trigger on CD2 - should i go through with retrieval?

trigger on CD2 - should i go through with retrieval?

buddircup
buddircup

August 14th, 2012, 1:45 pm #1

hi, This is the first time i'm posting, but i've been reading for a while. i'm in need of advice! i went in for baseline yesterday on CD2 for IVF #4 and my doc said i had one dominant follicle measuring 18. she said i was ready for trigger. i'm concerned it is a corpus luteum or a cyst and am afraid to waste an ivf cycle (paying out of pocket) but also don't want to miss the one good egg. CD2 b/w : E2 232, LH 1 and P4 1. My last cycle we tried retrieval and couldn't get an egg because i broke through cetrotide and the timing was off without the trigger, so we did an iui as backup. i'm afraid that stayed around as a cyst? Has this happened to anyone? thanks in advance for your help!

i'm 33 have high fsh - highest in the 30's, dh perfect, IVF 1 went for 2 eggs (high stim cycle modified Sher L-8 - neither made it past fertilization), IVF 2 went natural cycle (bad egg), ivf 3 (mini-stim with estrogen priming) converted to iui when i broke through cetrotide - started slow but everything looked good up until the end.
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Nancy
Nancy

August 14th, 2012, 3:39 pm #2

My opinion is that the follicle is more than likely a leftover cyst. I too have had these on CD 2 w/ similar numbers, the last one I had was about 20 mm, E2 was around 240, P4 .7 so I was told to wait. There just really is no way to know if its a leftover cyst, or a true follicle. I have never heard or seen anyone that has triggered on CD2 or CD3, and my personal opinion is that even if its a real follicle, thats just too early to trigger. I think I read somewhere, perhaps on this board, that most studies say your best chances are triggering after CD 8-10preferably after CD 10. Did you happen to ask them why they think its a real follicle vs. a leftover cyst? I am curious what they may have told youmaybe there is something more to this than I am understanding.

I wish you the best of luck, and feel bad for you having to go through this confusing situation. I have suffered many cysts (including one now), so I can totally relate to your questions about whether its a real follicle or not. Plus it sucks to have to wait it out and hope it goes away.

Nancy
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AJ
AJ

August 14th, 2012, 3:41 pm #3

hi, This is the first time i'm posting, but i've been reading for a while. i'm in need of advice! i went in for baseline yesterday on CD2 for IVF #4 and my doc said i had one dominant follicle measuring 18. she said i was ready for trigger. i'm concerned it is a corpus luteum or a cyst and am afraid to waste an ivf cycle (paying out of pocket) but also don't want to miss the one good egg. CD2 b/w : E2 232, LH 1 and P4 1. My last cycle we tried retrieval and couldn't get an egg because i broke through cetrotide and the timing was off without the trigger, so we did an iui as backup. i'm afraid that stayed around as a cyst? Has this happened to anyone? thanks in advance for your help!

i'm 33 have high fsh - highest in the 30's, dh perfect, IVF 1 went for 2 eggs (high stim cycle modified Sher L-8 - neither made it past fertilization), IVF 2 went natural cycle (bad egg), ivf 3 (mini-stim with estrogen priming) converted to iui when i broke through cetrotide - started slow but everything looked good up until the end.
IMO, it's likely to be an egg follicle rather than a CL cyst because of your E2 level. As for retrieval, are you comfortable with retrieving just one? I can understand worrying that you will miss the golden egg. With high FSH it's very common to have your follicles start developing before the next cycle starts. If it were me I'd probably trigger and just do TI or IUI and ask about taking estrace during the luteal phase to try to suppress the early recruitment and try again next cycle. If you do go through with retrieval I think you would most likely need to do an FET because your lining will be thin since you just had AF. Good luck and keep us posted!
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anonforthis
anonforthis

August 14th, 2012, 3:44 pm #4

hi, This is the first time i'm posting, but i've been reading for a while. i'm in need of advice! i went in for baseline yesterday on CD2 for IVF #4 and my doc said i had one dominant follicle measuring 18. she said i was ready for trigger. i'm concerned it is a corpus luteum or a cyst and am afraid to waste an ivf cycle (paying out of pocket) but also don't want to miss the one good egg. CD2 b/w : E2 232, LH 1 and P4 1. My last cycle we tried retrieval and couldn't get an egg because i broke through cetrotide and the timing was off without the trigger, so we did an iui as backup. i'm afraid that stayed around as a cyst? Has this happened to anyone? thanks in advance for your help!

i'm 33 have high fsh - highest in the 30's, dh perfect, IVF 1 went for 2 eggs (high stim cycle modified Sher L-8 - neither made it past fertilization), IVF 2 went natural cycle (bad egg), ivf 3 (mini-stim with estrogen priming) converted to iui when i broke through cetrotide - started slow but everything looked good up until the end.
Your hormones are not right if you are ready to ovulate on cd2. You could perhaps try naturally if that's an option for you, but I would NOT do IVF.
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AJ
AJ

August 14th, 2012, 3:49 pm #5

My opinion is that the follicle is more than likely a leftover cyst. I too have had these on CD 2 w/ similar numbers, the last one I had was about 20 mm, E2 was around 240, P4 .7 so I was told to wait. There just really is no way to know if its a leftover cyst, or a true follicle. I have never heard or seen anyone that has triggered on CD2 or CD3, and my personal opinion is that even if its a real follicle, thats just too early to trigger. I think I read somewhere, perhaps on this board, that most studies say your best chances are triggering after CD 8-10preferably after CD 10. Did you happen to ask them why they think its a real follicle vs. a leftover cyst? I am curious what they may have told youmaybe there is something more to this than I am understanding.

