanks!

[nicaliw]

Hey, regarding the lining. The general concencus seems to be that a lining that is at least 8mm by the time of transfer is good.
good luck!

[Dri-Jim]

^^^ Thanks. I'll find out where we are in about 9 hours and I'll post the results.

[Samara1]

Here is notes from my last cycle:

11/01/08 - start FSH - 250u
17/01/08 - U/S & bloods. Lead follicle 14mm, endometrium 9mm

This is just one example, I am not sure what the upper or lower acceptable limits are. Someone else might be able to help with this. It will also depend on how far into the cycle you guys are.

I would not worry about "four being at least 18mm". I think this is an urban myth. Your Dr will make a decision based on more than just this rule of thumb. I know of some women who have only had 3 follicles, not all measuring the same, who went on to retrieval.

With 7 follicles all about the same size, you guys will definitly be going to retrieval.

You may see more follicles on your next scan. But if you don't, I would be very pleased that your current bunch are all measuring a very similar size.

Good Luck, let us know how it goes!

[Dri-Jim]

Girls,

Thanks for all the input on the lining, follicles, etc. I have additional information from Adriana's US this morning. Here it is.

6 follicles on the left. 14.7, 13.6, 7.9, 14.1, 7.6 & 13.9 mm.
3 on the right. 12.6, 13.2 & 12.2 mm.

The doctor said this is very good and that the ER would probably happen Friday. 3 more days of the meds and an US on Tuesday morning. The follicles have grown nicely and I'm so anxious to see what the final #'s are!

Her estrogen levels were 250 when we started and 351 on day 4. The doctor called her in then to make sure one follicle wasn't dominant. Glad that's not the case. Now, the current level is 445 and they're telling us that it could go as high as 2,000. Now the doctor that told us this today was not our normal doctor, so I am wondering if this is correct.

Finally, the lining is at 12.7 mm. Very good from what I am being told. They explained the triple layer pattern that denotes a lack of progesterone, which is supposedly good at this point.

You should have seen me taking notes and thinking of you guys, lol.

So, things look to be going okay so far. Does anyone have any opinions either positive or negative? Should I be asking any other questions of them that I haven't?

Thanks, girls. Happy Sunday.

Jim

[Samara1]

It all looks great!

I don't ask for my estrogen values. It kind of makes me crazy, as I tend to over analyse everything. Someone else may have an opinion on those.

You may want to ask what the ratio of follicles to eggs retrieved may be, and what the ratio of eggs retrieved to fert rate may be. This will help you set your expectations.


Keep us posted! It is all looking good.

[Dri-Jim]

It all looks great!

I don't ask for my estrogen values. It kind of makes me crazy, as I tend to over analyse everything. Someone else may have an opinion on those.

You may want to ask what the ratio of follicles to eggs retrieved may be, and what the ratio of eggs retrieved to fert rate may be. This will help you set your expectations.


Keep us posted! It is all looking good.

Thx Samara1-

I will ask on Tuesday. I am hoping there are like 7 good eggs. I've heard that's a good #. If I'm not mistaken, having too many eggs can mean that many of them aren't well developed. I know ultimately you're looking for 2-3 grade-A puppies. I think....

[Samara1]

I am crossing everything for you both.

Keep us updated!

[Dri-Jim]

Okay, here's the update.

Sunday's #'s compared with today's, comments after.

Sunday

6 follicles on the left. 14.7, 13.6, 7.9, 14.1, 7.6 & 13.9 mm.
3 on the right. 12.6, 13.2 & 12.2 mm.

Estrogen levels were 250 when we started and 351 on day 4.

Finally, the lining is at 12.7 mm.


Today

7 follicles on the left. 18.5, 18.2, 15.8, 17.8, 9.3, 11.7
3 on the right. 15.7, 13.6, 14.8.

Estrogen level is at 700 (bw from 2 days ago, new bw results this afternoon)

Lining currently at 12.4 mm.

Okay, our regular doctor was in surgery and I have to call the nurse back at 2:30 to see if they want to trigger her tonight. She thinks they will wait until tomorrow because they want one more day out of the not so quite mature follicles.

She also said they probably would only trigger her if her estrogen skyrockets based on today's bw.

She said that everything looks great but did point pout that the left side is obviously more active. They're hoping to get 7-8 follicles out of the 9 into play.

Any thoughts guys (girls!)?

Thanks,

Jim

[Dri-Jim]

Just got the estrogen level. 1,625. Shot up! They say it's fine and that the trigger will be tomorrow.

What's good is that I think her doctor is really into his cases. We have to go to the office where he'll be tomorrow morning for him to do the US. He wants to do it, which really speaks well of his dedication. Who knows how this will turn out, but these people are real professionals.

[Samara1]

Looks good to me.

I also have a dominant ovary. Every time we get more follicles from one side.

Good luck with your trigger!!!!