Is ovulation the problem?
5 Replies
tinkerbell - April 14

Dear Dr. Jacobs,

I had a couple of failed IUIs (clomid-IUI procedure). When my doctor performed the IUI, he did not do an ultrasound on me to see how many follicles I had developed, rather he asked me to test for ovulation using predictor kits. The ovulation predictor kits tested positive on both times, afterwhich my doctor performed the IUI. Succeeding progesterone testing both yielded a count of 19, which the nurse explained to me as "I had ovulated".

When I asked the doctor if I should have an u/s prior to IUI (to see if I had developed follicles), he suggested that I can have it, and have hcg shots to induce ovulation. My question is: is my ovulation the issue here? didn't the progesterone result indicated that I had ovulated?

I want to get your opinion on this Dr Jacobs, before I proceed with my 3rd IUI. Thank you so very much for your kind attention.

 

Barry Jacobs, M. D. - April 14

Unless you stimulate ovaries with an FSH product, IUI does not provide better pregnancy rates than no treatment. It is not uncommon for infertile women to go through all the hormonal changes of ovulation without rupturing the follicle to release the egg. I do not know if ovulation is a problem for you. I suggest you see a Reproductive Endocrinologist. Your OB does not have adequate training to do a thorough job of evaluating and treating infertility. For more information, I invite you to see our web site, <www.texasfertility.com>.
Good luck.

 

tinkerbell - April 15

Dear Dr. Jacobs,

I am currently seeing an RE. He is the one who put me on clomid-IUI. Do you think he is not very knowledgeable if he wasn't testing for follicles development prior to IUI?

 

BabyBound - April 15

Hi tinkerbell, I just completed an IUI w/clomid and my RE did u/s prior to the trigger shot. I had 3 follicles, sizes 19, 17, 16 the day prior to the shot. I u/s is also tells them the thickness of the uterine lining. Hopefully, my first will will work. Did he say why they don't do u/s?

Good luck.

 

tinkerbell - April 15

BabyBound, thank for the input.
My RE did not do u/s, instead he asked me to monitor my ovuation using OPK. As soon as I get my LH surge, the IUI is scheduled for the next day. This has been the procedure for a couple of times, until I read in the posts about u/s and follicles testing prior to iui. That's why I asked why my RE did not subject me to the same procedure. :-\

 

Barry Jacobs, M. D. - April 15

First, the "ovulation predictor kits" do not tell you you ovulate. They tell you yo have had a surge of the pituitary hormone LH. Clomid, among it's other problems, increases the risk that you will go through all the hormonal changes of ovulation without releasing the egg. I have not prescribed Clomid in years. It can actually impair fertility. For more information, I invite you to see the discussions on our web page, <www.texasfertility.com>.
Good luck.

 

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