Egg collection and low follicles

[BlueSilver23]

Hi, I just started the process of egg collection for ICSI later on and was told that I had 18 follicles on my baseline scan which I was happy about as this seemed like a good number. However after taking the lowest protocol drugs (as I was told I wouldn't need the higher doses) for few days I've just been told that I've only got about 5-6 follicles and need to up my dose to help them mature as they are too small and that I'm now unlikely to get any more eggs than 5-6 from this cycle.

Am I wrong to feel slightly upset that so few follicles have matured on the protocol I was given compared to the number found on my baseline scan? I now feel like I should have been on the standard dose from the beginning and have now lost several eggs and put myself through all this as well as the cost when it could have potentially been avoided if I'd just been put on standard protocol in the first place? Am I overreacting? What has been peoples experience with the number of follicles/eggs collected compared to their baseline follicles? I am feeling quite upset as I don't have a lot of savings and feel like I just wasted thousands that I don't have to spare for another round. Would be grateful for any advice as this is my first rodeo so to speak!

Hi, so my AMH at baseline was 7 and collected 7
My previous cycle baseline was 9 and collected 9
So I think it should tally up in my experience

What dosage was you on? I was on highest
450iu menopur but because my AMH is low
(5.6) so my egg collection was a good number for my AMH

What is your AMH ?

I don't know the answer to your question but remember we don't ever know how our eggs are going to respond

Is this your first cycle ?

Have you had ec yet? Is there time to add more stims for longer ? How long has stims been for?

X

Hi @BlueSilver23

Something similar happened to me on my first cycle. I had an afc of 19 on my first scan but the level of medication wasn’t high enough and only 8-9 started to grow properly. I ended up with 5 after egg collection. I was really disappointed so can completely understand why you are upset. That being said, my clinic didn’t increase my dose throughout my cycle so that might make the difference for you!

I did a second round at a higher dose and ended up 15.

Unfortunately the first round can be a bit of an experiment as the doctors really have no idea how your body will react to the medication.

Fingers crossed your follicles continue to grow!

I had a scan several days before egg collection and the nurse said I had quite a few smaller follicles so she gave me extra meds to see if we could boost them before collection.

On the day of egg collection, the doctor came to see me and said that based on that scan, they were expecting maybe 13 eggs or so. I got 27. Which was higher than afc too. 25 were mature. Obviously I got OHSS so there's an argument to say they were wrong to give me extra, but it's just a bit of a guessing game at first.

I totally understand your feelings that you should have been on the standard protocol, and I think most people would rather risk getting ohss than risk getting too few eggs, but I guess they'll say they made the best decision they could with the information they had.

You don't say how long it is until your egg collection, but hopefully there's time for some to catch up and surprise you.

Hi @strawberrysummer19

I was on 150iu meriofert and fostimon, which now seems like it was too low. All the other people on this regimen seem to be on 225iu. My other tests were all normal, in fact I was told everything was very good for my age (35).

So I am upset and a bit perplexed, I could understand not matching perfectly but losing 75% of the follicles seems wrong? I am only on day 3 of these drugs and now they told me to up my fostimon and extend the stim for two more days before starting cetrotide (which I was supposed to start tomorrow) to try and help the small follicles mature but said I am unlikely to see the number increase from the 5-6 they saw. But now I'm wondering whether its even worth going through with this collection at all if the 5-6 follicles aren't even showing signs of being very viable?

When I spoke to the nurse who informed me of the scan results and told her my original follicle count was 18 all I got was a surprised 'oh' and then just told me the consultant said to up the dose of the fostimon to 225iu and she left it at that. I feel like I haven't been given an adequate explanation and perhaps wasn't given the correct regime. I feel like 18 follicles was a good starting point and this falling to just 5-6 barely possible and poorly matured follicles isn't good enough really. I feel a bit let down by the clinic after trusting them with something so important.

I've emailed asking for a more detailed explanation of whats happened but haven't had a reply. This is my first cycle yes so now I'm worried that despite my ovarian reserve tests etc all coming back normal that this cycle has uncovered a potential problem. I'm basically imaging every worst scenario! Does anyone more experienced than me at this has anything they think I should be querying? Feeling quite upset and deflated after initially being excited to finally start my journey.

Thank you @Holskey and @CurlyJ21

Now I'm wondering whether I should be asking if I should also increase the meriofert too? I too would rather cope with a little OHSS and get more eggs. Guess I'm going to be doing another time intensive and expensive cycle . I do understand that the first cycle is a bit of an experiment but just frustrated as to why I wasn't just put on the standard meds to start with.

