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caschere - March 13th, 2009 4:03 PM

I am 32 yrs, normal ovulating every month, day 3 FSH 7,5 LH 10 (little high), many little follicles on basal ultrasound, other test are all normal values (estradiol, TSH, etc). I did IUI whith bad response due to uterin linning. This month we did stim rFSH (Gonal-f) 75U from day 2 and on day 8 had 10 follies so my RE decided to cancell cycle she said to many follies for IUI. Next cycle we will try an IUI but lower stim. Do you think It could work or should go direct to IVF? Should I start stims on day 5 or day 7 and the dose you recommend?

B. Jacobs, M. D. - March 13th, 2009 4:37 PM

I typically start stimulating with FSH on cycle day 3 and try to grow 3 to 4 follicles to about 17 mm in average diameter. Frequently there are other smaller ones, which may not present problems. I reserve IVF for women with significant tubal problems, couples in whom there is a severe male factor and we have to inject sperm into eggs to attain fertilization, and for the occassional patient who does not become pregnant in 3 to 4 completed ovulation induction cycles.
Good luck.

caschere - March 13th, 2009 4:49 PM

Thanks for your response, I am from south america. On day 8 my RE said me to stop meds and today (day 11) I had 6 follies more than 17mm and others smallers so my RE cancelled. What dose do you recommend me for next IUI?

B. Jacobs, M. D. - March 14th, 2009 8:16 AM

Everytime we start stimulating a patient for the first time, we use our best judgement and best guess as to starting dose. I moderate and adjust the dose during stimulation based on ovarian response.
Good luck.

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