Didn't ovulate after the trigger

Didn't ovulate after the trigger

Joined: November 8th, 2011, 3:54 am

May 31st, 2012, 9:26 pm #1

Hi Ladies,

I had an HCG trigger on Thursday, but my U/S today (44 hours later) did not show the follicle had ruptured (it had grown from 17 to 25 and didn't have the "rupture" shape). My E2 and Prog levels suggested ovulation.

What gives? Is it possible that I might STILL ovulate? I'm feeling pretty discouraged.

Cooper just said that if I get a BFN in 2 weeks, they will use Lupron as a trigger next cycle.
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Nancy
Nancy

May 31st, 2012, 10:11 pm #2

Hi,

While I don't have experience w/ TI and trigger I can tell you that I seem to have an issue with "empty" follicle for IVF, where I am growing a follicle, but when they go in to retrieve it for IVF, it doesn't come out. This has now happened to me twice, and it's super frustrating. And then on u/s it doesn't look like it collapsed. So, maybe this is what is happening? I think you said that you had a temp shift as well? ( I did as well.) So based on my experience, it seems like maybe the egg didn't come out, but it's producing progesterone and therefore gives you signs like you ovulated. I think LUFS might show a similar pattern, but not sure. It could also be that the trigger might not have worked. Did they say if they think the egg will still come out? Based on what I have seen others post in the past, it also seems like your p4 can rise and look like ovulation w/ bbt shift, but it hasn't really happened yet. I might be confused, but I think I have seen this happen to others here so maybe this will also happen to you. I also know that some women (Dr. C just told me this), and it's very rare, don't ovulate or have mature eggs unless they are triggered when the follicles are much larger than normal. In fact, they suspect I may be one of those women and next time I am going to trigger when my follicles are much larger.

I hope this makes sense...it's all very confusing and I think there a few possibilities here, so hopefully some of what I said made sense. If not, let me know

Nancy
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MargieD
MargieD

June 1st, 2012, 12:40 am #3

Hi Ladies,

I had an HCG trigger on Thursday, but my U/S today (44 hours later) did not show the follicle had ruptured (it had grown from 17 to 25 and didn't have the "rupture" shape). My E2 and Prog levels suggested ovulation.

What gives? Is it possible that I might STILL ovulate? I'm feeling pretty discouraged.

Cooper just said that if I get a BFN in 2 weeks, they will use Lupron as a trigger next cycle.
Coopers thought that I didn't always release.

Local RE thought that I released (because of b/w numbers) but follicle filled up with fluid after rupturing. Coopers didn't seem to agree, though.

Anyway - Coopers said it was LUFS and next time to use Lupron... (and it worked)

It took some time to figure this out because my follicles would sometimes release and sometimes not and we didn't figure out what was really going on until after a few cycles... but maybe Nancy has a point - depends on the size...
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Joined: November 8th, 2011, 3:54 am

June 1st, 2012, 2:11 pm #4

Hi,

While I don't have experience w/ TI and trigger I can tell you that I seem to have an issue with "empty" follicle for IVF, where I am growing a follicle, but when they go in to retrieve it for IVF, it doesn't come out. This has now happened to me twice, and it's super frustrating. And then on u/s it doesn't look like it collapsed. So, maybe this is what is happening? I think you said that you had a temp shift as well? ( I did as well.) So based on my experience, it seems like maybe the egg didn't come out, but it's producing progesterone and therefore gives you signs like you ovulated. I think LUFS might show a similar pattern, but not sure. It could also be that the trigger might not have worked. Did they say if they think the egg will still come out? Based on what I have seen others post in the past, it also seems like your p4 can rise and look like ovulation w/ bbt shift, but it hasn't really happened yet. I might be confused, but I think I have seen this happen to others here so maybe this will also happen to you. I also know that some women (Dr. C just told me this), and it's very rare, don't ovulate or have mature eggs unless they are triggered when the follicles are much larger than normal. In fact, they suspect I may be one of those women and next time I am going to trigger when my follicles are much larger.

I hope this makes sense...it's all very confusing and I think there a few possibilities here, so hopefully some of what I said made sense. If not, let me know

Nancy
Nancy,
I am sorry to hear that you've had difficulties with this as well.
Thanks for sharing your experience. So it might be an empty follicle, or perhaps needs to be a much larger follicle before triggering.

I've been trying natural cycles with TI for well over a year. It makes me wonder whether some or most of these times I might not even have been releasing an egg. Geez! I was relying on my temp shifts to indicate my ovulation, but it sounds like the egg can produce prog even if it doesn't release-- so then my question is, does it ever release? And is it bad if it doesn't release within that 36 hr trigger shot timeframe?

Cooper nurses were vague about whether they thought I would release the egg. I suppose I could only find out through another U/S.