@BlueSilver23 sorry you're only on day of stims? Isn't that far too early to be concerned about not having enough?
Bearing in mind people stil for 10-14 days ? Sometimes longer ? So if you have 5-6 at the moment on such a low dose surely that's a good thing ? Or am I missing something
Maybe I've read wrong
X

@BlueSilver23 I think I'd try to speak to them about it and if they really think you'll only get 5 or 6 as a best case scenario, I'd ask about cancelling and restarting, and I would ask them about costs. I don't know how that would go down because I've never done it, but if you're feeling that bad about it and like mistakes have been made, you might feel better with a restart on a higher dose. Seems like early days in the cycle so it might be doable without costing too much more.

Hi @strawberrysummer19

Yes day 3 today, which is of course early but I was disappointed that nurse said I'm unlikely to see more than 5-6 follicles even with increasing the meds a bit, that this was being done purely to try and mature the the 5-6 follicles that are there. But it seems like there may perhaps be hope that the number of follicles could increase with a couple more days of stims from the posts above? I wasn't sure if this was possible? I'm all over the place with this fertility thing and don't know anyone else who has ever been through it. I think I just wasn't expecting the number to be so low based on the AFC and got my hopes up so its thrown me a bit.

I had good AFC and AMH but didn't respond well to the medication and only got 6 eggs at egg collection. I think particularly the first round is a bit of trial and error - needing to work out how your body responds to certain medications and doses, etc. I felt really down about it throughout, that this was one of a very limited number of attempts we could make and it felt like it was doomed from the start. However, one of those eggs made it to blastocyst and transfer and is still going strong at 27 weeks so far... Don't give up hope. 💜

Afterwards they just said that probably wasn't the right medication and dose regime for me.

Thank you for trying to reassure me, think I've got myself in a bit of a tizz (I'm blaming the drugs! ). Will try and settle myself into a frame of mind to do a second cycle and keep my fingers crossed that I get a few more than what nurse predicted this time round!

@Scirocco

Thank you, and thats wonderful news, congrats! Hope it all goes well for you and the little one!

My last cycle I started with an Afc of 15 and only ended up with 7 retrieved and 5 fertilized out of which 2 developed into embryos. During stims some of the eggs developed too fast and turned into estrogenic cysts rather than good follicles, so I was at risk of OHSS. Of course I was upset, I expected more eggs retrieved.
I too agree with the fact that the first round is a kind of trial round. On top of that it is a numbers game and unfortunately there is little we can do about the results.
Don't get disheartened. You still have plenty of days left. Good luck! 🍀

@strawberrysummer19 @Holskey @CurlyJ21 @Scirocco @Yuliaaa

So I had a scan today and from 5-6 follicles reported a couple of days ago I was today told that there are now 30........ so I suppose thats good news! However not all of these are a good size so I am unlikely to get eggs from a few of them but even half that would be good for a first try I think. Hopefully I'll get a couple more than 5-6 at least.

But I'm thinking the sudden jump in follicles in just two days might have something to with my unexpected trip to A&E yesterday for extreme headache and vomiting, despite being told by the clinic the drugs/potential OHSS had nothing to do with it!

Thanks to everyone who reassured me and pointed out I had a few days left to improve on the numbers. Not sure why the nurse at the previous scan told me I'd be unlikely to see an improvement from the 5-6 follicles she found, that was stress I didn't need and apparently not true. And it seems upping meds a bit helped.

They are keeping me on the increased dose and aiming to collect at the end of the week/early next week so fingers crossed all goes well after a slightly rough start! As you've all said above you just a need a couple of good ones, quality over quantity!

Sounds like a positive update. Hopefully you'll get a number you're happy with 🤞 Good luck and keep us updated 😊

Good luck!🍀

Thanks everyone @strawberrysummer19 @Holskey @CurlyJ21 @Scirocco @Yuliaaa

So scan today shows that the number of follicles of the right size are still quite low, there are a number of follicles but most are too small really. A couple of big ones ready to go. Got one more day of stims so best bet will be about 8-9 if we are lucky, so despite seeing 30 follicles we are back to the nurses original prediction of about 8. Slightly disappointed as it seems there was a lot of potential given the afc and number of follicles but most quite small it seems.

Will be asking for the normal dose rather than the lower dose of stims from the start next time to hopefully ensure that the follicles grow enough. The numbers are there it seems but not the size. Can’t help feeling like this round was a bit of a missed opportunity….. but only a few more days to go. I’ve asked to postpone the next round I have booked for a bit as I feel quite uwell from all of this! Need a break

@BlueSilver23 I'm sorry you're feeling unwell - I've often read that people collect much more eggs at collection sometimes so maybe that will happen for you? Have they provisionally booked egg collection? Xx