Saturday, July 08, 2006

The Case of the Disappearing Follicles

This cycle has just raced by. Given the megadoses of stims that I have taken, my follicles have grown very quickly. Unfortunately, they have not grown at a uniform pace. At yesterday's monitoring appointment (Day 8 of stims), I had eight follicles between 12.3 mm and 25.2 mm. Unfortunately, only three are in the 17.1-17.8 range. THREE! The rest are under 16 or over 23mm. I am really worried that all but three follicles will yield overly mature or immature eggs. And even though we are ICSI'ing those little eggies, we don't seem to have much room for error.

I am also concerned that a couple of follicles have seemed to have vanished for no particular reason.

  • On Wednesday, we had ten follicles between 9.5 and 19.7 mm.
  • On Thursday, I had nine follicles between 10.9 and 22.9 mm.
  • By Friday, we were down to just eight follicles.


I have had the same technician perform all of my u/s and when I asked both the technician and Dr. L what could account for my diminishing follicle count, I was told that often the smaller ones reabsorb. Also, I was told that the smaller ones aren't measured every day. However, the ones that have vanished weren't small, I had an 18 mm vanish between Thursday morning and Friday morning. Why is this happening???? With such a small output, I don't have the luxury of losing any mature follicles.

I can only assume that one of the following is happening - they are measuring endometrioma and mistakenly, assuming they are follicles. Perhaps, as they get larger, it is easier to determine that they aren't follicles. This isn't a good theory, b/c if they are mistaking endometrioma for follicles, I might have even fewer good follicles than we think. My other theory is that perhaps given the position of my ovaries and the endometrioma, it is not always apparent where the follicles are, so that one or two may be more difficult to find from one day to the next. If this is the case, we may be pleasantly surprised by an extra egg or two tomorrow. I hope really hope the latter is the case.

At 7pm yesterday, David triggered me without incident. This morning David, Jerry (9 yo stepson) and I ran some errands. Since returning home, David has been downstairs cooking up a storm and has banished me to the bedroom to nap. I am really tired today. I am not sure why I am so tired, but I can only assume that it is b/c my ovaries are in overdrive! This evening, David will drop Jerry off with his mom. (Obviously, no kids allowed tomorrow.)

Tomorrow morning at 6am, we are scheduled to arrive at Ginormous for my first egg retrieval scheduled for 7am. Dr. L informed me that he will not be doing my ER but assured me that all of his colleagues are extremely experienced and that I have nothing to worry about. OKAY! I'm not worried. (Yeah, right.)

So wish us luck. We are hoping for some good news.


At 5:48 PM, Blogger Lut C. said...

That must be disturbing. I hope some turn up unexpected for the retrieval anyway.

At 7:54 PM, Blogger Sarahbchicago said...

Lots of luck for your retrieval. I had the same problem of disappearing follices from scan to scan. By trigger, it looked like I had 12 total of various sizes, but at ER, they got 21 eggs, 17 mature.

At 8:25 PM, Blogger Debbi said...

good luck tomorrow! I'll be thinking of you.

At 9:15 PM, Blogger Meg said...

Chee Chee... good luck with the retrieval... don't do your head in, eh? You'll have a definative answer very very soon. (Course, I should just shut my mouth, as I am hardly a non-worrier...and I know.. the relax stuff is never welcome x)

At 9:16 PM, Anonymous Paige said...

Good Luck tomorrow. You are in my thoughts and I hope they retrieve mor than you think.

At 1:48 AM, Blogger Zee said...

Good luck tomorrow! I hope lots of good follicles stay put for the occasion, and that all of them contain fabulous eggs. I'm not sure what the deal is with that disappearing and reappearing follicle thing, but it's happened to me too. Could it be that some of us have ovaries that exist in several dimensions at once, and the follies are there or not depending upon which dimension is accessed by the scan? Don't look at me like that, it's as good a theory as any! Anyway, I'll be thinking good thoughts for you!

(BTW Thanks for stopping by the blog! I really appreciated it!)

At 7:19 AM, Blogger Larisa said...

Good luck! I hope they find the "missing" follicles during the retrieval. Fingers SO crossed for you!

At 7:56 AM, Blogger StellaNova said...

Hi, I've only just found your blog - I hope you don't mind me commenting. I hope everything goes well for you and those missing follices reappear. I thought that endometriomas were fairly distinctively different in an ultrasound - with a 'ground glass' appearance - that's what my doctor told me. I think your theory about the follicles hiding behind them might be a good one though. I wish I had a better one for you. Good luck.

At 4:24 PM, Blogger Nico said...

You have waited so long for this, I really hope that all goes well tomorrow, and some of those disappearing follicles reappear. I can't believe that an 18mm would just reabsorb, I like zee's theory much better. Good luck, will be thinking of you in the am!

At 5:07 PM, Blogger GLouise said...

Best wishes!!!

At 12:00 AM, Anonymous Anonymous said...

Hi Guys,
Please help, I am totally and utterly defeated this time.

My first IVF cycle, egg collection was late for about 1 hour and 45 minutes. I ovulated before hand.

2nd cycle, u/s showed 4 viable sized follicles, 9 eggs collected.

3rd cycle, u/s showed 4 viable sized follicles, 10 eggs collected.

Fourth cycle, ultrasound showed 6 good size follicles from 17mm to 21mm.

On egg collection yesterday, these big ones were gone! Doctor said he was surprised he couldn't find them but there was no sign of ovulation. 2 eggs collected from the (immature) follicles, none fertilised.

How could follicles just disappear into thin air?

Is the doctor lying? Did I ovulate again before egg collection?

The egg collection was only about 25 minutes late this time, so it should be ok.

I can't stop crying ...


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