Polycystic Ovary Syndrome (PCOS)

Newbie: Timing of Ovulation following Clomid and Profasi (long)

Question:

Kay – Thank you so much for the information.  I have been very frustrated and appreciate finding a ng where people are available for info and support.  I have not been offered IUI yet, but think I will ask about next cycle.  Dr. said he was going to put me on Fertinex next cycle (perhaps with Clomid as well).  Is it possible that continued use of Clomid or Fertinex can cause you to have PCO? I had a post coital test, but it was during the stage of diagnosis, so I wasn’t really ovulating at the time (prior to any of my three months of Clomid).  I have anovulation probably because I do not produce sufficient estrogen.  I did kill all of the sperm, so perhaps IUI might be a better option. It appears that you can only use Clomid for a maximum no of months (7 or – is this because it can damage your ovaries?  Is there a limitation for other drugs like Fertinex? I have not been told that there have been any issues with the uterine lining, but I will ask the Dr. next time we talk to make sure. Thanks again – I appreciate the support available here and hope to be of help to other members. Lisa

– Hide quoted text — Show quoted text – <<Is it possible for that second ovary to ovulate later even though Profasi was given earlier? Not really.  Once follicles ovulate, they produce progesterone which suppresses subesquent ovulation.  Since you had your hCG shot on Day 13 and still have a few follicles 3 days later, chances are those won’t ovulate. <<If I do not ovulate, what happens to the follicles on that ovary? They will either become resorbed, become cysts and *eventually* become resorbed or grow and burst, or they could just stay there  (e.g. polycystic appearing ovaries). <<Does anyone know what the smallest follicle that can be successful is — e.g. does it have to be 18-20 mm or can a smaller follicle possibly release a viable egg? To release it on its own, I believe a follicle has to be at least 16mm at the time of the hcg shot.  If you were doing IVF, viable eggs could be retrieved from follicles less than 10mm, but if left to ovulate on their own, they probably would not. Sorry to hear of your terrible hsg!  :(  I hope you’re feeling better. You are on a pretty high dose of clomid, and from your hsg description, it seems like you are using intercourse, rather than IUI.  Did you have a post-coital test (pct)?  High doses of clomid can cause your cervical mucus to dry up, hindering sperm travel, preventing pregnancy.  I assume your uterine lining was fine at the time of your ultrasound, so maybe mucus isn’t an issue? Good luck, and welcome! -Kay

Response:

Hi, I am a newbie here, and hoping to get some help in answering a few questions regarding ovulation.  I am 37 and do not regularly or successfully ovulate — apparently because I have very low levels of estrogen.  I have been taking Clomid for the past 3 mos. (150mg this month).  This month, my Dr. gave me a shot of Profasi (HCG, I think) on day 13 following Ultrasound (showing at least one follicle big enough) to cause ovulation.  Later ultrasound (Day 16) showed that one ovary had released follicles, but other ovary still had egg follicles.  Regarding ovulation, I have the following questions: Is it possible for that second ovary to ovulate later even though Profasi was given earlier? If so, can I get pregnant later in my cycle — e.g. day 17 or later from the second ovary ovulating later than the first? If I do not ovulate, what happens to the follicles on that ovary? Does anyone know what the smallest follicle that can be successful is — e.g. does it have to be 18-20 mm or can a smaller follicle possibly release a viable egg? Any insights would be greatly appreciated. As an aside, I had a terrible experience with HSG test this past week. Excruciatingly painful – and subsequent fever.  Was hospitalized for a day getting IV antibiotics just in case of  infection.  Fortunately, I probably did not have an infection, but I have significant and continued discomfort from the test.  I  will not likely get pg this month as I have missed my ovulation because I have been unable to have sex due to the hospitalization and subsequent discomfort (unless second ovary ovulates later for some reason).  Feeling quite frustrated!  The only good news is that HSG showed that everything was clear. Glad I found this ng — it is nice to know that I am not alone and my prayers are with all of you for success!  Thanks to anyone who can share some info!

Response:

<<Is it possible for that second ovary to ovulate later even though Profasi was given earlier? Not really.  Once follicles ovulate, they produce progesterone which suppresses subesquent ovulation.  Since you had your hCG shot on Day 13 and still have a few follicles 3 days later, chances are those won’t ovulate. <<If I do not ovulate, what happens to the follicles on that ovary? They will either become resorbed, become cysts and *eventually* become resorbed or grow and burst, or they could just stay there  (e.g. polycystic appearing ovaries). <<Does anyone know what the smallest follicle that can be successful is — e.g. does it have to be 18-20 mm or can a smaller follicle possibly release a viable egg? To release it on its own, I believe a follicle has to be at least 16mm at the time of the hcg shot.  If you were doing IVF, viable eggs could be retrieved from follicles less than 10mm, but if left to ovulate on their own, they probably would not. Sorry to hear of your terrible hsg!  :(  I hope you’re feeling better.   You are on a pretty high dose of clomid, and from your hsg description, it seems like you are using intercourse, rather than IUI.  Did you have a post-coital test (pct)?  High doses of clomid can cause your cervical mucus to dry up, hindering sperm travel, preventing pregnancy.  I assume your uterine lining was fine at the time of your ultrasound, so maybe mucus isn’t an issue? Good luck, and welcome! -Kay

Response:

Filed under: Polycystic Ovary

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