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kiwi - February 12th, 2007 12:17 PM

Dear Dr. Jacobs,
What size follicles do you typically like to see before HCG trigger? During a cycle if you have different ranges, with four being 18/19mm but most being around the range of 12m to 15m, is it worth pushing one more day (given all your other bloods look good) to give your smaller follicles a chance to grow bigger? Your four bigger follicles may die off, but is it worth waiting so that your other follicles have time to grow bigger?
Thanks alot!

B. Jacobs, M. D. - February 12th, 2007 6:02 PM

If you are using gonadotropins to stimulate ovulation, you need follicles to be about 17 mm to be big enough to ovulate. If you try to push further, you will turn the lead follicle(s) int cysts, which do not ovulate, but secrete progesterone. The cycle is over.
Good luck.

kiwi - February 13th, 2007 10:59 AM

Dear Dr. Jacobs,
I am using recombinant FSH (follitropin alpha) to stimulate ovulation...
Today, my biggest follicle is 24mm and others are 16-19mm... i am very concerned about the lead follicle which might be way too big, you think??
Thank alot!
P.S. will have HCG injection tonite...

B. Jacobs, M. D. - February 13th, 2007 5:40 PM

The only potential problem is if your lead follicle has actuall become a cyst, which is now secreting progesterone. If that is the case, this cycle is lost.
Good luck.

B. Jacobs, M. D. - February 16th, 2007 5:35 PM

The decision about day 3 vs day 5 transfer depends on the capability of the lab. Not all labs can relaibly grow embryos to blastocyst.
Good luck.

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