Size Matters (Follicle Size That Is…)

This is Part 4 of the series on my recent egg retrieval. If you haven’t read Parts 1, 2, or 3, you can read them here, here, and here.

So today, we are going to talk all about follicles.

What exactly are follicles and what do they have to do with the egg retrieval process?  Each ovarian follicle contains (hopefully) an egg.  And as you probably guessed it…it wouldn’t really be much of a retrieval process unless you are retrieving some eggs.

I was shocked to find out that for my age, I needed to have around 20 retrieved, with 15 eggs capable of being frozen.  What the heck?

How are you supposed to get that many eggs when your body generally just releases one mature egg per month?  This is where all those shots come in.  Lots and lots of shots.  Shots that will stimulate (or “plump up”) your ovaries to make lots and lots of follicles.

In order to keep an eye on all of the follicles while they are growing and plumbing up, your doctor will have you come in for frequent ultra sounds so that he/she can measure the size of each follicle.  This is where good old “Wanda” comes in.  Be prepared to become best buds with Wanda.

To be considered “mature,” an egg needs to measure around 18 mm.  This means that each follicle has to grow a LOT.

As luck would have it,  my eggs were slow to grow.  Like super slow.  My good fortune meant that I had an extremely long stimulation cycle (14 days).  See, I told you that me and Wanda become BFFs.

So what does slow look like?  After 10 LONG days of stimulation, I had 11 follicles that we could see, with the following measurements:

Right: 12, 14, 16, 13, 14, 15, 11, 15

Left: 15, 13, 12 (Leftie would not get with the program)

On Day 11 of stimulation, I had 13 follicles, with the following measurements:

Right: 18, 16, 17, 18, 12, 13, 17, 16, 17, 16

Left: 16, 17, 16

With just an extra day of stimulation, I went from zero follicles at the 18 mm mark, to two follicles at the 18 mm mark, and another 9 follicles at the 16-17 mm mark.

On Day 12 of stimulation, I had 13 follicles again, with the following measurements:

Right: 18, 18, 17, 14, 15, 19, 17, 15

Left: 19, 14, 17, 14, 11

After 12 days of stimulation I had 4 follicles measuring at “mature” and a handful of others that were pretty close.  Not exactly great.

Two other items your doctor will monitor – your “lining” and your estrogen levels.  Your lining is measured during your ultra sounds.  For your estrogen, your doctor will order blood work throughout your stimulation cycle in order to make sure that it’s increasing (but not too much, since too high of an estrogen level can cause other complications).  On the day of my trigger shot, my estrogen measured at 2,800, which, according to my doctor, was lower than expected.  Your estrogen is directly correlated to how many follicles you have and their size.

The follicle sizes, lining, and estrogen levels determine when they  when you should “trigger.”  You can’t stay on the stimulation meds indefinitely, and so, though I wasn’t exactly where we hoped I’d be by Day 12 of stimulation, we were essentially out of time. At least I had some mature eggs.  It was time to collect these babies (or I guess future babies in my case)!