IVF stimulations for 17 days - at what size should be trigger?

[Lily_82]

Hi All,

This is my 7th and possibly last cycle with OE. I usually needed about 11-13 days of stimulations. I had my scan today on 14th days of stimulations and 15th day of my cycle.

My follicle sizes are 21,18,16,2x15,3x14. The clinic has advised to have another scan on Friday and collection on Monday (they do collections only 3 times a week), it will mean I will be on 450 meriofert for 17 days! The nurse has checked with consultant and they think we might lose 2 biggest ones but others should be ok.

That seems to make sense but did any of you were on stimulations for so long and had a good result? I have just read that trigger is best when follicles are 12-19mm and worry they might be too big by Monday 🫣 I appreciate we need to trust professionals and it is possibly best decision but need some reassurance please 🙏

Thank you and sending you warriors some baby dust xx

[Fruitandflowers]

So I'm actually glad to see someone else who stimmed for 14+days - I did, twice. First time they started on a super low dose as they'd predicted an over response and OHSS, but very little happened for at least a week, probably longer, and right at the end a load suddenly grew and some more came through. Same thing second time even though I was on higher doses much earlier, they still had to keep increasing and that time I had one big dominant follicle early on (26mm I think) as was told it would be a cyst or not contain a viable egg. First time I got 9 eggs although lowish fertilisation due to a one-off sperm quality issue, and second time 5 (including from the bigger ones) and all went to blast. I had two early losses but then a successful FET from those, and frosties. I was actually advised to cancel the second round due to the slow response and one big follicle, but I kept going because of what happened first time, and am now so grateful I did. Everyone's different and hindsight is perfect but I just wanted to share what happened with me as you may be in need of a bit of hope right now x

[Lily_82 in reply to Fruitandflowers]

Thank you for your reply and congratulations on your success 🤗

Can I ask what’s the maximum days of stimulations you had?

I have started from the beginning with max dose of 450 so can’t get any more, I am 42 now so age is not on my side also xx

[Fruitandflowers in reply to Lily_82]

I5 days each time, and mainly on 350 gonal f, which they seemed to be saying was the max. They couldn't explain why I reacted like that as my AMH was very high and was in my mid 30s when I started. I even had a round cancelled about 18mnths before where my body simply 'ignored' the meds entirely and just did its own normal ovulation thing... and there's nothing apparently wrong with my eggs (am about to have a baby aged 40, first ever natural pregnancy) so I wouldn't necessarily feel it's all about age, some of us just don't respond at all or the way they expect. But if you're on your 7th round I completely get that this may not be too much comfort and you've probably been through every variation of treatment already, so I just really hope this is the one that works for you x

[DianeArnold Partner Nurse Fertility Network UK]

Hi Lily. Leading follicle should be around 17 m. Good luck. Diane

[Twiglet2]

my clinic would trigger now. If there is a follicle over 18m they trigger. The fact you have 2 over and a few close behind they would defo trigger that day or the next! Have they said why they want to keep you stimming for longer at the risk of being her maturing the lead ones? I know they sometimes do this if a history of having a high % of immature eggs collected for example Xx

[Lily_82 in reply to Twiglet2]

Thank you for your reply Twiglet. As far as I know there was no issues with immature eggs, rather empty follicles. They said only 2 are big enough and by waiting other 6 should be ready even if 2 biggest would be lost. I am just worried they all might get too big by Monday 😔 xx

[Twiglet2 in reply to Lily_82]

Ah that might be why they want to push some more to a bigger size then, I hope you aren’t too uncomfy 🤗 xxx

[AshleyJB]

Hi there. On my first round I did stims for 18 days on a low dose because of my OHSS risk. My clinic said they wanted the follicles at 20mm. I remember them telling me they could push it for longer with no issues and they were right. Lots of luck to you. Xx

[Lily_82 in reply to AshleyJB]

Thank you for your reply AshleyJB, I hope they are right xx