I wish you the best of luck, and feel bad for you having to go through this confusing situation. I have suffered many cysts (including one now), so I can totally relate to your questions about whether its a real follicle or not. Plus it sucks to have to wait it out and hope it goes away.

Nancy
With previous REs, an early follicle with high E2 was referred to as an estrogen producing cyst and the cycle was cancelled. With C.heck he's thought that these were egg follicles. But on the TI cycles that I'm doing it would've been pointless to continue because of my lining. So I just don't know what the deal is really- it's hard to say:( I too am curious what makes the OPs RE think it's a viable egg-

So frustrating for sure!!!!
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Nancy
Nancy

August 14th, 2012, 4:46 pm #6

My opinion is that the follicle is more than likely a leftover cyst. I too have had these on CD 2 w/ similar numbers, the last one I had was about 20 mm, E2 was around 240, P4 .7 so I was told to wait. There just really is no way to know if its a leftover cyst, or a true follicle. I have never heard or seen anyone that has triggered on CD2 or CD3, and my personal opinion is that even if its a real follicle, thats just too early to trigger. I think I read somewhere, perhaps on this board, that most studies say your best chances are triggering after CD 8-10preferably after CD 10. Did you happen to ask them why they think its a real follicle vs. a leftover cyst? I am curious what they may have told youmaybe there is something more to this than I am understanding.

I wish you the best of luck, and feel bad for you having to go through this confusing situation. I have suffered many cysts (including one now), so I can totally relate to your questions about whether its a real follicle or not. Plus it sucks to have to wait it out and hope it goes away.

Nancy
One more thingI forgot to mention that when I had my last cyst, they didnt know either if it was a real follicle or just a leftover cyst. Since they made me wait anyways, I ended up getting checked again a few days later and for sure it was a leftover because according to my BBT and P4 check, I never ovulated (I know some will say BBTs are not accurate, but I have been tracking mine a long time and for me, they are, and the trends do correspond to my actual b/w numbers and a low BBT for me has always corresponded to low P4, and vice versa).

I also had follow-up b/w and my P4 was low. I got AF on CD 12 of that cycle, so they said it really wasnt CD12, but rather I had breakthrough bleeding earlier (so my CD 12 was really CD 40-something). So, in my case it really did end up being a CL cyst. But, as AJ said, its also likely that it could be an early recruited follicle. But regardless, as the others are saying, I dont think Id trigger for IVF in such a situation, especially if you are paying out of pocket. Maybe you could trigger and do IUI or TI?

Good luck!

Nancy
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buddircup
buddircup

August 14th, 2012, 5:03 pm #7

IMO, it's likely to be an egg follicle rather than a CL cyst because of your E2 level. As for retrieval, are you comfortable with retrieving just one? I can understand worrying that you will miss the golden egg. With high FSH it's very common to have your follicles start developing before the next cycle starts. If it were me I'd probably trigger and just do TI or IUI and ask about taking estrace during the luteal phase to try to suppress the early recruitment and try again next cycle. If you do go through with retrieval I think you would most likely need to do an FET because your lining will be thin since you just had AF. Good luck and keep us posted!
hi AJ and Nancy, Thanks so much for your opinions. Unless you are "in the game" its a hard situation to even explain to someone! I talked to my Dr a little while ago, mentioning almost exactly what Nancy said about a CL cyst. She said there is no way to really know that and that if it turns out not to be an egg that she won't count this cycle against me financially. So, it's worth a shot! She tends to think it's a follicle because I do recruit follicles early and AF was a week later than expected (while I'm not very regular, I tend to be after I know I ovulate for sure). I only had 2 follicles with high stims so 1 is pretty much the best I can get. I was going to do a natural cycle this time anyway. I'm planning on banking for CGH, but just haven't made it that far yet. I have 2 more tries after this in my package. So fingers crossed.
Nancy, I'm sorry to hear about your battles with cysts and AJ good luck with your cycle.
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AJ
AJ

August 14th, 2012, 5:33 pm #8

If that's the case then I agree that it's worth a shot if you don't have anything to lose financially if it is a cyst....I assume since you're doing IVF that you do progesterone supps after retrieval. Are you taking estrace as well? Like I said before, that might help with the early follicle. Thanks for the good wishes and good luck back to you!
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buddircup
buddircup

August 14th, 2012, 6:06 pm #9

I'm going to freeze, so luckily I don't have to do Progesterone or anything afterwards. Just more waiting for the next!
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Anonymous
Anonymous

August 14th, 2012, 6:15 pm #10

Good luck to you! Please keep us posted if you feel comfortable ! Its a very interesting scenario and would be good to know how it turns out. That is nice of your doctor to do it for free if its not an egg. Good luck! When will er be? Btw I only make 1-2 fcollicles max too so I can relate to how you are feeling...you never know if it's the golden egg!

Nancy
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