I think my options at this point are to go with Lupron next cycle and perhaps do another phone consultation w/Dr. C.

Thanks for your response and best of luck to you!
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Joined: November 8th, 2011, 3:54 am

June 1st, 2012, 2:12 pm #5

Coopers thought that I didn't always release.

Local RE thought that I released (because of b/w numbers) but follicle filled up with fluid after rupturing. Coopers didn't seem to agree, though.

Anyway - Coopers said it was LUFS and next time to use Lupron... (and it worked)

It took some time to figure this out because my follicles would sometimes release and sometimes not and we didn't figure out what was really going on until after a few cycles... but maybe Nancy has a point - depends on the size...
First I've heard of LUFS. Good to know. Cooper didn't mention that to me.
I'm really glad to hear that Lupron worked for you. Have you had some success then?

Thanks for your response!
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MargieD
MargieD

June 1st, 2012, 4:48 pm #6

I don't think Coopers likes to diagnose LUFS until they are absolutely sure. If it was one cycle - they are probably waiting it out to be sure.

As for me - it took a couple of cycles before I (actually - WE) understood the whole thing. Sometimes I would release on one side but not the other. Each month was different. It was not like I was consistently not releasing.

Yes - I had success but from IVF which I eventually m/c-ed. After finding out about LUFS, I also found out about a blocked tube. I got it cleared but DH and I were not willing to try a couple more natural cycles especially after spending almost a year trying naturally with Coopers. We are gearing up for another IVF cycle.

Best to you!
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Nancy
Nancy

June 1st, 2012, 10:09 pm #7

Nancy,
I am sorry to hear that you've had difficulties with this as well.
Thanks for sharing your experience. So it might be an empty follicle, or perhaps needs to be a much larger follicle before triggering.

I've been trying natural cycles with TI for well over a year. It makes me wonder whether some or most of these times I might not even have been releasing an egg. Geez! I was relying on my temp shifts to indicate my ovulation, but it sounds like the egg can produce prog even if it doesn't release-- so then my question is, does it ever release? And is it bad if it doesn't release within that 36 hr trigger shot timeframe?

Cooper nurses were vague about whether they thought I would release the egg. I suppose I could only find out through another U/S.

I think my options at this point are to go with Lupron next cycle and perhaps do another phone consultation w/Dr. C.

Thanks for your response and best of luck to you!
It's very frustrating because we can't phsycially see what's going on! ONly rely on the u/s to give us some idea...in terms of LUFS, I believe, and I may be wrong, that the egg does not release, but the follicle "acts" like it did. Sounds like lupron helps with this. I agree with MargieD, that it may take a few cycles to figure out what's going on and if you really have LUFS.

I think in empty follicle, it could go either way (it depends on why it was "empty", which is really a misnomer becaus they are not empty, it's just that for some reason the egg doesn't release...it could be improper medication, faulty egg, or trigger too soon...or maybe even LUFS?? I get confused as to what determines LUFS vs. empty follicle...I think there are other reasons so depending on why you get the empty follicle, the egg might still be released later). At least when I had empty follicle, they said the egg might still release so I did an IUI as a backup as I had only one follicle and they couldn't get the egg out...(if was BFN but that's another story).

If it's the situation where your follicle must be bigger before normal trigger time, I am not sure how they figure that out unless you do IVF because I am not sure how they'd know if the egg was mature, immature, or dead and relate it to the size of the follicle. I know for me, they always triggered me at 18-19, like they did for my first 2 IVFs, and both times I had empty follicle and immature eggs. I had previously done 4 IUIs and no one suspected anything. (and they actually never did an u/s dpo, so they never confirmed if they did release...my suspicion is that they didn't based on my IVF experience).

Keep us posted on how things go!

Nancy

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Joined: November 8th, 2011, 3:54 am

June 2nd, 2012, 3:50 pm #8

I don't think Coopers likes to diagnose LUFS until they are absolutely sure. If it was one cycle - they are probably waiting it out to be sure.

As for me - it took a couple of cycles before I (actually - WE) understood the whole thing. Sometimes I would release on one side but not the other. Each month was different. It was not like I was consistently not releasing.

Yes - I had success but from IVF which I eventually m/c-ed. After finding out about LUFS, I also found out about a blocked tube. I got it cleared but DH and I were not willing to try a couple more natural cycles especially after spending almost a year trying naturally with Coopers. We are gearing up for another IVF cycle.

Best to you!
I'm wishing you the best for your next round of IVF. Are you doing it w/Cooper?
My heart goes out to you for your loss.
I will watch for any updates on the board and cheer you on.
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MargieD
MargieD

June 3rd, 2012, 10:56 am #9

Will watch for your updates as well!
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