As a low responder, my first ultrasound after 4 days of stimulation brought me to new highs last Sunday. I was told at a previous baseline ultrasound that my antral follicle count(AFC) was only 8, thus leading to my aggressive antagonist protocol and max drug dosage. At my first ultrasound after stim, my AFC shot up to 22! Although this was not a promise that this many follicles would mature and the same number of eggs would be retrieved, I was ecstatic. To my dismay and sudden drop from ecstasy, two days later at my second ultrasound session, there were only 3 measurable follicles. (Along with 15 smaller ones.) I tried not to lose hope, but being shot up with crazy hormones, it was difficult! My solution: stuffed my face with pizza and chicken wings.
This didn't end my obsession to google every number, every outcome, and every detail I have about my cycle. So to put my obsession to good use, here are some useful information that I've gathered.
My previous reading on Antral Follicle Count lead me to believe that having more was good, and that it gave me a better chance at retrieving more eggs:
Experience, however, tells me that your AFC will vary. I've read cases of girls having a AFC range of 6-25. Having a low AFC will likely mean you will get less eggs, but having a higher AFC doesn't guarantee you a basketful either...
Your follicle count at ultrasound usually begins, 4-7 days after you begin your stimulation. From my excessive googling, I've read cases of girls at certain clinics where monitoring doesn't even begin until day 7, or some that will start as early as day 1. From what I've read in general, REs expect your follicles to gain 1-2mm per day while on your drugs. It needs to get to >15mm for them to get really excited. Having a good size follicle again, does not guarantee that it will contain a mature egg. There is a possibility that an immature one can be prompt to grow in the lab, but overly mature eggs are not good. Therefore, consistent and good size follicles are what we like to see. But the human body works in funny ways.
At my day 7 ultrasound, only follicles >9mm made it to my chart, and I had 3. This does not seem to relate to my AFC of 22 at day 4 scan whatsoever! What else can the infertility gods throw at us?
Yes, the dreaded E2 number. Too low and you're not responding well, too high, and you're at risk for Ovarian Hyper-stimulation Syndrome (OHSS). Although low responders, meaning ladies with low ovarian reserve, are not at too much risk for this. OHSS also doesn't happen until the trigger is administered and will get worst if the transfer leads to a pregnancy. (Yes I googled that too.) A bit of bloating though is normal, as I've been feeling super bloated.
For low responders, just getting to egg retrieval is a big deal. It involves a lot of trial and error to find the protocol that you respond to best. Then, with a bit of luck, maybe we get a few to put back the oven. I've been talking to my follicles and begging them to grow. I'm not out of the woods yet...
Ever wonder what a tummy looks like after 8 days of injections?
You would think that I would have had enough needles to last me a century... but I went in for an acupuncture appointment today. Studies have shown pregnancy rates to increase with acupuncture on the day of the egg transfer. (Studies have also shown no change in pregnancy rates with acupuncture!) Yes, it is a controversial treatment and it's not for everybody. My appointment gave me a taste of what acupuncture feels like and if this is something I would want to do on my ET day. I must say that I am skeptical. However, if there is a possibility of better success, what's there to lose? (Except hard-earned money.) I won't ever be able to say, I got my positive because of acupuncture. BUT I won't ever have to think, I could have gotten a positive if only I had done acupuncture.
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