Bricking it - over 20 follicles on 1st scan

[JuicyLu]

Hello everyone, I’m wondering if this has happened to anyone else as I’m feeling anxious. We’re having another IVF round with the same stims as before (Menopur) but more than twice the dose (375iu). I don’t really understand why the high dose as I responded well last time but I’m now 2 years older (39). Anyway, first scan showed over 20 follicles which seems excessive. I’ve still got 5 days to go until likely egg collection!

I’m concerned about what will happen with Pre genetic screening as we wanted embryos screened but I don’t know if there is a limit to how many they can test in terms of numbers in the embryo scope and if there is what they do with the others?

Has anyone had these numbers at 1st scan and what happened? I’m worried about sacrificing quality and what happens about trying to culture so many potential embryos. Oh, and the collection will take ages I guess? 🥺

[Florencehill]

Hi JuicyLu,

Are you having treatment on NHS or privately? In UK or abroad?

If privately theres no limit to how many you can have tested but they will only test blastocysts that have a good development. You have to pay per blastocyst /embryo tested.

With regards to the number of follicles, bare in mind that sometimes not all the follicles will contain eggs, and that unfortunately not all harvested will fertilize or develop. So you are in a good position at the moment although I appreciate how tender you will be feeling.

If you are worried about OHSS ask your clinic.

Hopr that helps.

[JuicyLu in reply to Florencehill]

Thanks, yes it’s private and UK. I think there are limits in my clinic to how many they can fit into the embryoscope and this is a requirement for the PGS there. Good point about the follicles/eggs/embryos, i don’t expect them all to have eggs in. No massive symptoms of OHSS but I’m definitely aware of that one! XX

[Ivfgotadream]

20 follicles doesn’t necessarily equal 20 blastocysts (I’ve read before of women having 50+ follicles and still only getting 1 or 2 blastocysts at the end of it)

I’d check your PGS policy -mine had a minimum initial cost and then £500 per blastocyst but there were some packages which were fixed price up to a maximum of 5 blastocysts

[JuicyLu in reply to Ivfgotadream]

Yes, we have to pay £295 per embryo tested but good point about the number of embryos. I’d be amazed if all the follicles had eggs in, never mind made embryos! This is one of my worries (quality is better than quantity), but it’s too late to be worrying about that now I guess xx

[Blissful_kk]

Hello JuicyLu nothing to worry. It's normal some have less follicles and some have more.. my friend scenario she was 37 and they collected 30 eggs.. 23rd fertilised and 20 formed as blastocyst..they transferred one fresh embryo (unfortunately not successful, waiting for her FET) and they frozen the 19 embroys.. recently I have read in this blog that for another family they collected 70 eggs..

So it's quite common. If you are having severe pain in your lower abdomen it might be causing because of OHSS problem. Let your clinic know if you're having any pain..so that they will recommend you to go to emergency in your nearest hospital. Hope this helps.

[JuicyLu in reply to Blissful_kk]

Thanks for the reply, that is very reassuring! I’m just a bit uncomfortable (and soooo tired), but if I get pain I’ll definitely contact the clinic x

[hifer]

Hey there, we have ours PGS tested and there is no limit on how many you can test. There isn’t a cost per blasto so you can test as many as you like. Just be aware that not all follicles equal blastocysts. The eggs need to be mature and then fertilise and then reach day 5 until they can be biopsied. Good luck x

[JuicyLu in reply to hifer]

Good point - we probably won’t end up with so many eggs/blastocysts as there are follicles. In our clinic we have to pay per embryo tested (£295), plus a one-off set up free for all that includes the cost of the embryoscope, which has limited room. So we do want a good number - but not too many! I guess we’ll have to wait and see xx

[hifer in reply to JuicyLu]

Ahh I see, wishing you loads of luck xx

[Goldie24]

I’m not sure about the genetic testing but I had a lot of follicles early on. I ended up with 40 and 33 eggs collected so they did a freeze all anyway because of the risks of OHSS. 24 fertilised normally, 23 made it to day 4 and we had 14 blastocysts suitable for freezing (10 grade A and 4 grade C) so I would say please don’t worry about the quality x

[JuicyLu in reply to Goldie24]

That’s a really good number of blasts - congrats! Also reassuring so thanks 😊 Time will tell for us, but other people’s experience has reassured me that the follicle count so far isn’t necessarily something to freak out about xx

[Goldie24 in reply to JuicyLu]

All I would say is make sure they monitor you really carefully. I was quite poorly afterwards but I didn’t get very good care from my clinic and they pushed me too far with the stimulation, I believe to fit in with their scheduling so just make sure you question them if you feel they’re pushing you too far xx

[JuicyLu in reply to Goldie24]

Thanks, yes, sorry to hear you were poorly. I’ll definitely be keeping an eye on how I feel after EC xx

[EliseMac]

To echo everyone else, it’s good to be aware and informed about the risks, but 20 follicles is just fine. I had 20+ on my one ovary at my baseline scan—i.e. totally naturally. I’m of course at risk for OHSS, but my clinic is on top of this and my stim doses to manage things accordingly.

Best of luck!!

[JuicyLu in reply to EliseMac]

Great, many thanks. I think I’ll be nervous until about a week after EC just in case of OHSS, but will be vigilant xx