I went in for my CD11 ultrasound yesterday to check the lining and see how my follicles were developing. To recap, everybody believes I ovulate regularly and have slightly long (32ish day), but regular cycles. I also have 40+ resting follicles. That’s a lot. This cycle, our first with ultra-conservative-by-the-book RE, I was prescribed 100 mg clomid, CD 4-8. Both my wife and I suspected that this new surge of estrogen would produce a lot of eggs. And it did.
As of yesterday, I had one 16.4 mm leader, a 14 mm runner-up on the other side, three 12 mm tagalongs, two 11 mm friends, and two 8/9 mm squirts. Add that up. Nine. Nine developing follicles. Say hello to the world’s next octomoms! Just kidding. Gross.
So now what? I go back in tomorrow for another ultrasound. In a perfect scenario, the 16 and 14 will continue developing, and the others will fade away. In a less ideal scenario, three to five of the smaller follicles (the 11 and 12’s) will continue to grow, leaving us 5-7 viable follicles. That is still too many, but statistically, it is unlikely that all of those will fertilize and implant. I have read that follicles over 14 mm at ovulation are viable. Since follicles grow 1-2 mm per day, I could have as many as 5 viable follicles today. Trigger should happen when the lead follicle is 20 mm. I’m guessing that we will be there tomorrow.
I know that one of the conversations we will be having tomorrow will be about selective reduction. And honestly, I don’t know what to think/feel about it. If you’re unfamiliar, the basic idea is if three or more eggs fertilize and implant, a doctor will terminate one or more. I know this is a super touchy/loaded topic, and I don’t want to step on anyone’s toes. For the record, I am very pro-choice and believe that this is a decision that should be made by parent(s) and their doctor. However, when faced with the possibility of having to make that choice, I’m stumped. On a theoretical level, I think I could do it to give the other remaining embryos a chance at a healthy pregnancy and birth. But when I think of the real nitty gritty details, I kind of want to vomit.
The alternative is cancelling the cycle and trying a lower dose of clomid next month. This isn’t the worst plan out there, but it sure is painful losing another cycle without trying.
Honestly, I’m not even sure that we will get a choice. We haven’t been consulted by the RE on any of the plans thus far, so I’m probably kidding myself to think that he would ask us what we want to do. If he had asked us, I would have told him 50 mg clomid was the place to start, since I already ovulate. It is funny (or not so funny) thinking that one of the first things I told him was that we are concerned about multiples. Twins we can handle. It would be a hard, and that’s an understatement. But we can make it work. Triplets? The probability of problems/complications skyrockets.
What would you do? Did any of you have to consider selective reduction?
In lighter news, here are some photos from a quick backpacking trip we took this weekend. Our friends visited from San Diego, and they were thrilled to get out of the heat. The leaves are changing here, and the nights are cool, so it was a really lovely trip.