Timing of Meds, Ovidrel and IUI Seems Off
5 Replies
anjabelle - January 16

Hi -- I am somewhat new to this site and have searched to see if there are any threads on this, but after reading all the e-mails, I just feel as though I am not asking my RN enough questions and that I am so clueless on how things should be working.

That being said -- here's my situation. I am on my 3rd IUI. I have been taking Gonal-F starting on day 3, 4, 5 and 6 of my cycle. On day 7 (today) I went in for bloodwork and US and I have follicles (although I don't know how many or how large) and while my E2 was good (434), my LH level was apparently low at 1.9 so I was not anywhere near ovulating. As such, they suggested I take Gonal-F again tonight, and then administer the Ovidrel tomorrow and then come in for IUIs on day 8 and day 9.

This is fairly consistent with what they did the first 2 rounds (which were obviously unsuccessful) although I didn't seem have a low LH level then and therefore didn't have to take 1 more day of Gonal-F, BUT -- I am confused about several things:

1) shouldn't I technically be going in for at least bloodwork tomorrow (after another night of Gonal-F) to see if my LH level has improved? AND THEN, determine when to inject the Ovidrel trigger?

Any thoughts on timing based on your experiences with Gonal-F would be really helpful. I just can't help feeling like maybe the timing is off and that the weekend is interfering with things and they're trying to get around it which would of course be horrible/rotten/compromising of my chances if that was really the case.

2) why would they have me take the Ovidrel the night before my first IUI -- meaning, if I take it at say between 8PM and come in for an insemmination at 11AM the next day-- that's just over 12 hours after the trigger!! Everything I've read suggest that the first IUI should occur more like 24-36 hours after the trigger? Or, am I wrong about that? Granted, they have me coming in for another IUI the next day. Any thoughts on the timing of this would be greatly appreciated.
I'm just wondering if it doesn't have more to do with the fact that otherwise they might have to do my first IUI on Friday and then a second on a Saturday (which is less desirable for them).

Thank you very much for any help anyone can offer. This is just so frustrating sometimes and I just feel like I should be pressing my nurses for more complete information.

 

liz - January 17

Hello and welcome to shared journey!

I have never had an iui however I have been on injections and I have had to do the trigger shot so let me see if I can answer a couple of your questions.

While I was on my injections I was seen for my first u/s and bw on about day 8-9 of my cycle. I am having trouble remembering what day I started the injections I believe it was day 5 which is later than you so your u/s and bw would be about equal in timing as mine if you factor that in. They did the u/s and told me how many follicles I had and the size then a little later in the day they would call with the lab work results. At that time my re would determine if he felt I needed more injections or it was time to do the trigger. For me personally (and every women is different) I would usually end up going a couple more days of injections before my re was happy with the follicle size and the estrodial level. I did go everyday from that first u/s and bw to see how things were moving along. I believe every doctor is different in that aspect but I would have asked for it if my office did not do it that way. I felt better going in every morning and knowing exaclty what was happening in there.

2) You are absolutly correct with you knowledge of the trigger shot (Ovidrel). I was always told and also read that you will ovulate 24-36 hours after the trigger shot is administered. For me I was closer to 36 everytime, I always got the cramping when ovulation was starting. To me yes it does seem premature to go in in only 12 hours after the trigger. The next day seems more like it but I can't help but wonder if you are wasting that first round and should actually be going on the second day and then the third.

My suggestion would be to bring up your points to your re. I ask a ton of questions and although I would apologize for my constant questions to the nurses I think it kept me better informed and I never had any question lingering in my mind. It is your right to know what your treatment plan is and why. I was fortuante that I had one wonderful nurse who was extremely patient, understanding and very informative with me. I had another one who I did not care as much for but it all worked out in the end. If I didn't like her answers I would ask my other nurse the next time I saw her and she helped me understand better.

I wish you the best of luck and if you have any other qusestions, please feel free to post.

Take care,
Liz

 

amandarenae - July 28

Hi there anjabelle,

I'm sorry to hear about your failed cycles.

I will tell you a little bit about my cycle. I have PCOS, and I do not ovulate on my own at all. My husbands motility, morphology, and volume are slightly below averageā€¦ but his count was good. Due to his slightly below average statistics, and my PCOS, the doctor suggested an IUI.

I took provera to induce a period (since I don't get them on my own). On day 3 of my period I went in for an internal ultrasound and blood work. They verified I wasn't pregnant (policy I guess), and I started clomid. So day 3, 4, 5, 6, and 7 were all clomid. After that I started my FSH (Gonal-F injections) I did 12 days of gonal f. 8 days on 75 iu's and 4 days on 150 iu's. While on Gonal-F, I was going in for blood work and ultrasounds every 2 days.

I have 2 follicles growing, one was at 11 mm and the other at 17 mm on Tuesday. I took my ovidrel shot tonight (Thursday). They are asking that I return into the office on Saturday morning for my IUI. Which would be about 36 hours after.

Now, I know that sperm can live for up for 7 days, but the average is 3-4 days. Perhaps they were triggering you, then having your first IUI right after, then another the next day in order to ensure there are sperm in there when you ovulate?

Asking more questions never hurts!!!

 

nrstam - November 14

I am really confused too. Anyone have any thoughts? I took clomid days 5-9. Went in for an US on day-9 and I had 3 large follicles. I was asked take the ovidrel shot on day 10 (8am)and have timed intercourse on day 11 (8pm-10pm). Timed intercourse would of been exactly 36 hours after ovidrel shot. So, we had teh timed intercourse but, boyfriend could not ejaculate. I dont know if he lost concentration or what. This happens alot and we will just lay in bed awhile and watch tv and then round 2 well last night I got so mad because he said that he had to go to get ready for work the next day. We had sex for like 30 minutes but he never 'finished'. I am really upset. Debating what to do now. Is it too late to get pregnant 72 hours after taking ovidrel shot? I feel the weird ovulation pain. So, I think I may be ovulating now? Is it too late? I heard you are suppose to have timed intercourse before ovulation so that the sperm is there waiting for egg? Thanks.

 

Mhk015 - January 24

Hi,
I complete myth it'd round of IUI. I have always had the procedure 12-15 hours after the Ovidrel trigger. The reason for this is, the Ovidrel guarantees ovulation in 36-40 hours. When they insert the sperm, the Soren can live up to 5-7 days. Therefore, they are literally making sure the superb are right there waiting for that egg to appear.

My 3rd IUI and my boos tests shows 59.03 IUI HCG levels at 11DPO. Have an ultrasound scheduled this Friday. Crossing my fingers everything is well! ;)

 

Mhk015 - January 24

Sorry. So many grammatical errors typing on my iPhone. Let me rewrite.

I've always had my IUI procedure 12-15 hours after the Ovidrel trigger shot. The reason for this is, the sperm can live 5-7 days; therefore, they are trying to make certain the sperm are there and waiting when the egg releases. So you not worry about this. I would worry doing the procedure at 36 hours post Ovidrel.

I completed my 3 IUI and my blood work shows 58.03 IUI HCG at 11DPO. Going in for an ultrasound in Friday. Hope everything goes well.

 

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