HCG Question, Predisone and linning
9 Replies
faith2006 - May 8

Dr - I have 3 questions:

1.What makes Dr. decide whether to trigger with 5000 iu of hcg or 10,000? Does it make any difference in how quickly you ovulate? Will you ovulate within 24hrs after trigger with 10,000 and maybe within 36hrs with 5000 iu? Also will 10,000 increase maturity of the follicles more so than 5000 iu?

2. When do you use predisone with iui? I know with ivf it’s usually on day 4 after retrieval, correct? Can you start on day 4 after iui too?

3. What is the ideal thickness for the linnning with iui? Is 11.5 good enough or just border line?


Thanks
Faith

 

Barry Jacobs, M .D. - May 8

1) You will ovulate about 36 hours afte hCG administration in an FSH stimulated cycle, regardless if you are using 500 units or 10,000 units of hCG. Some people think there may be a lesser risk of hyperstimulation with the lower dose. I have not observed that.

2) I do not use Prednisone in IUI cycles.

3) Your endometrium needs to be greater than 7 mm thick on day of hCG.

Good luck.

 

faith2006 - May 9

Dr - Thanks.

Is there a level that determines impending OHSS, like if your E2 is at a certain level?

Thanks
Faith

 

Barry Jacobs, M. D. - May 10

Unfortunately, we do not have a measure to accurately warn us of hyperstimulation, before we give hCG.
Good luck.

 

faith2006 - May 10

Dr Barry – One more question about HCG trigger, you said ovulation happens usually 36 hrs after trigger shot in a stimulation cycle.

Does it matter what size the follicle is before the trigger in an iui cycle with FSH only?

If the biggest follicle is already 21mm before the trigger will you still ovulate after 36hrs or most likely within 24hrs?

Have you performed iui less than 36hrs after the hcg trigger and was it successful?

Thanks
Faith

 

Barry Jacobs, M. D. - May 10

Follicles have to be about 17 mm in mean diameter to be big enough to ovulate. If your lead follicle was 21 mm in MEAN diameter, it may hve become a luteal cyst, and will not ovulate.
Good luck.

 

faith2006 - May 11

Dr – So would the ones that were 17 – 19mm probably ovulate in 36hrs or is it possible that the bigger ones like the 19mm will ovulate within 12 – 24hrs?

Also is it true that thawed sperm from frozen sample lives only 12 – 24hrs?

Thanks
Faith

 

Barry Jacobs, M. D. - May 11

Ovulation takes place about 36 hours after hCG. All follicles large enough to ovulate will do so about 36 hours after hCG. It does not matter if the follicle is 19 mm, unless it is a cyst, it will ovulate at abouot 36 hours after hCG. If follicle is less than 16 mm, it will probably not ovulate.

 

faith2006 - May 12

Thanks Dr.

You didn't remember to answer my question on thawed sperm from frozen sample.

How long does it live after it is thawed?

Thanks
Faith

 

BArry Jacobs, M. D. - May 12

n an incubator, under proper conditions, they can last over night. The same is true for in the fallopian tubes.

 

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