The Most Peculiar Cycle

When it comes to IVF cycles, I am convinced that it’s best to know your body and to be vocal.  Let me tell you why.

After all the crying and then being told to proceed with the cycle, I took 5mg of Letro.zole from cycle day three to cycle day seven.  AF was very short this time.  I only bled for three days.  We baby danced on Sunday.  Then I started spotting again on Tuesday which actually matched my experience with my previous cycles with cysts, that I would usually spot mid-cycle.  I have been doing castor oil pack nightly to help reduce the size of Muriel the Cyst.  When I saw the spotting, I knew that the castor oil pack was doing its thing.

We went back to the clinic for a scan on Wednesday.  Dr. Dry Humor, who did my second retrieval at the current clinic, was the one who was present for my scan.  My lining was 9.5mm and the size of my cyst had reduced from 25mm to 16mm.  Way to go Muriel and castor oil pack!   He didn’t see much follicle growth on either ovaries and told me to return in a few days for another scan.  I didn’t have an expectation of the scan so I didn’t have much feeling or thought about the outcome. I was just glad that the devilish cyst decided to pack her bag and begin her departure.

Out of curiosity, I took my basal body temperature the next morning, which was cycle day 10 according to my own cycle and cycle day 9 according to the clinic.  It was the first time I had temped during this cycle, so I had no way of knowing what my BBT was from cycle day 1 to cycle day 8.  But I was shocked when I saw that it was 98.  98 may not mean anything to others but it often means that I am either sick or I have ovulated.  My cover line is usually around 97.3 and 97.4.  Anything above that usually means ovulation.  Period.  I thought it was a fluke so I asked around.  Some ladies who have experience with Clom.id or Fe.mara told me that sometimes their BBT goes up during and a couple of days after they took the meds.  The next morning, my BBT was 97.6.  Still above my usual cover line.  BBT this morning was 97.7 and was taken an hour before my usual time, so it could have been even higher had I taken the temperature at my regular time.  I was determined to get to the bottom of it.  So I decided to ask for my progesterone level to be checked.

Today is CD 11 (according to the clinic calendar) or CD12 (based on my natural cycle).  Dr. Italian did my scan.  Lining has gone down to 8mm.  The cyst seemed small, although it wasn’t measured.  Then the strangest thing happened.  My right ovary had a 10mm follicle and my left one had a 12mm and a 10mm.  I didn’t expect any follicles because there were none three days ago.  I told the doctor about my elevated basal body temperature and he agreed to check my estradiol level and my progesterone level.  I also reported to him that I had been spotting and was still spotting.  I was instructed to return on Monday to check on the progress of the follicle.  We got my blood work done and left.

The phone call this afternoon confirmed to me that yes, as a patient, we have to be on top of things and know our body.  The progesterone level is 17.1.  Based on this level, it means that I did indeed ovulate.  It’s actually a good progesterone level.  I’m so glad that I checked my basal body temperature and trusted my instinct.  But I don’t know what this all means.  Isn’t it odd for my body to be producing multiple follicles during the luteal phase?  What does that mean for the timing of retrieval (if indeed the follicles continue to grow bigger and bigger for retrieval to happen)?  Or maybe Muriel the Cyst was actually a follicle that began to grow in my last luteal phase and matured in the follicular phase of this cycle, hence the size of 25mm on cycle day 2 (or cycle day 3).   It’s all very puzzling to me.

I asked the nurse who phoned me what this all means.  She did not have an answer for me.  She told me to ask the nurse practitioner that I usually see for my monitoring scan on Monday.  I am so curious to see what Dr. No Nonsense will say about this.  I have heard of women with high FSH who would start to recruit follicles during the luteal phase when the ovaries are supposed to be quiet.  The end result is an early ovulation the following cycle.  I don’t really know how healthy the follicles/eggs may be if they were recruited out of phase.  Do I take birth control pills to sync up my follicular growth with the right phase of my cycle?  This is all so puzzling.

I don’t know how to feel about this.  I guess I will hold off my opinions, feelings, and thoughts until our scan on Monday.  This is the strangest place of unknown I have ever been.  When do I get my period next if I had ovulated early?  When should we do a transfer next?  Will I still get my period fourteen days after ovulation even with follicular growth in the luteal phase?  This is an uncharted territory and I feel like I am lost.

Pray that God will give us clarity and wisdom for directions in the upcoming days and weeks.  It’s hard to wait for God’s timing without being able to predict approximately when things will happen.  This journey requires us to exercise patience and trust.  I am definitely experiencing that right now.

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15 thoughts on “The Most Peculiar Cycle

  1. Our bodies can be very mysterious, but I agree you should trust your instincts! although that might not seem helpful during an IVF cycle where things are supposed to happen on a schedule. How would the ooctors tell the difference between a follicle and a cyst, to be able to say which you had? It might be worth asking. I also seem to remember learning somewhere that a follicle can be recruited during the luteal phase, though I can’t recall anything else about it.

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  2. Were they not measuring your E2 levels at baseline and that first scan? I have never done a monitored cycle where they didn’t check E2 at every scan appointment. If they checked do you know what your estradiol progression was before you got the second scan and bloodwork? I am assumimg they tested E2 at baseline to assess if Muriel was active or not? The early O is confusing. I hope you don’t feel distressed by your body being out of sync this go around. Sending a warm hug and peaceful thoughts. All the best tomorrow.

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    • They measured my E2 at baseline, which was in the 800s. But I was taking estrogen for priming for days before baseline, so the level wouldn’t be of much use anyways. At the second scan, there was only the cyst and nothing else. Did not do blood work this time. At the scan yesterday, E2 was 197, so it seems like something is growing? But I was also on Femara from cd3 to cd7. Doesn’t Femara suppress the E2 level? So this adds to the confusion. Yeah I am doing okay with my emotions with this. I am not particularly upset about anything. I’m just curious to see what will happen next because this has never happened (or that I know of). Thanks girl. We’ll definitely find out more on the next scan. 🙂

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  3. It’s hard to be patient and trust doctors. But I don’t think there is a real alternative.. I hope they know what they are doing and that they are being careful enough. You deserve full attention and care. Sending lots of love! x

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  4. I was always an early recruiter and ovulator, it’s apparently a thing with DOR. Even when I was downregulated I would still have a 10mm follie growing on CD3 when I went in for my first monitoring. 25mm seems really big, though, so it seems more like a cyst…but then where did you ovulate from?? So very weird. Hope you can get some answers!

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  5. That’s crazy! Good for you for speaking up- I so wish I had been more vocal and more demanding when I was going through treatment. I trusted the docs more than I trusted my own instincts! Hopefully you get some answers today. Good luck!

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